HISTORY
TRIALS AND TRIBULATIONS
DRUG WARS
SYNDROMES
SURPRISE!!!
100
This Professor of physiology from small Dutch town of Leiden, recorder the first human electrocardiogram
Who is Willem Einthoven
100
This landmark trial showed that adding coronary artery bypass grafting to optimal medical therapy improves long-term survival in patients with ischemic cardiomyopathy and reduced ejection fraction.
What is the STICH trial?
100
The drug, cilostazol, has been shown to improve pain-free walking distance and overall walking distance in patients with claudication. Clinical practice guidelines recommend a trial of cilostazol be considered in patients with claudication. This is the mechanism of action of cilostazol and this is the black box warning.
What is PDEIII inhibition and what is contriaindication in CHF
100
This genetic syndrome is linked to atrioventricular septal defects and is the most common chromosomal cause of congenital heart disease.
What is Down Syndrome?
100
This is the assumed formula for VO2 that is commonly used in Fick Cardiac output equation
What is 125 x BSA?
200
First coronary angiography was done by
Who is Mason Sones
200
This trial showed that sacubitril/valsartan was superior to enalapril in reducing mortality and hospitalization in HFrEF patients.
What is the PARADIGM-HF Trial?
200
Ibutilide, used for chemical cardioversion of atrial flutter/fibrillation, carries this primary risk that necessitates 4 hours of post-infusion monitoring.
What is QT prolongation/Torsades de pointes
200
Autosomal dominant condition which affects bones in the arms and hands and may also cause heart problems
What is Holt-Oram syndrome
200
This is the formula for Duke Treadmill Score and this cutoff is considered high risk
what is DTS = Exercise time (min) − (5 × max ST deviation mm) − (4 × angina index)
What is ≤ −11: High risk (5% annual mortality)
300
First cardiac catheterizaton of a living human heart was by?
Who is Werner Forssmann
300
This contemporary trial used coronary CT angiography to exclude left main disease and showed an initial invasive strategy did not reduce death or MI compared to conservative management in stable ischemic heart disease.
What is the ISCHEMIA Trial?
300
Ticagrelor should be avoided or used with caution with this commonly prescribed antibiotic due to CYP3A4 inhibition raising ticagrelor plasma levels and bleeding risk.
What is Clarithromycin (think azoles, macrolides, protease inhibitors)
Azithromycin is safe
The flip side — strong CYP3A4 inducers reduce ticagrelor levels (loss of efficacy):
- Rifampin
- Carbamazepine
- Phenytoin
- Phenobarbital
300
This congenital syndrome is associated with supravalvular aortic stenosis, “elfin facies,” and hypersensitivity to vitamin D.
What is Williams Syndrome?
300
This is the formula and normal cutoff for diastolic Pulmonary gradient.
What is DPG = dPAP − PCWP → What is Normal: < 7 mmHg
400
Name the physician-scientist who first applied continuous-wave Doppler to clinical cardiology in the late 1970s–early 1980s to non-invasively measure transvalvular gradients
Who is Liv Hatle
400
This trial showed that PCI for ischemic cardiomyopathy with severe LV dysfunction did not reduce all-cause mortality or HF hospitalization compared to optimal medical therapy, contrasting prior surgical data.
What is the REVIVED-BCIS2 Trial?
400
LMWH has greater activity against factor _____ compared to UFH
What is Factor Xa?
400
This is the syndrome with ASD + mitral stenosis?
What is Lutembacher syndrome
400
RV SWI less than _____ is considered the threshold for RV failure
Right Ventricular Stroke Work Index (RVSWI) = SVI x (MPAP – RAP) x 0.0136
Normal is 5 – 10 gm-m/m2/beat
RV failure <4 gm-m/m2/beat or <300 mmHg.mL
500
Who discovered betablockers and won nobel prize for it?
Who is Sir James Black
500
In STEMI patients undergoing primary PCI, routine manual thrombectomy, as compared with PCI alone did not reduce MACE, within 180days but was associated with increased rate of stroke within 30days.
What is the TOTAL Trial?
500
Bivalirudin compared to UFH + GPI in HORIZONS-AMI showed reduction in this outcome, at the cost of increased early stent thrombosis. Name both the benefit and the tradeoff.
What is Reduced major bleeding (benefit); what is increased acute/early stent thrombosis within 24 hours (tradeoff)
500
This is the syndrome with Hypertelorism + bifid uvula/cleft palate + aortic aneurysm
What is Loeys-Dietz Syndrome (TGFBR1/2 mutation)
500
This is the formula and cutoff for Index of Microvascular Resistance (IMR)
What is IMR = Pd × Tmn (during hyperemia). An IMR value >=25 is generally considered indicative of microvascular dysfunction.