Learning Cardiology

Click on the link below. Bicuspid aortic valve with infective endocarditis

Click on the link below. Non restrictive VSD with overriding of aorta

Click on the link below LV and RV function assessment on echocardiography

Q. Most common type of VSD is? A. Muscular B. Perimembranous C. Inlet D. Outlet Answer: Perimembranous VSD

Q. Which of the following is smallest cardiac valve? A. Aortic valve B. Mitral valve C. Tricuspid valve D. Pulmonary valve Answer: D. Pulmonary valve Tricuspid valve is largest whereas pulmonary valve is smallest.

Q. Patient being evaluated for cause of ascites. Constrictive pericarditis or Restrictive cardiomyopathy? Simultaneous LV and RV pressure trace is being shown here. Answer: Here,  RV and LV discordance is present which is suggestive of constrictive pericarditis. RCM will have LV and RV concordance during respiration.

Q 1. Contrast CT angiography of a patient. What is the Diagnosis? Q 2. What is optimum mode of management? Answer 1: Type A aortic dissection Answer 2: Surgical repair

Q 1. Patient with intracranial hemorrhage found to have weak femoral pulses. What may be the diagnosis? Q 2. What is the cause of intracranial hemorrhage? Answer 1: Coarctation of Aorta (CoA)- See the notching of inferior margins of ribs Answer 2: Ruptured Berry's aneurysm

1. What is the diagnosis? 2. What is the name of this sign? Answer 1: Hypertrophic obstructive cardiomyopathy (HOCM) Answers 2: Brockenbrough-Braunwald-Morrow sign Explanation: There is a decrease in pulse pressure and increase in left ventricular outflow tract gradient after the ventricular ectopic beat in HOCM patients. This phenomenon is known as Brockenbrough-Braunwald-Morrow phenomenon or sign.  

Q 1.  What does arrow indicate? Q 2. What is the diagnosis of the patient? Answer 1: Epsilon wave Answer 2: Arrhythmogenic right ventricular cardiomyopathy (ARVC)

Q. Which of the following is false about ORBITA trial:  A. Stable ischemic disease patients were included and were randomized either to PCI or sham procedure. B. Patients with multi-vessel disease were included whereas acute coronary syndrome patients were not included. C. PCI did not result in significant improvement in exercise time as compared to sham procedure. D. Diabetic patients were included. Answer:  B. Patients with  multi-vessel  disease were included whereas acute coronary syndrome patients were not included. Explanation:  ORBITA trial:  Objective Randomised Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina Patients with stable angina and severe single-vessel stenosis were randomized in a 1:1 fashion to either PCI or a placebo sham procedure.   Coronary angiography was done via a radial or femoral arterial approach in all patients.  In all patients, a research invasive physiological

Q. Which of the following is false about Leriche syndrome? A. Claudication of buttocks and thighs B. Impotence C. More common in females D. Usually affects young adults (30 to 40 years) Answer: C. More common in females Explanation: Leriche syndrome: Leriche syndrome, also referred to as aortoiliac occlusive disease , is due to thrombotic occlusion of the abdominal aorta just above the site of its bifurcation and distal to renal arteries. Presents with triad of  1. Claudication of buttocks and thighs 2. Impotence 3. Absent bilateral femoral pulses Etiology may be: Atherosclerotic, Vasculitic or thrombotic obstruction. Commonly affects younger (30-40 years) males. Treatment includes: Endarterectomy, Aortofemoral bypass or Percutaneous transluminal angioplasty and stentin.