Under Pressure
Muscle and Tussle
Read between the Lines
Before the Break
Name it and Win it!
100

18-year-old man with Marfan syndrome with fibrillin 1 (FNB1) mutation. He has a family history of ascending aortic aneurysm without dissection. He had a cardiac magnetic resonance (MR) imaging today that revealed a normal aortic diameter of 3.6 cm (unchanged from a prior study) and mild mitral valve prolapse with trace mitral regurgitation.

When should aortic imaging be repeated in this patient?  

1 year

100


What is the diagnosis?

Pre-excited AFIB

100

In an ACS patient already receiving maximally tolerated statin therapy, reaching this LDL-C threshold triggers a Class I recommendation to add a nonstatin drug.

LDL-C ≥70 mg/dL

100

In a small double-blind, sham-controlled trial, CTO PCI significantly improved angina and increased angina-free days.

ORBITA-CTO

200

What is the currently accepted criteria for the presence of vasoreactivity in PAH?

Demonstration of ≥10 mm Hg reduction in mPAP to a value of <40 mm Hg and without a reduction in CO.

200

What is the diagnosis?

Dextrocardia

200

These are the 2026 LDL-C and non–HDL-C goals for secondary prevention in very-high-risk ASCVD.

LDL-C <55 mg/dL and non–HDL-C <85 mg/dL

200

In high-risk patients with atherosclerosis or diabetes but no previous MI or stroke, evolocumab reduced coronary death, MI, or ischemic stroke from 8.0% to 6.2% (HR 0.75). Which trial was this?

Vesalius CV

300

What criteria is currently being used to determine the probability of MARFAN's SYNDROME?

Revised Ghent Criteria

300

According to Revised Task Force, name at least 2 major criteria for diagnosis of ARVC?

  • Structural abnormality/RV dysfunction
    • Regional RV akinesia, dyskinesia, or aneurysm, plus:
      • Echo: PLAX RVOT ≥32 mm or ≥19 mm/m²; PSAX RVOT ≥36 mm or ≥21 mm/m²; or RV FAC ≤33%
      • CMR: RVEDVi ≥110 mL/m² in men or ≥100 mL/m² in women; or RVEF ≤40%
    • RV angiography: regional akinesia, dyskinesia, or aneurysm
  • Tissue characterization
    • Residual myocytes <60% by morphometry or <50% if estimated, with fibrous RV free-wall replacement, with or without fat
  • Repolarization
    • T-wave inversion in V1–V3 or beyond in patients >14 years without complete RBBB
  • Depolarization
    • Epsilon wave in V1–V3
  • Arrhythmia
    • Sustained or nonsustained VT with LBBB morphology and superior axis
  • Family history/genetics
    • ARVC confirmed in a first-degree relative by Task Force Criteria
    • ARVC confirmed pathologically in a first-degree relative
    • Pathogenic or probably pathogenic ARVC-associated mutation in the patient
300

What is the clinical diagnosis likely suspected?


Hypothermia with Bradycardia, Prolonged QT with stretched ST segment and upright T waves, Osborne waves and shivering artifact

300

Define Stage 1 Hypertension

SBP 130-139 and DBP 80-89 mmHg

300

In anticoagulated patients with chronic coronary syndrome and previous stenting, adding aspirin increased cardiovascular events from 12.1% to 16.9% and major bleeding from 3.4% to 10.2%. Which trial was stopped early for harm?

Aquatic

400

EKG shows?

This is a classic tracing for HCM with “septal Q waves”. Severe septal hypertrophy of HCM often produces “dagger-like” deep septal Q waves in anterolateral (V4-V6), and/or inferior (II, III, aVF) and/or lateral (I, aVL), leads.

400

In stage 1 hypertension without established CVD, diabetes, or CKD, this 10-year PREVENT-CVD risk threshold supports starting medication immediately.

≥7.5%

400

Weight management is associated with a reduction in atrial fibrillation (AF) symptom burden. This trial, 335 patients with BMI >29 kg/m2 were offered weight management assistance and followed for 5 years. Weight loss of ≥10% of body weight resulted in a sixfold greater probability of arrhythmia-free survival at 5 years. What is it?

LEGACY

500

The 2026 lipid guideline recommends measuring this inherited lipoprotein at least once, what is it and at what value is it considered risk enhancing?

Lp(a) and ≥125 nmol/L or 50 mg/dL is risk-enhancing 

500

n women with suspected ANOCA/INOCA, intensive statin, ACEI/ARB, and aspirin therapy did not significantly reduce death, MI, stroke, HF, or angina hospitalization versus usual care.

warrior

M
e
n
u