Cardiology Qs Flashcards
(30 cards)
Pharmacologic vasodilators?
Can can this adverse effect during stress testing? Therefore contraindicated in a which pateints?
dipyridamole, adenosine, and regadenoson
bronchospasm
those currently wheezing
Surgical aortic valve replacement is indicated for?
symptomatic patients with severe aortic stenosis OR asymptomatic patients with severe aortic stenosis and LV systolic dysfunction (LV ejection fraction <50%)
When should the warfarin goal be reduced to 2-2.5?
If warfarin is used as an anticoagulant during triple therapy (in a pt without mechanical valves)
Severe MV stenosis but asymptomatic - when is intervention indicated?
planned pregnancy or MVA<1 with amenable valve
Patients with medically refractory frequent PVCs or should undergo catheter ablation if?
develop left ventricular dysfunction
BB for pregnancy?
labetalol
AV nodal blocking agents that do not need to be stopped for stress test?
CCBs
Minimal criteria for adequacy for an exercise stress test?
85% of the age-predicted maximal heart rate and maximal metabolic demand
Role for Cilostazol?
PAD - improves pain-free walking and overall walking distance in patients with claudication
Cilostazol contraindication?
heart failure or a left ventricular ejection fraction below 40%
Medications for pericarditis that are not recommended Post MI?
NSAIDs and Colchicine
Typical EKG for atrial fibrillation with aberancy?
irregularly irregular rhythm with a typical right bundle branch block
Appropriate screening interval for an asymptomatic 1st° relative of a patient with HCM?
Every 5 years
Caveat in dealing with patients with Eisenmenger syndrome?
All IV lines need air filters
When do patients with asymptomatic mitral regurgitation require valve replacement?
asymptomatic patients with chronic severe mitral regurgitation and mild to moderate LV dysfunction (ejection fraction of 30%-60% and/or LV end-systolic dimension ≥40 mm).
When does A type B aortic dissection require surgery?
complicated type B aortic dissection defined by refractory pain or hypertension, rapid aneurysmal expansion, rupture, or malperfusion syndrome.
In patients with severe pulmonary valve stenosis, when is valve intervention recommended?
all the time - regardless of the presence or absence of symptoms.
Which HF patients should get a ICD? Who is excluded from this?
NYHA functional class II and III symptoms, ejection fraction less than or equal to 35% on guideline-directed medical therapy, and a life expectancy of at least 1 year
Class IV symptom pateints are excluded - ICDs are not indicated in this population except in patients who are awaiting transplantation or undergo placement of a mechanical circulatory device.
When should patients with HCM get an ICD placed?
any of the following risk factors for sudden cardiac death:
(1) Wall thickness ≥30 mm;
(2) previous cardiac arrest
(3) blunted blood pressure response or hypotension during exercise;
(4) unexplained syncope;
(5) nonsustained ventricular tachycardia on ambulatory electrocardiography
(6) family history of sudden death due to HCM.
Anti-platelet agent to use with thrombolytics?
Clopidogrel (no proven benefit of ticagrelor or prasugrel)
Follow-up for a young patient with a bicuspid aorta?
reassessment need if the aortic root or ascending aorta dimension is 4.0+ cm,
Annual evaluation should occur if the aortic diameter is greater than 4.5 cm.
EKG Contraindications to exercise stress testing?
LBBB, a paced rhythm, or baseline ST-segment depression greater than 1 mm,
hen should aspirin NOT be given for primary prevention in a diabetic?
low cardiovascular risk (men younger than 50 years and women younger than 60 years without other major risk factors such as hypertension or tobacco use).
Diagnostic test for restrictive pericarditis in a patient with a inadequate echo?
hemodynamic study with cardiac catheterization
