CMC Risk Assessment & Management 4

Question 1

A patient presenting with chest pain has a HEART score of 7. What is the recommended management course?

Accepted Answer

Admit and consider early invasive strategy

Answer

A HEART score of 7–10 indicates high risk for MACE (>65% event rate), necessitating admission and consideration of early invasive evaluation.

Question 2

Which finding on a dobutamine stress echocardiogram is considered a high-risk marker predicting adverse cardiac outcomes?

Accepted Answer

New wall motion abnormality in ≥ 3 segments at low dose dobutamine

Answer

Inducible wall motion abnormalities in ≥ 3 segments at low dobutamine doses indicate extensive ischemia and are a high-risk marker associated with adverse outcomes.

Question 3

In chronic kidney disease (CKD) stage 3b, how does the estimated GFR impact cardiovascular risk stratification?

Accepted Answer

CKD stage 3b (eGFR 30–44) is a risk-enhancing factor that raises ASCVD risk

Answer

CKD stage 3b (eGFR 30–44 mL/min/1.73m²) is a recognized risk-enhancing factor in 2018 ACC/AHA guidelines, increasing baseline ASCVD risk estimate.

Question 4

A 58-year-old man with known CAD and recent PCI is prescribed dual antiplatelet therapy (DAPT). Which DAPT score component indicates a patient who benefits more from prolonged DAPT beyond 12 months?

Accepted Answer

Prior MI or prior PCI

Answer

Prior MI or prior PCI is a positive scoring component in the DAPT Score, indicating patients who may benefit from prolonged dual antiplatelet therapy beyond 12 months post-PCI.

Question 5

In the management of hypertensive emergency with acute aortic dissection, what is the primary blood pressure target and preferred agent class?

Accepted Answer

SBP < 120 mmHg and HR < 60 bpm using IV beta-blockers first

Answer

For aortic dissection, IV beta-blockers (e.g., esmolol) are first-line to reduce HR < 60 bpm and SBP to 100–120 mmHg to minimize aortic wall shear stress.

CMC - Cardiac Medicine Certification Practice Test

CMC - Cardiac Medicine Certification Practice Test

CMC Risk Assessment & Management 4