HEART

Question 1

VALVE AREA > 1.5CM2 AND < 25 mmHg is defined as (mild/moderate/severe) grade aortic stenosis

Answer 1

mild- no restriction Suggest annual physical and echo

Question 2

VALVE AREA 1.0CM2-1.5CM2 AND aoritc pressure 25-40 mmHg is defined as (mild/moderate/severe) grade aortic stenosis

Answer 2

moderate- low intesnity sports as long as does no abnormal heart rhythms, BP, ST changes.

Question 3

VALVE AREA < 1cm2 >40mmHg is defined as (low/moderate/severe) grade aortic stenosis

Answer 3

severe- cannot play * Moderate with symtpoms also cannot play

Question 4

In what circumstanes would athlete with MVP be resticted from sport?

Answer 4

Moderate to severe Regurg Famly History of MVP death history of cardiac syncope ventricular arrythmias

Question 5

ARVD athletes recomendations for sport

Answer 5

Cannot compete in endurance or competitive sport. Can participate in low intensity recreational sport.

Question 6

Most common form of SCD > 35 yrs

Answer 6

CAD

Question 7

Coronary arty risk score >___ should have LV function. assessed

Answer 7

100

Question 8

EF < ___% with exercse is considered substantial risk factor for athletes with CAD

Answer 8

50%

Question 9

Anybody with MI should refrain from vigorous physical activity for at least __ week

Answer 9

4

Question 10

How can one try to differeiante Athletic heart vs HCM

Answer 10

Athletic heart- Increased wall thickness and increased cardiac chamber volume HCM- increased wall thickness and decreased cardiac chamber volume

Question 11

When should you screen someone for LV function ?

Answer 11

asymptomatic patient with diabetes starting a vigorous exercise program. or men >45 and woman >55 previously sedimentary starting rigours exercise program

Question 12

Athlete with 145/90 during screening physical allowed to play?

Answer 12

Stage 1 or 2 htn, no restriction as long as no end organ damage. May not participate until BP well controlled if has end organ damage

Question 13

What is the recomended study for pediatric athletes with HTN

Answer 13

renal ultrasound

Question 14

What is recomended for children >95% or 90-94% with DM or renal disease?

Answer 14

echocardiogram

Question 15

BP meds recomended for athletes?

Answer 15

ARBS, ACE, and CCB

Question 16

Most common arrhythmia in athletes

Answer 16

A-fib

Question 17

Can athletes with a-fib play competative sport?

Answer 17

as long as no structural heart disease

Question 18

How doese exercise relate to A-fib

Answer 18

vigorous exercise proportional to prevalence

Question 19

One lab to order with AFib?

Answer 19

TSH

Question 20

Medication managment for athletes with A-fib?

Answer 20

Beta blocker Avoid collision sports if starting on Blood thinners

Question 21

RTP after A-fib ablation

Answer 21

4-6 weeks

Question 22

After diagnosis of Myocarditis should refrain from strenuous activity for _____

Answer 22

6 months

Question 23

Commotio Cordis as result of what kind of irregular heart rhyth

Answer 23

v-Fib , right before T wave

Question 24

Presentation of Anomalous CA

Answer 24

SCD, exertional CP, syncope, and pre syncope

Question 25

Workup for Anomalous CA

Answer 25

Coronary artery angiography

Question 26

Anomalous CA can RTP how long after correct surgery?

Answer 26

None until 3 months after surgery

Question 27

What are EKG signs for ARVD

Answer 27

T wave inversion V1-V3 followed by flat or downsloping ST segement

Question 28

ARVD pathology

Answer 28

mutations in desmosomal proteins that replace muscle fibers with fibrofatty replacement usually in RV

Question 29

Harsh crescendo-decrescendo systolic murmur R 2nd intercostal

Answer 29

Aortic Stenosis ( Squatting - increases preload) and will make it louder

Question 30

decrescendo blowing **diastolic murmur** heard best at the **left lower sternal border.**

Answer 30

Aortic Regurgitation Diastolic is the leafy valve letting blood back in the left ventricle

Question 31

An innocent murmur can be any murmur excluding (diastolic/systolic)

Answer 31

diasystolic

Question 32

Diastolic murmur lower left sternal border

Answer 32

Tricuspid stenosis

Question 33

Systolic murmur upper left sternal border

Answer 33

Pulmonary stenosis

Question 34

Diastolic murmur heard at apex w/ opening stap

Answer 34

Mitral stenosis Snap is heard as LV trying to fill. after systole

Question 35

Systolic injection murmur in a football physical. What could you do exacerbate the murmur if you are concerned for HCM?

Answer 35

Valsalva - decrease venous return/increases arterial resistance Sitting to standing- decrease venous return

Question 36

What is the name of this wave and what heart condition is it specific for?

Answer 36

epsilon wave ARVD

Question 37

Genetic link for HCM

Answer 37

Auto Dominent

Question 38

Describe EKG findings in HCM

Answer 38

Inferiolateral Leads V4-V6, 1, 2, AVF, AVL Deep T wave inversion Dagger like Q WAVES V5, V6, II, AVF

Question 39

EKG OF 16 YR OLD AAMALE BASEKTBALL PLAYER

Answer 39

NORMAL IF ASYMPTOMATIC ST ELEVATION DOME V1-V4

Question 40

MARFAN'S SYNDROME has a defect in the ___ gene.

Answer 40

Fibrillin

Question 41

Name one eye abnormality and 2 heart conditions of Marfans

Answer 41

1. Lens Dislocation 2. Aortic dissection 3. Mitral and Aortic valve incompitancy

Question 42

Marfan's is passed down how?

Answer 42

Auto dominent

Question 43

Answer 43

Marfans'

Question 44

Ho often are follow up echos needed for Marfans?

Answer 44

\<45 mm- 12 months \>45 mm -6 months

Question 45

What size aortic root in Marfans would require surgery?

Answer 45

\>50 mm

Question 46

What heart condition is this seen in ?

Answer 46

Delta wave WPW The other signs would be long QRS AND SHORTENED PR INTERVAL

Question 47

Patient with suspected WPW put on treadmill for further assessment and was identified as risk as inconclusive? What is the next step?

Answer 47

EP study

Question 49

What is this abnormality and what is it associatied with?

Answer 49

Ebstein's abnormality Tricuspid valve mutation Dilated RV

Question 50

Seen in what cardiac condition

Answer 50

Brugada. Right Bundle branch block and ST elevation in V1-V3

Question 51

Which heart condition involves mutated sacromeres proteins.

Answer 51

HCM

Question 52

Mutation in the ryanodine,calsequestrin, or ankyrin B proteins

Answer 52

Catecholaminergic Polymorphic Ventrical Tachycardia

Question 53

Resting ECG of qtc \> ____ is diagnostic Prolonged QT syndrome

Answer 53

500 Recommended exercise stress test

Question 54

Characterized by prominent trabeculae and deep interrebecular recesses

Answer 54

LV Non Compaction

Question 55

ST CONVEX ELEVATION FOLLOWED BY INVERSE T WAVE IS NORMAL IN WHAT LEADS?

Answer 55

V1-V4 AA ATHLETE

Question 56

WHAT IS THE DIFFERENCE IN THE MURMUR OF AORTIC STENOSIS VS HCM?

Answer 56

HCM DOES NOT RADIATE TO THE CAROTIDS.