Blonder

Question 1

ASD

Answer 1

opening in intra-atrial septum

most common - secundum

closure - catheter device

Question 2

patent foramen ovale

Answer 2

foramen covered by septum primum not sealed shut in 20% of normal subjects

bubble study on echo

Question 3

over time ASD

Answer 3

resistance - stiff and non-compliant

then pressure increases

pressure follows resistance

Question 4

myxomatous mitral valve

Answer 4

mitral valve prolapse syndrome

Question 5

most common septal defect

Answer 5

bicuspid AV

ASD is second**

Question 6

ASD

Answer 6

usually asymptomatic until adult - surgery by age 40

atrial arrhythmia, paradoxical emboli, cerebral abscess, right heart failure, pulmonary HTN > eisenmanger syndrome

Question 7

ASD at bottom of septum

Answer 7

primum

-worse

Question 8

sinus venosus ASD

Answer 8

least common
-cannot be closed percutaneously

two types
-superior (SVC) and inferior (IVC)

Question 9

scimitar syndrome

Answer 9

partial anomalous venous return

hypoplasia of lobe of right lung

thoracic aorta > pulmonary artery collaterals

Question 10

lesions <8mm without symptoms

Answer 10

larger lesions enlarge with age

Question 11

pulmonary HTN and eisenmenger syndrome

Answer 11

require >2.5:1 shunt

Question 12

wide fixed split S2

Answer 12

ASD - splitting stays equal

Question 13

increased P2

Answer 13

pulmonary HTN

Question 14

S1 split

Answer 14

tricuspid component

Question 15

upper left sternal border murmur

Answer 15

systolic ejection murmur

Question 16

most common congenital heart disease at birth

Answer 16

VSD

spontaneous closure

Question 17

infundibular VSD

Answer 17

below aortic and pulmonic valves

leading to progressive aortic regurgitation, the hallmark

Question 18

membranous VSD

Answer 18

conoventricular

deficiency of membranous septum

Question 19

inlet defect VSD

Answer 19

AV canal

down’s

Question 20

muscular VSD

Answer 20

in trabecular system

Question 21

small/restrictive VSD

Answer 21

orifice diameter < or = 25% aortic annulus diameter

no LV volume overload
no pulmonary HTN

Question 22

moderate size VSD

Answer 22

orifice 25-75% diameter

mild-moderate volume overload

Question 23

large VSD

Answer 23

orifice 75% diameter

moderate L>R shunts with LV volume overload

pulmonary HTN
> eisenmenger

Question 24

tetralogy of fallot

Answer 24

VSD
aorta overrides
concentric RV hypertrophy
RVOT obstruction

Question 25

causes of AV block

Answer 25

-vagal tone increase -fibrosis of conduction system (50%) -IHD -cardiomyopathy and myocarditis -congenital heart disease familial AV block (auto dom)

Question 26

latrogenic

Answer 26

Dr. caused AV block -digitalis, non-DHP CCBs, beta blockers, amiodarone, adenosine cardiac surgery catheter alcohol septal ablation

Question 27

first degree AV block

Answer 27

PR interval >0.2 decreased CO

Question 28

progressive PR interval prolongation

Answer 28

mobitz type I second degree AV block

Question 29

PR interval unchanged, but get P wave that doesn't conduct

Answer 29

mobitz type II second degree AV block

Question 30

P and QRS dissociation

Answer 30

third degree AV block usually need a pacemaker

Question 31

rheumatic heart disease

Answer 31

mitral valve stenosis

Question 32

indication for pacing

Answer 32

wide QRS

Question 33

most common arrhythmia

Answer 33

atrial fib more in men, increases with age reduced CO - decreased diastolic filling time

Question 34

risk factors for A fib

Answer 34

hypertensive heart disease CHD RF

Question 35

AF that terminates spotaneously or within 7 days, may recur

Answer 35

paroxysmal AF

Question 36

AF that fails to terminate within 7 days

Answer 36

persistent require pharm or cardioversion

Question 37

AF longer than 12 months

Answer 37

long standing persistant

Question 38

patients with persistant AF where joint decision is made to no longer control rhythm

Answer 38

permanent AF

Question 39

palpitations, syncope, dyspnea, fatigue

Answer 39

AF

Question 40

rate control for AF

Answer 40

patient anti-coag | -rate controlled by AV blockers

Question 41

rhythm control for AF

Answer 41

anticoag and restore NSR by meds -or electrical cardioversion TEE used to rule out LA thrombus prior to cardioversion

Question 42

CHA2DS2 - Vasc

Answer 42

``` CHF HTN Age 65-74 1 point >75 2 points DIabetes Stroke 2 points ``` Vasc disease Hx +1 Female +1 all 9 15% per year for A-fib stroke risk

Question 43

PVCs

Answer 43

with syncope = serious** very common complaint - not really that big of a deal - unless with acute coronary syndromes or MI reassurance is mainstay of treatment beat after pause - very forceful