Cardiology MCQ 74. PTMC

Q. Which of the following is not an absolute contraindication for PTMC?
A. Moderate MR
B. LA clot
C. Severe bicommissural calcification
D. Wilkins score of 10

Answer: D. Wilkins score of 10

Explanation:
Absolute contraindications of PTMC include-
1. Moderate to severe MR
2. LA clot
3. Severe bicommissural calcification

NB: Mild MR and LAA clot are not absolute contraindications for PTMC.

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ECG Spotter

What is the diagnosis? Click the button below to view answer: Show Answer

High heart rate

The patient contacts the doctor over phone with this report. Obviously anxious because of his high heart rate (199 beats per minute) as detected by ECG machine. Should he be worried about this and come to emergency department as soon as possible? Correct answer- ECG machine has calculated his heart rate incorrectly. Heart rate is around 100 beats per minute. Other findings in this ECG include ST segment elevation in anterior chest leads along with presence of Q waves, denoting old MI changes with possibly development of LV aneurysm. In such cases, ST segment elevation can persist for long periods. Now, should he come to emergency department? Not because of detection of high heart rate. But, if he is having symptoms such as shortness of breath or chest pain, he should visit emergency department. Otherwise, if he is asymptomatic, he can schedule a regular visit with his cardiologist.

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