CCS Treatment Planning & Management 3

Question 1

A 72-year-old with severe symptomatic aortic stenosis (AVA 0.7 cm², mean gradient 52 mmHg) is deemed high surgical risk. What is the preferred treatment?

Accepted Answer

Transcatheter aortic valve replacement (TAVR)

Answer

TAVR is the preferred treatment for severe symptomatic AS in high-surgical-risk and intermediate-risk patients, with outcomes equivalent or superior to SAVR.

Question 2

Which medication reduces hospitalizations in chronic HFpEF (EF ≥50%) and has received FDA approval for this indication?

Accepted Answer

Empagliflozin

Answer

SGLT2 inhibitors (empagliflozin, dapagliflozin) reduce cardiovascular death and HF hospitalizations in HFpEF and have FDA approval for this indication.

Question 3

A patient with chronic stable angina has a positive stress test and FFR of 0.78 in the LAD. What does this FFR value indicate?

Accepted Answer

Hemodynamically significant stenosis; revascularization beneficial

Answer

FFR ≤0.80 indicates hemodynamically significant stenosis where PCI reduces angina and improves outcomes compared to medical therapy alone.

Question 4

A patient develops complete heart block after inferior STEMI. Which artery is most likely occluded?

Accepted Answer

Right coronary artery

Answer

The RCA supplies the AV node in approximately 90% of patients; inferior STEMI from RCA occlusion commonly causes transient AV block.

Question 5

For a patient with hypertrophic obstructive cardiomyopathy (HOCM) and severe symptoms refractory to disopyramide and beta-blockers, what is the next step?

Accepted Answer

Refer for septal reduction therapy (myectomy or ASA)

Answer

Septal reduction therapy—surgical myectomy or alcohol septal ablation—is recommended for HOCM patients with severe symptoms refractory to maximal medical therapy.

(CCS) Certified Cardiovascular Specialist Practice Test

(CCS) Certified Cardiovascular Specialist Practice Test

CCS Treatment Planning & Management 3