Cardiology Flashcards

A 62-year-old man presents with crushing chest pain radiating to his left arm. ECG shows ST elevation in leads II, III, and aVF. Which coronary artery is most likely occluded?

Answer: Right coronary artery

ST elevation in leads II, III, and aVF indicates an inferior STEMI, which is most commonly caused by occlusion of the right coronary artery.

A patient with heart failure has an ejection fraction of 35%. Which medication class has been shown to reduce mortality in this population?

Answer: Beta-blockers

Beta-blockers (carvedilol, metoprolol succinate, bisoprolol) have a Class I indication for reducing mortality in HFrEF with EF ≤40%.

A 55-year-old woman presents with palpitations. ECG shows absent P waves and irregularly irregular rhythm. What is the most appropriate initial anticoagulation strategy if she has a CHA₂DS₂-VASc score of 3?

Answer: Oral anticoagulation with a DOAC

A CHA₂DS₂-VASc score ≥2 in women with atrial fibrillation warrants oral anticoagulation, and DOACs are preferred over warfarin for non-valvular AF.

Which finding on echocardiography is most consistent with cardiac tamponade?

Answer: Right ventricular diastolic collapse

Right ventricular diastolic collapse is the classic echocardiographic sign of cardiac tamponade, caused by elevated pericardial pressure exceeding RV diastolic pressure.

A patient with hypertrophic obstructive cardiomyopathy (HOCM) experiences syncope during exercise. Which medication is contraindicated?

Answer: Nitroglycerin

Nitroglycerin is contraindicated in HOCM because vasodilation reduces preload, worsening the dynamic outflow tract obstruction and potentially causing hemodynamic collapse.

A 70-year-old man has a resting heart rate of 48 bpm and an ECG showing PR interval of 280 ms with all P waves followed by QRS complexes. What is the diagnosis?

Answer: First-degree AV block

A PR interval greater than 200 ms with every P wave followed by a QRS complex and no dropped beats defines first-degree AV block.