Critical Thinking
Cardiology 101
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100
The hemodynamic effects of milrinone include the following:
___ on cardiac output & ___ on systemic vascular resistance
Increases Cardiac Output
Decreases Systemic Vascuolar Resistance
100
This is the preferred imaging modality to diagnose intramural hematoma of the thoracic aorta
Cardiac CT
100
This is the gold standard for diagnosing Myocarditis
Endomyocardial Biopsy
100
IV Cangrelor is being infused in a patient with a STEMI. To ensure absorption, only this approved antiplatelet can be given while Cangrelor is being infused.
Ticagrelor
Cangrelor decreases clopidogrel and prasugrel absorption by receptor binding competition.
200
This medication is commonly prescribed for claudication symptoms, however should not be used in CHF due to inhibition of phosphodiesterase
Cilostazol
200
What are the four components of Metabolic syndrome
Elevated fasting serum glucose, elevated TG, abdominal obesity and Hypertension.
Metabolic syndrome is diagnosed when a person has three or more of the following conditions:
- Abdominal obesity – Waist circumference >40 in men or >35 inches in women
- High BP - >130/80
- Fasting glucose >110 ,g/dl
- High TG - >150 mg/dl
200
Thiazide diuretics can result in what abnormality in a lipid panel
Hypertriglyceridemia
200
Spontaneous coronary artery dissection (SCAD) occurs most commonly in this coronary artery
LAD
-LAD most common (32-46%)
-Lcx (15-40%)
-RCA (10-39%)
-LM (~4%)
400
This is the mechanism of action of mavacamten, which has shown in the EXPORER Trial to improve exercise capacity, LVOT obstruction and NYHA functional class in patients with obstructive hypertrophic cardiomyopathy
Cardiac Myosin Inhibitor
400
This is the predominant blood supply to the Bachmann’s Bundle
RCA
The Bachmann's bundle is a structure in the heart that is part of the electrical conduction system, specifically involved in transmitting the electrical signal from the right atrium to the left atrium. The predominant blood supply to the Bachmann's bundle comes from the right coronary artery (RCA), specifically its atrial branch.
400
The Pulmonary Artery Pulsatility Index (PAPi) is used to assess RV failure in cardiogenic shock. This is the equation
PA systolic – PA diastolic / Right Atrial Pressure
400
The scoring system used in evaluating a patient for patent foramen ovale (PFO) closure which may assist in determining the likelihood the stroke was related to the presence of the PFO
ROPE Score
800
According to the SCAI classification of cardiogenic shock, a patient with a pH of <7.2 and lactate >8 have biochemical markers consistent with this stage of shock…
Stage E
800
In patients with Asymptomatic Severe AS, aortic valve replacement is reasonable (2a level guideline recommendation) when an exercise test demonstrates this level of change in systolic BP from baseline to peak exercise.
Fall of SBP ≥10 mm Hg
In asymptomatic Severe AS – Decreased exercise tolerance, SBP >10 mm Hg
Vel >5 m/sec, gradient >60 mm Hg, BNP >3 times upper limit of normal, increase in AV vel >0.3m/s every year
800
This value is the potassium cut off where spironolactone should NOT be initiated for heart failure therapy in HFrEF with EF <35%
Serum potassium >5
800
The 2020 ACC/AHA Guideline for Valvular heart disease recommends TEER (transcatheter edge to edge repair) in patients with chronic severe secondary MR related to LV systolic dysfunction above this Ejection Fraction
LVEF > 20%