Which is the most common cause of sudden death among young athletes?

1. Hypertrophic cardiomyopathy
   
2. Anomalous origin or coronary arteries
   
3. Myocarditis
   
4. Commotio cordis

A college basketball athlete is found to have anomalous origin of left coronary artery from right sinus of Valsalva with interarterial course on a computed tomography (CT) of the chest performed for an unrelated reason. He has no cardiac symptoms. What will you recommend?

1. Continue with competitive sport as he has no symptoms
   
2. Perform a stress test and if it is normal allow competitive athletic activity
   
3. Advise against further competitive activity and refer for further evaluation and possible surgical reimplantation of left coronary artery
   
4. None of the above

For a 72-year-old asymptomatic diabetic man scheduled for cataract surgery, which of the following preoperative tests are indicated?

1. Resting electrocardiogram (ECG)
   
2. Echocardiogram
   
3. Stress ECG
   
4. None of the above
   
5. All of the above

For a patient with moderate asymptomatic aortic stenosis undergoing an elective high-risk surgery, which of the following statements are accurate?

1. There is a higher risk of perioperative myocardial infarction
   
2. There is a higher risk of 30-day cardiac event rate
   
3. There is a higher 30-day mortality
   
4. All of the above
   
5. None of the above

An asymptomatic patient with severe aortic stenosis with normal left ventricular (LV) function and pulmonary artery (PA) pressure is scheduled for knee replacement. What would you recommend?

1. Aortic balloon valvuloplasty before surgery
   
2. Transcatheter aortic valve replacement before surgery
   
3. Proceed with surgery with close hemodynamic monitoring
   
4. Proceed with surgery with beta blockade

A 76-year-old man with severe symptomatic aortic stenosis is admitted with abdominal pain and diagnosed to have rupture of abdominal aortic aneurysm (AAA) deemed to be unsuitable for endovascular aneurysm repair. What is the right course of action?

1. Proceed with AAA repair surgery
   
2. Perform aortic balloon valvotomy before surgery
   
3. Treat medically
   
4. None of the above

Routine use of beta blockers before surgery may result in higher risk of which of the following?

1. Hypotension
   
2. Stroke
   
3. Bradycardia
   
4. None of the above
   
5. All of the above

Which of the following statements are accurate regarding elective surgery after percutaneous coronary intervention?

1. Should be postponed >14 days if aspirin (ASA) needs to be stopped and balloon angioplasty was performed
   
2. Should be postponed >30 days if dual antiplatelet therapy needs to be stopped and bare-metal stent was implanted
   
3. Should be postponed >1 year if dual antiplatelet therapy needs to be stopped and drug-coated stent was implanted
   
4. None of the above
   
5. A, B, and C

Based on the 2014 American College of Cardiology/American Heart Association guidelines (Box 26.2), which of the following are class I indications for beta blockade perioperatively?

1. Those on chronic beta blockade
   
2. Those with moderate or high risk myocardial ischemia on preoperative stress testing
   
3. Those with three or more revised clinical risk index (RCRI) risk factors; for example, diabetes mellitus, heart failure, coronary artery disease (CAD), renal insufficiency, cerebrovascular accident
   
4. All of the above

Results of the POISE trial addressing perioperative beta blockade yielded which of the following results?

1. Use of beta blocker reduced risk of atrial fibrillation
   
2. Use of beta blocker reduced risk of myocardial ischemia
   
3. Beta blocker use resulted in higher risk of stroke and noncardiac death
   
4. All of the above

In a patient with stable CAD on ASA, beta blocker, and statin undergoing AAA surgery, which of the following would you recommend to reduce the risk of perioperative myocardial ischemia?

1. Continue beta blocker
   
2. Continue statin
   
3. Continue ASA if possible
   
4. Administer perioperative prophylactic intravenous nitroglycerine
   
5. All of the above
   
6. A, B, and C

Which of the following is the predominant cause of mortality in patients with end-stage renal disease (ESRD) on dialysis?

1. Cardiac
   
2. Hyperkalemia
   
3. Stroke related to hypertension
   
4. Progressive renal failure

How does CAD in ESRD differ from patients without ESRD?

1. ESRD patients have more extensive CAD
   
2. ESRD patients have medial calcification more than intimal calcification
   
3. ESRD patients have more extensive coronary calcification
   
4. All of the above
   
5. None of the above

A 62-year-old ESRD patient with diabetes and hypertension is being evaluated for renal transplant. The resting ECG and LV wall motion on echo are normal. EF is 65%. He had a stress echocardiogram which was negative for ischemia at a heart rate of 136 bpm and 8.7 METs. On the insistence of the renal transplant committee, he had a coronary angiogram which showed a 70% mid left anterior descending (LAD) artery lesion. What has been shown to reduce the risk of perioperative cardiac events?

1. LAD artery stent drug eluting stent
   
2. Left internal mammary artery to LAD artery
   
3. Perioperative beta blockade
   
4. None of the above

A 48-year-old patient with ESRD on hemodialysis is seen because of dyspnea. His heart rate is 75 bpm, and blood pressure is 134/80 mmHg. He has no edema, has positive abdominojugular reflux, and no murmurs. Hemoglobin (Hb) is 12.2 g/dL. An echocardiogram shows mild LV hypertrophy, moderate left atrial enlargement, EF of 60% with normal wall motion and normal valves. The calculated PA systolic pressure is 50 mmHg, inferior vena cava is flat, mitral E/A velocity ratio is 1.5, and E/medial Em ratio is 22. Isovolumic relaxation time is 70 ms. What would you recommend?

1. Reduce the dry weight by 4–5 lbs (1.8–2.3 kg) by dialysis
   
2. Prescribe Coreg®
   
3. Recommend pulmonary vasodilator
   
4. Prescribe oral frusemide

Which medications are recommended for a 63-year-old nondiabetic patient with ESRD and normal blood pressure on hemodialysis?

1. ASA
   
2. Statin
   
3. Beta blocker
   
4. Angiotensin-converting-enzyme inhibitor

What echocardiographic findings may you encounter in a patient with end-stage liver disease?

1. LA enlargement
   
2. Hyperdynamic left ventricle with high cardiac output
   
3. Elevated pulmonary pressure
   
4. All of the above