• IN HF with mid range EF Diastolic dysfunction means:

A- E/e′ ≥13 and a mean e’ septal and lateral wall ,9 cm/s.

B- E/e′ ≥14 and a mean e’ septal and lateral wall ,7cm/s.
C- E/A ≥2 and a mean e’ septal and lateral wall ,11cm/s.
D- E/e′ ≥13 and e’ septal of 11 cm/s.
• A
• Using deformation indices, i.e. strain and strain rates
in a TTE protocol in subjects at risk of developing HF
is class :
• I
• II a
• II b
• III
B
• Regarding CMR indications in HF the following sentence is false: :

• CMR is recommended for the assessment of myocardial structure and function

(including right heart) in subjects with poor acoustic window .

• CMR with LGE should be considered in patients with dilated cardiomyopathy in order
to distinguish between ischaemic and nonischaemic myocardial damage if equivocal
clinical and imaging data .

• CMR is recommended for the characterization of myocardial tissue in case of

suspected myocarditis.

• CMR is recommened for the assessment of myocardial ischaemia and viability in

patients with HF and CAD (considered suitable for coronary revascularization) before
the decision on revascularization .
D
 Choose the false answer
• Invasive coronary angiography is a class 1
indication in patients with HF and :

• angina pectoris recalcitrant to

pharmacological therapy
• symptomatic ventricular arrhythmias
• aborted cardiac arrest
• None of the above
 Extra minute
• ICD is recommended in these patients except:
• asymptomatic LV systolic dysfunction (LVEF ≤30%) of
ischaemic origin, who are at least 40 days after acute
myocardial infarction
• with asymptomatic non-ischaemic dilated cardiomyopathy
(LVEF ≤30%), who receive OMT therapy,in order to prevent
sudden death and prolong life.
• DCM patients with symptomatic HF (NYHA Class I–III), and an
LVEF ≤35% despite ≥3 months of OMT, provided they are
expected to survive substantially longer than one year with
good functional status.
C
• Treatments that may cause harm in patients with symptomatic
(NYHA Class II–IV) heart failure with reduced .ejection
fraction :

• Thiazolidinediones .

• NSAIDs .

• Diltiazem.

• All of the above .

E
• Harmfull combinations in patients with HF and
angina include the following EXCEPT :

• ivabradine, ranolazine
• ranolazine, nicorandil
• Nitrates , ranolazine
• Nicorandil , nitrates
C
In patients with AHF all of the following is class I
recommendation except :

• 12-lead ECG
• chest X-ray .
• cardiac troponins, BUN (or urea), creatinine,
electrolytes
• complete blood count, liver function tests and TSH.
• None of the above.
E
• Intubation is recommended in AHF that
caused respiratory failure that cannot be
managed non-invasively. leading to:
• acidosis (pH <7.35)
• acidosis (pH <7.30)
• acidosis (pH <7.40)
• None of the above
A
• IN cardiogenic shock:

• Fluid challenge is recommended as 1st line if no signs of vloume

overlaod

• Invasive monitoring with an arterial line is not recommended.

• IABP is routinely recommended in cardiogenic shock.

• If cardiogenic shock complicating ACS an immediate coronary

angiography is recommended (within 3 hours from hospital
admission)
a