Before the heart was
The smooth-walled outflow portions of the ventricles arise embryologically from this structure.
What is bulbs cordis?
This coronary artery most commonly supplies the AV node.
What is the RCA?
ST elevation in V1–V4 most commonly indicates occlusion of this coronary artery.
What is the LAD?
This biomarker is commonly elevated because of myocardial wall stress in heart failure.
What is BNP or NT-proBNP?
Sudden severe chest or back pain described as maximal at onset should raise concern for this catastrophic diagnosis.
What is acute aortic dissection?
This maneuver increases the intensity of the murmur of hypertrophic obstructive cardiomyopathy while decreasing most other systolic murmurs.
What is Valsalva (or standing from squatting)?
This is the most common type of atrial septal defect and occurs in the region of the fossa ovalis.
What is an ostium secundum ASD?
The LAD travels in this anatomic groove.
What is the anterior interventricular sulcus?
A patient presents with an NSTEMI and is started on aspirin. This second antiplatelet drug class is commonly added to provide dual antiplatelet therapy.
What is a P2Y12 inhibitor?
Name the four foundational medication classes for contemporary HFrEF guideline-directed medical therapy.
What are ARNI/ACEi/ARB, evidence-based beta blocker, MRA, and SGLT2 inhibitor?
In the Stanford classification, any dissection involving this portion of the aorta is Type A.
What is the ascending aorta?
A patient with an inferior STEMI becomes hypotensive after nitroglycerin. The lungs are clear and JVP is elevated. What additional ECG leads should you obtain?
What are right-sided leads, particularly V4R?
Failure of the endocardial cushions to fuse appropriately produces this type of ASD, which is strongly associated with AV septal defects.
What is an ostium primum ASD?
This venous structure courses through the posterior atrioventricular groove and drains most of the myocardium into the right atrium.
What is the coronary sinus?
A patient presents 48 hours after an acute MI with recurrent severe chest pain. ECG shows diffuse ST-segment elevations and PR depressions. What is the most likely diagnosis?
What is post-MI pericarditis?
A patient with HFrEF has an EF of 25%, LBBB, QRS 165 ms, and remains symptomatic despite optimized GDMT. This device therapy should be considered.
What is cardiac resynchronization therapy (CRT)?
What is the imaging modality of choice for a hemodynamically unstable patient with suspected aortic dissection who cannot safely go to CT?
What is bedside TEE?
A patient with atrial fibrillation and WPW develops an irregular wide-complex tachycardia. Which commonly used AV-nodal blocking medications should be avoided? Name at least 2
Beta-blockers, nondihydropyridine calcium-channel blockers, adenosine, and digoxin.
A newborn with Down syndrome is found to have a large primum ASD, inlet VSD, and a common AV valve. Failure of this embryologic structure to develop normally explains the defect.
What are the endocardial cushions?
A patient develops hoarseness due to compression of the left recurrent laryngeal nerve by a thoracic aortic aneurysm. Around which cardiovascular structure does this nerve loop?
What is the aortic arch?
A patient presents with intermittent chest pain. While pain-free, the ECG demonstrates deeply inverted, symmetric T waves in V2–V4. Troponin is minimally elevated. What critical coronary lesion should be suspected?
What is critical proximal LAD stenosis (Wellens syndrome)?
A patient with HFrEF is started on sacubitril/valsartan. Because of the risk of angioedema, how long must you wait after stopping an ACE inhibitor before starting this medication?
What is 36 hours?
A patient with an acute Type A aortic dissection develops sudden neurologic deficits involving the right side of the body with aphasia. Extension of the dissection into which major aortic arch branch should be suspected?
What is the left common carotid artery?
A patient presents with syncope. ECG shows a short PR interval, wide QRS, and delta wave. What is the underlying electrophysiologic abnormality?
What is an accessory atrioventricular pathway (Bundle of Kent) causing ventricular pre-excitation?
A newborn develops differential cyanosis with lower-extremity desaturation. Imaging demonstrates severe coarctation of the aorta near the site where a fetal vascular connection normally enters the descending aorta. Name that fetal structure.
What is the ductus arteriosus?
During infective endocarditis, an abscess involving this fibrous structure may produce new-onset complete heart block because of its close relationship to the AV conduction system.
What is the membranous interventricular septum?
A patient presents with crushing chest pain and ST depression in V1–V3 with tall R waves and upright T waves. What acute coronary syndrome should you suspect, and which additional ECG leads can confirm it?
What is a posterior MI, confirmed with posterior leads V7–V9?
A patient with severe HFrEF is taking carvedilol, sacubitril/valsartan, spironolactone, and dapagliflozin. He remains in sinus rhythm with an LVEF of 30% and resting HR of 78 bpm despite maximally tolerated beta-blocker therapy. Ivabradine is started. What is the mechanism of action?
What is a selective inhibitor of the funny current (If) in the SA node.
A patient with acute aortic dissection develops sudden paraplegia with preserved upper-extremity function. Compromise of which artery supplying the spinal cord should be suspected?
What is the artery of Adamkiewicz (great anterior radiculomedullary artery)?
A patient presents with syncope. ECG shows RBBB with left anterior fascicular block. Several hours later, telemetry demonstrates intermittent complete heart block. What conduction abnormality was present on the initial ECG?
What is bifascicular block?