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
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
- Regional RV akinesia, dyskinesia, or aneurysm, plus:
- 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
In stage 1 hypertension without established CVD, diabetes, or CKD, this 10-year PREVENT-CVD risk threshold supports starting medication immediately.
≥7.5%
400
In patients with type 2 diabetes and ASCVD or CKD, oral semaglutide reduced cardiovascular death, nonfatal MI, or nonfatal stroke from 13.8% to 12.0% (HR 0.86). Which trial was this?
SOUL
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