CSC Cardiac Subspecialty 3

Question 1

A 58-year-old with severe aortic stenosis (AVA 0.7 cm², mean gradient 52 mmHg) is asymptomatic. Which finding would prompt intervention?

Accepted Answer

LV ejection fraction <50% on serial echocardiography

Answer

Asymptomatic severe AS with LVEF <50% is a Class I indication for valve replacement due to evidence of LV dysfunction.

Question 2

Which finding on coronary angiography is most consistent with a fractional flow reserve (FFR) value of <0.80, indicating hemodynamically significant stenosis?

Accepted Answer

80% diameter stenosis in a large obtuse marginal branch supplying viable myocardium

Answer

An 80% stenosis in a territory supplying viable myocardium is most likely to produce a pressure drop resulting in FFR <0.80.

Question 3

A patient with long QT syndrome type 1 (LQT1) presents after a near-syncopal episode during swimming. What is the most appropriate management?

Accepted Answer

Initiate beta-blocker therapy and restrict swimming

Answer

Beta-blockers are highly effective in LQT1 and mandatory after a symptomatic event; swimming is a specific trigger and should be restricted.

Question 4

Which statement about cardiac MRI in patients with known or suspected myocarditis is MOST accurate?

Accepted Answer

T2-weighted imaging can detect myocardial edema, reflecting active inflammation

Answer

T2-weighted CMR detects myocardial edema and is a key component of the Lake Louise criteria for myocarditis diagnosis.

Question 5

A patient develops ventricular fibrillation during a diagnostic coronary angiogram. After successful defibrillation, coronary arteries are found to be normal. What is the most likely diagnosis?

Accepted Answer

Coronary vasospasm causing Prinzmetal angina

Answer

Coronary vasospasm (Prinzmetal variant angina) can cause VF during angiography due to transient occlusive spasm even in angiographically normal arteries.

CSC - Cardiac Subspecialty Certification Exam Practice Test

CSC - Cardiac Subspecialty Certification Exam Practice Test

CSC Cardiac Subspecialty 3