New Series of Interactive Cardiology MCQs 14
❤️ Advanced Cardiology Series – Part 14
Interactive Cardiology MCQs #14
Post-Graduate Level Clinical, ECG & Hemodynamic Masterclass
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Q1
A 68-year-old patient with classical low-flow, low-gradient aortic stenosis (aortic valve area 0.8 cm², mean gradient 28 mmHg, LVEF 30%) undergoes dobutamine stress echocardiography. Which finding confirms true severe aortic stenosis rather than pseudosevere AS?
Q2
When transitioning a patient with heart failure with reduced ejection fraction (HFrEF) from an ACE inhibitor (e.g., enalapril) to an ARNI (sacubitril/valsartan), what is the mandatory washout period and the primary reason for it?
Q3
In tissue Doppler imaging (TDI) of the mitral annulus, what is the significance of “annulus reversus”?
Q4
A patient presents with classical chest pain. An ECG demonstrates upright, symmetrical, and prominent T waves in the precordial leads (V1-V6) with a > 1 mm J-point ST depression. What does this “de Winter” ECG pattern indicate?
Q5
In invasive coronary physiology, what is the primary difference between Fractional Flow Reserve (FFR) and instantaneous wave-free ratio (iFR)?
Q6
A 72-year-old patient with suspected transthyretin cardiac amyloidosis (ATTR-CA) undergoes a Technetium-99m pyrophosphate (Tc-99m PYP) scan. The scan yields a Grade 3 uptake. What does this grade signify?
Q7
In the evaluation of a jugular venous pulse (JVP) tracing, the presence of irregular “cannon a-waves” is pathognomonic for which of the following?
Q8
What is the long-term complication most universally expected in adult patients who underwent complete surgical repair of Tetralogy of Fallot involving a transannular patch during childhood?
Q9
Amiodarone is unique among Class III antiarrhythmics. Which of the following best describes its distinct properties and side effect profile?
Q10
In a patient with Wolff-Parkinson-White (WPW) syndrome who presents with pre-excited Atrial Fibrillation (AFib) and a heart rate of 190 bpm, but maintains stable blood pressure, which pharmacological agent is recommended?
Q11
According to current guidelines, what is the target “door-to-balloon” time for primary percutaneous coronary intervention (PCI) in a patient presenting to a PCI-capable hospital with a STEMI?
Q12
Which physical exam finding differentiates severe tricuspid regurgitation (TR) from severe mitral regurgitation (MR)?
Q13
In echocardiography, the Pressure Half-Time (PHT) method is commonly used to estimate Mitral Valve Area (MVA) in mitral stenosis. What is the empirical constant used in the formula MVA = Constant / PHT?
Q14
Which statement accurately describes the mechanism of action of PCSK9 inhibitors (e.g., evolocumab, alirocumab)?
Q15
Following a Transcatheter Aortic Valve Replacement (TAVR), which conduction abnormality is the most common reason for requiring a permanent pacemaker implant?
Q16
Which clinical presentation distinguishes Long QT Syndrome Type 3 (LQT3) from Types 1 and 2?
Q17
In patients with Hypertrophic Obstructive Cardiomyopathy (HOCM), Systolic Anterior Motion (SAM) of the mitral valve results in dynamic Left Ventricular Outflow Tract (LVOT) obstruction. What concurrent valvular issue almost always accompanies SAM?
Q18
When performing a right heart catheterization, which parameter specifically defines pre-capillary Pulmonary Arterial Hypertension (WHO Group 1) as opposed to post-capillary pulmonary hypertension (WHO Group 2)?
Q19
In cardio-oncology, how does anthracycline-induced cardiotoxicity (e.g., Doxorubicin) primarily differ clinically from trastuzumab-induced cardiotoxicity?
Q20
When evaluating a wide-complex tachycardia on an ECG, which feature definitively establishes the diagnosis as Ventricular Tachycardia (VT) rather than SVT with aberrancy?
Q21
In intracoronary imaging, what is the principal advantage of Optical Coherence Tomography (OCT) compared to Intravascular Ultrasound (IVUS)?
Q22
A patient with a mechanical mitral valve presents with acute pulmonary edema. Fluoroscopy reveals severely restricted leaflet motion. An echocardiogram confirms obstructive valve thrombosis. She is hemodynamically unstable. According to guidelines, what is the preferred first-line therapy?
Q23
In right heart catheterization, which hemodynamic profile is classic for isolated acute right ventricular myocardial infarction?
Q24
A patient’s ECG shows a “Type 1” Brugada pattern (coved ST-segment elevation >2 mm followed by a negative T wave in V1-V2). To unmask or provoke a Brugada ECG pattern in suspected patients, which class of drugs is infused during testing?
Q25
What is the “Gorlin Formula” used for in the cardiac catheterization laboratory?
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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