Rheum
Name That Mass
Psych-Neuro
Renal
Autonomic
100
This vasculitis in children may cause coronary artery aneurysms
What is Kawasaki disease?
100
This primary cardiac tumor constitutes 50% of all benign cardiac tumors in adults
What is myxoma?
80% LA, can be seen in any chamber
100
After an angry outburst, the risk of acute myocardial infarction increases within this short time window
What is 2 hours?
1994 Northridge earthquake (Los Angeles)
MI: ↑ 35%
Sudden cardiac death: 4.6/day → 24/day
1995 Great Hanshin (Kobe) earthquake
MI: ↑ 3.5-fold
Fatal MI: ↑ (significant increase)
1989 Loma Prieta earthquake
MI: no increase
1991 Persian Gulf War (missile attacks on Israel)
CV mortality: ↑ 58% (day 1)
September 11, 2001 (New York City)
CV mortality: no increase
Bereavement (death of a child – Danish study)
First MI: ↑ 31%
Fatal MI: ↑ 58%
Death of a loved one (Determinants of MI Onset Study)
MI risk: ↑ 21-fold
Bereavement (UK primary care study, 30-day outcomes)
MI: rate ratio 2.14
Stroke: rate ratio 2.40
100
This process is accelerated in CKD and contributes to CAD, valvular disease, and arrhythmias
What is (medial) calcification?
100
In a denervated heart, this happens to heart rate (increase vs decrease)
Increase. Sinus normally runs >100 bpm, parasympathetic input dominates
200
In patients <40 years old, these red flags may be related to Takayasu arteritis (count 2)
TABLE 97.3
“Red Flags” for Takayasu Arteritis
In patients younger than 40 years the following may indicative of TA:
Unexplained acute-phase response (raised ESR and/or CRP)
Carotidynia
Hypertension
Discrepant blood pressure between the arms (>10 mm Hg)
Absent/weak peripheral pulse or pulses
Limb claudication
Arterial bruit
Angina
TABLE 97.2
Cardiovascular Disease in the Systemic Vasculitides
Vasculitides Cardiovascular Complications
Large-Vessel Vasculitis
Giant cell arteritis Thoracic/abdominal artery aneurysm, limb ischemia, pericarditis, coronary arteritis, IHD, MI
Takayasu arteritis Aortic regurgitation, limb ischemia, aortic stenosis, aortic aneurysm, stroke, hypertension, coronary arteritis and aneurysm, IHD, MI, myocarditis, cardiac failure
Kawasaki disease Coronary artery aneurysm, MI, myocarditis, pericarditis, valvular dysfunction, cardiac failure
Medium-Vessel Vasculitis
Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) Myocarditis, pericarditis, coronary arteritis, cardiomyopathy, cardiac fibrosis, valvular dysfunction, MI
Polyarteritis nodosa Myocarditis, pericarditis, coronary arteritis, coronary aneurysm, hypertension, cardiac failure
Wegener granulomatosis (granulomatous polyangiitis) Myocarditis, pericarditis, coronary arteritis, valvular heart disease, cardiac failure
Microscopic polyangiitis Pericarditis, coronary microaneurysm, MI
200
48 year old woman with breast cancer - suggestive of
What is catheter related thrombus?
No LGE
200
This genetic muscle disease primarily affects the posterior wall initially, can cause tall R waves in V1
What is Duchenne's MD?
200
This urine test (with a threshold of 30–300 mg/g) defines microalbuminuria and independently predicts cardiovascular risk.
What is albumin-to-creatinine ratio (ACR)?
200
This diagnosis is defined by a resting sinus rate over 100 bpm, or an average Holter rate over 90 bpm, without a reversible cause.
What is inappropriate sinus tachycardia (IST)?
300
This vasculitis with a prodrome of allergic rhinitis, sinusitis, asthma precedes cardiac involvement (up to 60% of cases)
What is EGPA (Churg Strauss)?
pericarditis, myocarditis, coronary arteritis, myocardial infarction, cardiac fibrosis, arterial thrombosis, and valvular dysfunction. Cardiac disease is a prominent cause of death.
300
This is an autosomal-dominant condition associated with cardiac myxomas, myxomas in other regions (cutaneous or mammary), hyperpigmented skin lesions, hyperactivity of the adrenal or testicular glands, and pituitary tumors
What is Carney Complex?
Younger age, multiple myxomas
300
This personality type, combining negative affectivity and social inhibition, has been linked to worse cardiovascular outcomes.
What is Type D personality?
300
This inotrope dose needs to be adjusted to kidney function, avoided in CKD 5/ESRD
What is milrinone?
300
This ablation aims for gangilonated plexi for vasovagal syncope
What is cardioneuroablation?
400
This endocarditis type happens in SLE patients, commonly with bilateral mitral leaflet involvement and negative blood cultures
What is Libman-Sacks endocarditis? (verrucous endocarditis)
400
This diagnosis is associated with malignancies, give a possible symptom
What is SVC syndrome? Stenting. Head fullness, arm swelling, redness
400
This SSRI prolongs QTc the most in a dose dependent fashion
What is citalopram?
400
After many small, suggestive studies, a large (n = 2308) randomized trial of this medication showed no differences in the rates of contrast induced AKI (12.7% for both groups), ESRD, or other outcomes
What is N-acetylcysteine 1200 mg p.o. bid the day before and after the procedure?
400
This bedside procedure targets the stellate ganglion with local anesthetic in the supraclavicular region and can suppress refractory ventricular arrhythmias.
This surgical treatment removes the lower stellate ganglion and T2–T4 ganglia and is used for refractory VT/VF, long QT syndrome, and catecholaminergic VT.
What is stellate ganglion block?
What is cardiac sympathetic denervation?
500
This vasculitis with uveitis, genital and oral ulcers may cause pulmonary artery aneurysms
What is Behcet's disease?
500
In children, this is the most common benign cardiac tumor and is strongly associated with tuberous sclerosis
What is a rhabdomyoma?
500
This specific ventricular tachycardia mechanism seen in myotonic dystrophy originates from the His-Purkinje system.
What is bundle branch reentry tachycardia?
500
2/4 of these antiarrhythmics needs to be renally dosed
Amiodarone, Dofetilide, Sotalol, Dronaderone
What is Dofetilide and Sotalol?
Amiodarone → No dose adjustment
Dronedarone → No dose adjustment
Dofetilide →
CrCl >60 → 500 mcg BID
CrCl 40–60 → 250 mcg BID
CrCl 20–39 → 125 mcg BID
CrCl <20 → ❌ Contraindicated
Sotalol →
CrCl 30–59 → Dose q24h
CrCl 10–29 → Dose q36–48h
CrCl <10 → Individualize
500
The diagnosis in this tilt table test
What is POTS?
