QUESTIONS WITH SOLUTIONS GRADED A+
◉ CV procedures wait periods. Answer: Post PCI- Wait period one
week, ETT 3-6 months after PCI
Post MI- Wait period 2 months, LVEF > 40%, ETT every two years
Post CABG - Wait period 3 months, LVEF >40% and after 5 years
needs an annual ETT
Any cardiac surgery 3 month wait period
◉ Cardiomyopathies. Answer: Hypertrophic or restrictive - NO
Idiopathic - Yes if...
Asymptomatic, LVEF >40%, no ventricular arrhythmias
Asymptomatic, LVEF >50% if ventricular arrhythmias present
Annual certification with cardiac evaluation that includes echo and
holter.
◉ Any cardiovascular disease. Answer: ANNUAL certification
◉ Ventricular Tachycardia. Answer: Sustained vtach >15 sec
EF <40%- do not certify
EF >40% and asymptomatic- wait period of one month after
successful treatment and cleared by cardiologist
Annual certification
, ◉ SVT. Answer: Prognosis is excellent but may have syncope or
symptoms of cerebral hypoperfusion
WPW - pre-excitation presents risk for death or syncope if atrial
fibrillation develops
Wait period of 1 month
Annual certification if asymptomatic
◉ A Fib. Answer: Anticoagulated for 1 month
Monitored by monthly INR
Rate/rhythm control deemed adequate
Annual certification
◉ Pacemakers. Answer: Certify annually if...
One month after implantation, unless neurogenic or carotid sinus
syncope, wait period is 3 months
Documented correct function and regular pacemaker checks
Underlying disease not disqualifying
Defibulators are disqualifying
◉ Aortic stensosis. Answer: Mild - annual cert if asymptomatic, echo
every 5 years
Moderate - 3 month wait period after surgery, certify annual with echo
every 2-3 years
Severe - NO unless 3 months post surgery, certify annual
, ◉ Aortic regugitation. Answer: Mild and moderate disease:
Annual certification
Echo every 2-3 years
Severe aortic regurgitation:
(see guideline)
◉ Mitral regurgitaiton. Answer: Mild - certify annual
Moderate - certify annual if echo shows normal LV size and function
Severe - annual if asymptomatic, echo every 6-12 months. NO if
symptomatic
◉ Mitral stenosis. Answer: Mild: MVA >1.6
Moderate: MVA 1.0-1.6, certify annual if asymptomatic
Severe: NO if NHYA class II or MVA <1.0
◉ Vascular disease. Answer: PVD - certify annual
Intermittent claudication:
If surgery wait 3 months
If asymptomatic- annual certification
If symptomatic - NO
DVT: Acute, do not certify until no residual thrombosis
PE: No if symptomatic
3 months with no PE and on long term treatment