Decongestion
Critical Thinking
Not your Normal Tissue
Hanging around the Heart
Congenital Heart Disease
200
Aside from hypersensitivity to its components, these are the two contraindications to the use of Sacubitril-valsartan.
What is concurrent ACEi use (or within 36 hours of a dose) and any history of angioedema?
200
Toxicity from this common cardiac ICU drug can lead to a "cherry red" appearance, confusion, seizures, and skin rashes.
What is nitroprusside?
-Use can lead to cyanice/thiocyanide toxicity.
-The cherry red appearance can result from impaired tissue utilization of oxygen, increase venous oxyhemoglobin.
200
Type and Position of this valve is?
What is a single tilting disk Mitral valve?
200
The diagonsis portrayed by the image is...
What is constriction or constrictive pericarditis?
-Note the position of diagphragm
-The left is expiration, and the right is inspiration
-With inspiration there is increased filling of the RV as noted by the increase in size. Because there is a realtively fixed pericardial space, the increaded RV filling reduced LV filling and results in flattening of the interventricular septum.
200
The diagnosis depicted by this image is...
What is cor triatriatum (sinister)?
-Uncommon congenital anomaly that separates the left atrium into two chambers.
-Communication can be through defects in the membrane or through an ASD
400
Vericiguat is a class of this type of drug, which has been shown in a cohort of high-risk patients with HFrEF to reduce a composite endpoint of hospitalization for HF and cardiovascular death.
What is an oral soluble guanylate cyclase stimulator?
-VICTORIA trial was the RCT that demonstrated this
-The benefit was significant but modest overall, primarily driven by a borderline reduction in HF hospitalizations.
400
This is the CPO and PAPI for the following set of hemodynamics
RA 15
RV 32/15 (21)
PA 32/25 (27)
PCW 23
CO 3.4 L/min, CI 1.8 L/min/m2
HR 60bpm, BP 92/61 (71)
What is CPO 0.54, and PAPI 0.47
400
After the first 3 months, INR targets for the On-X valves in the aortic position can be reduced to this INR range when there are no other thromboembolic risk factors.
What is 1.5-2.0?
ACC/AHA 2020 Valvular Heart Disease Guidelines
400
According to the ESC guidelines, hospitalization for acute pericarditis is recommended for high-risk patients with any of these risk factors (name two).
What is Fever>38C, or subacute course, or tamponade/hemodynamic instability, or large pericardial effusion, or lack of response to ASA/NSAIDS, or myopericarditis, or immunosuppression or trauma, or oral anticoagulation.
2015 ESC Guidelines on Pericarditis
400
ACC/AHA guidelines recommends (Class 1) surgical repair for adults with the condition shown in the image if any of these criteria are present (name one)
What is HF symptoms, objective evidence of worsening exercise capacity, or progressive RV systolic dysfunction?
(Ebstein's Anomaly)
600
In heart transplantation, this can occur in the setting of pre-formed cytotoxic antibodies to the donor heart.
What is hyperactue rejection?
This may be seen in patients that are highly sensitized or in cases of ABO-mismatch
600
Current ACLS guidelines provide information on assessing the quality of CPR. In addition to visual assessment of the depth and speed of compressions, this is one of two objective thresholds that indicate inadequate CPR Quality.
What is End-tidal CO2 (EtCO2) <10 mm Hg OR Diastolic blood pressure <20mm Hg
600
Clots larger than this size by area favor the decision to proceed with surgery over fibrinolysis for acute mechanical valve thrombosis.
What is >0.8 cm2
ACC/AHA 2020 Valvular Heart Disease Guidelines
600
This condition is evidenced by the presence of a pericardial effusion with tamponade physiology and failure of RA pressures to fall>50% or below 10 mm Hg after a pericardiocentesis
What is effusive constrictive pericarditis?
-The increased RA pressure with tamponade should be relieved with fluid removal
-Persistent RA pressure elevation in these cases indicates constrictive physiology
600
The cause of the echocardiogram finding is...
What is persistent left-sided SVC?
-An agitated saline injection into the LUE would normally be directed into the SVC and then the RA then CS.
-With a persistent LSVC, the drainage goes into the coronary sinus first then RA. There is often CS dilation.
800
Per the 2024 ACC/AHA guidelines, the surveillance screening interval of asymptomatic adult first-degree relatives of patients with clinically diagnosed hypertrophic cardiomyopathy is...
What is every 3-5 years?
800
According to the SCAI classification of cardiogenic shock, a patient with a pH <7.2 and a lactate >8 have biochemical markers consistent with this stage of shock
What is Stage E (extremis)
800
This is one of the two (Class 2A) recommendations for adjustment to therapy when a patient with mechanical MVR and therapeutic INR has a CVA.
What is increase INR goal to 4.0 OR add ASA (75-100mg)?
2020 ACC/AHA Valvular Heart Disease Guidelines
800
The diagnosis of recurrent pericarditis includes these time-based criteria from ESC...
What is recurrent disease after a documented symptom-free interval of 4-6 weeks or longer
ESC 2015 Pericardial Disease Guidelines
800
The diagnosis indicated by the echocardiogram below...
What is quadricuspid aortic valve?
-This is a rare congenital defect
-Can present with aortic regurgitation and aortic dilation
-Other congenital defects such as septal defects, persistent LSVC and PDA can be seen.