Mixed Deck — All CCS Topics Flashcards

A CCS professional discovers that a patient's diagnosis was delayed because of a system error in the EHR. Ethically, the professional should:

Answer: Report the error through incident reporting systems and participate in root-cause analysis to prevent recurrence

Transparent reporting of medical errors through institutional systems and participation in quality improvement is an ethical and professional obligation.

A patient develops cardiac tamponade after an electrophysiology procedure. The immediate treatment is:

Answer: Pericardiocentesis under echocardiographic guidance

Pericardiocentesis is the emergent procedure to drain the pericardial effusion and relieve the life-threatening hemodynamic compromise of tamponade.

Which medication is the first-line treatment for acute anaphylaxis that can cause cardiovascular collapse?

Answer: Epinephrine

Epinephrine (1:1000, 0.3–0.5 mg IM) is the first-line treatment for anaphylaxis due to its vasoconstrictive and bronchodilatory effects.

A CCS professional is asked to participate in a research study involving cardiovascular patients. Which condition is ethically required before enrolling patients?

Answer: IRB approval and written informed consent from each participant

Research involving human subjects requires Institutional Review Board (IRB) approval and documented informed consent to protect participant rights and welfare.

A patient refuses a recommended cardiac catheterization after being fully informed of risks and benefits. The cardiovascular specialist should:

Answer: Document the refusal and respect the patient's autonomous decision

Informed refusal by a competent adult must be respected and documented; patient autonomy is a foundational ethical principle.

What is the approximate normal cardiac output at rest in a healthy adult?

Answer: 5–6 L/min

Normal resting cardiac output is approximately 5–6 L/min, representing heart rate multiplied by stroke volume.

A patient is referred for cardiac evaluation prior to a high-risk non-cardiac surgery. The patient can climb two flights of stairs without symptoms. What does this functional capacity represent, and does it require further cardiac testing?

Answer: ≥4 METs; additional cardiac stress testing is generally not required

Climbing two flights of stairs represents ≥4 METs of functional capacity; ACC/AHA guidelines suggest surgery can proceed without further cardiac testing if this threshold is met.

During electrophysiology study, what maneuver is used to differentiate AVNRT from AVRT?

Answer: His-refractory premature ventricular complex (PVC) during tachycardia

A His-refractory PVC that advances or terminates the tachycardia proves accessory pathway involvement (AVRT), as the AV node is bypassed.

Which situation requires a mandatory breach of patient confidentiality in most U.S. jurisdictions?

Answer: A patient discloses they are experiencing suicidal ideation with a specific plan and means

Imminent risk of harm to self or others mandates breach of confidentiality to protect the patient and comply with duty-to-warn statutes in most U.S. jurisdictions.

A patient with severe symptomatic mitral regurgitation (primary, degenerative) has preserved EF of 62% and LVESD of 43 mm. What management is recommended?

Answer: Mitral valve repair or replacement surgery

LVESD ≥40 mm in severe primary MR is a Class I indication for mitral valve surgery even with preserved EF, because ventricular dysfunction will progress without repair.

A patient with a patent foramen ovale (PFO) and cryptogenic stroke is referred for closure. Which device is most commonly used for transcatheter PFO closure?

Answer: Amplatzer Septal Occluder or GORE CARDIOFORM device

Double-disk occluder devices such as the Amplatzer PFO Occluder or GORE CARDIOFORM are the standard percutaneous tools for closing PFOs.

A nurse asks a CCS about the correct technique for measuring ankle-brachial index (ABI). Which ABI value is diagnostic of peripheral arterial disease?

Answer: ABI ≤ 0.9

An ABI ≤0.9 is diagnostic of peripheral arterial disease, reflecting reduced arterial perfusion to the lower extremities.

The term 'cardiomegaly' refers to:

Answer: Enlargement of the heart

Cardiomegaly means abnormal enlargement of the heart, detectable on chest X-ray or imaging.

On a coronary angiogram, TIMI 3 flow is defined as:

Answer: Complete perfusion with normal flow distal to the lesion

TIMI 3 represents complete and normal antegrade flow through the coronary artery, equivalent to normal coronary flow.

Which intervention is MOST effective in preventing hospital-acquired pressure ulcers in cardiovascular patients?

Answer: Repositioning patients regularly to relieve pressure

Repositioning patients regularly to relieve pressure is the MOST effective intervention in preventing hospital-acquired pressure ulcers, especially in cardiovascular patients who may have limited mobility or prolonged bed rest. This practice redistributes pressure away from vulnerable bony prominences, maintaining adequate blood flow to the skin and underlying tissues. Consistent repositioning prevents tissue ischemia and breakdown, which are precursors to pressure ulcer formation.

Which antiplatelet regimen is recommended immediately following drug-eluting stent (DES) implantation for stable coronary artery disease per current ACC/AHA guidelines?

Answer: Aspirin 81 mg plus a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) for at least 6 months

Current guidelines recommend dual antiplatelet therapy (aspirin plus a P2Y12 inhibitor) for at least 6 months after DES in stable CAD, with duration tailored to bleeding and ischemic risk.

Which antiplatelet medication inhibits ADP-mediated platelet aggregation and is commonly prescribed after coronary stent placement?

Answer: Clopidogrel

Clopidogrel is a P2Y12 receptor antagonist that inhibits ADP-mediated platelet aggregation and is used for dual antiplatelet therapy after stenting.

During pulmonary vein isolation (PVI) for atrial fibrillation ablation, esophageal temperature monitoring is used to prevent which serious complication?

Answer: Atrio-esophageal fistula

Atrio-esophageal fistula is a rare but often fatal complication of AF ablation caused by thermal injury to the posterior left atrial wall adjacent to the esophagus.

Which nuclear imaging agent is most commonly used for myocardial perfusion imaging?

Answer: Technetium-99m sestamibi

Technetium-99m sestamibi (Cardiolite) is the most widely used tracer for myocardial perfusion SPECT imaging due to its favorable imaging characteristics.

Which regulatory body oversees radiation safety and radioactive materials licensing for nuclear cardiology laboratories in most U.S. states?

Answer: Agreement State radiation control programs (or the NRC in non-agreement states)

Radioactive materials used in nuclear cardiology are licensed by Agreement State radiation control programs in most U.S. states, or directly by the NRC in non-agreement states.