New Series of Interactive Cardiology MCQs 13
❤️ Advanced Cardiology Series – Part 13
Interactive Cardiology MCQs #13
Post-Graduate Level Clinical & Hemodynamic Masterclass
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Q1
A patient with a continuous-flow left ventricular assist device (CF-LVAD) presents with syncope and a low-flow alarm. Echocardiography reveals a severely shifted interventricular septum toward the left ventricle and frequent premature ventricular contractions. What is the most likely diagnosis and appropriate initial management?
Q2
According to ACC/AHA and ESC guidelines, which anticoagulation strategy is recommended during the first trimester for a pregnant woman with a mechanical mitral valve whose pre-pregnancy warfarin dose requirement was 3 mg daily?
Q3
In patients with AL (light chain) cardiac amyloidosis, the Mayo Clinic staging system utilizes which two primary serum biomarkers to stratify disease severity and predict median survival?
Q4
During a catheter ablation procedure for typical, isthmus-dependent right atrial flutter, the electrophysiologist creates a linear lesion across the cavotricuspid isthmus (CTI). What are the anatomical boundaries of the CTI?
Q5
Which of the following describes the mechanism of action of bempedoic acid, a non-statin lipid-lowering therapy?
Q6
Based on the landmark COAPT trial, which set of echocardiographic and clinical parameters identifies patients with secondary (functional) mitral regurgitation who benefit most from transcatheter edge-to-edge repair (TEER / MitraClip)?
Q7
During simultaneous right and left heart catheterization, a patient exhibits a “dip and plateau” (square root) sign in both ventricular pressure tracings. Which hemodynamic feature reliably distinguishes constrictive pericarditis from restrictive cardiomyopathy?
Q8
An asymptomatic 28-year-old male with Ebstein anomaly undergoes routine follow-up. According to ACHD guidelines, which of the following is a Class I indication for surgical intervention (tricuspid valve repair/replacement)?
Q9
A patient presenting with acute chest pain is found to have deep, symmetrical T-wave inversions in leads V2 and V3 while currently pain-free. What anatomical lesion does this Wellens syndrome pattern predict?
Q10
During pre-procedural CT planning for Transcatheter Aortic Valve Replacement (TAVR), which anatomical finding places the patient at the highest risk for acute coronary obstruction during valve deployment?
Q11
Which of the following echocardiographic criteria indicates severe, primary mitral regurgitation?
Q12
A patient undergoing treatment for metastatic melanoma with the immune checkpoint inhibitor (ICI) ipilimumab/nivolumab presents with new-onset high-degree AV block and significantly elevated troponins. What is the most crucial first step in management?
Q13
What is the mechanism of action of vericiguat, a drug approved for patients with high-risk heart failure with reduced ejection fraction following a recent hospitalization?
Q14
An ECG demonstrates wide-complex tachycardia at 160 bpm with a Left Bundle Branch Block (LBBB) morphology and an inferior axis (positive QRS in leads II, III, aVF). What is the most likely origin of this ventricular tachycardia?
Q15
A patient presenting with acute chest pain has an ECG showing horizontal ST-segment depression in leads V1 to V3, prominent R waves in V1-V2, and upright T waves. What is the most appropriate next diagnostic step to confirm the suspected diagnosis?
Q16
Which rare genetic disorder should be highly suspected in a young male presenting with unexplained concentric left ventricular hypertrophy, neuropathic pain (acroparesthesias), angiokeratomas, and proteinuria?
Q17
During cardiac tamponade, what is the pathophysiologic mechanism responsible for “pulsus paradoxus” (an abnormally large > 10 mmHg drop in systolic blood pressure during inspiration)?
Q18
Which specific side effect is uniquely associated with ticagrelor compared to other P2Y12 inhibitors (like clopidogrel or prasugrel), leading to discontinuation in up to 15% of patients?
Q19
Based on the results of the EMPEROR-Preserved and DELIVER trials, which drug class has received a Class 2a recommendation for treating patients with Heart Failure with Preserved Ejection Fraction (HFpEF)?
Q20
Which genetic mutation is responsible for approximately 20-30% of all confirmed cases of Brugada syndrome?
Q21
During a percutaneous coronary intervention (PCI), a high-pressure balloon inflation results in an Ellis Grade III coronary artery perforation with rapid extravasation into the pericardium. What is the most definitive immediate interventional treatment?
Q22
Which congenital heart defect is most frequently associated with the development of a ‘parachute mitral valve’ and subaortic stenosis as part of Shone’s complex?
Q23
In the management of infective endocarditis, what is the most common indication for urgent or emergent surgical valve replacement?
Q24
Which parameter is measured by the CardioMEMS device, a wireless implantable sensor used to monitor patients with advanced heart failure and prevent hospitalizations?
Q25
A patient with an acute coronary syndrome is treated with bivalirudin during primary PCI. What is the mechanism of action of this anticoagulant?
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About The Author
Johnson Francis
Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal