)
1. Q: What is afterload? ANSWER: Afterload is the resistance the left
ventricle must overcome to eject blood during systole, primarily determined by
systemic vascular resistance.
2. Q: Which heart valve prevents backflow from the left ventricle into the
left atrium? ANSWER: The mitral (bicuspid) valve prevents backflow from
the left ventricle into the left atrium.
3. Q: What is the primary pacemaker of the heart? ANSWER: The
sinoatrial (SA) node is the primary pacemaker of the heart, located in the right
atrium.
4. Q: What is the intrinsic rate of the SA node? ANSWER: The SA node
fires at an intrinsic rate of 60-100 beats per minute.
5. Q: What is the intrinsic rate of the AV node? ANSWER: The AV node has
an intrinsic rate of 40-60 beats per minute.
6. Q: What is the function of the AV node? ANSWER: The AV node delays
the electrical impulse from the atria to allow ventricular filling before
ventricular contraction.
7. Q: What does the P wave represent on an ECG? ANSWER: The P wave
represents atrial depolarization.
8. Q: What does the QRS complex represent on an ECG? ANSWER: The
QRS complex represents ventricular depolarization.
9. Q: What does the T wave represent on an ECG? ANSWER: The T wave
represents ventricular repolarization.
10. Q: What is the normal PR interval? ANSWER: The normal PR interval is
0.12-0.20 seconds (3-5 small boxes on ECG).
11. Q: What is the normal QRS duration? ANSWER: The normal QRS
duration is 0.06-0.10 seconds (1.5-2.5 small boxes).
,12. Q: What is the normal QT interval? ANSWER: The normal QT interval
is 0.36-0.44 seconds, but it varies with heart rate.
13. Q: Which coronary artery supplies the SA node in most people?
ANSWER: The right coronary artery supplies the SA node in approximately
60% of people.
14. Q: Which coronary artery supplies the left ventricle? ANSWER: The
left anterior descending (LAD) and left circumflex arteries supply the left
ventricle.
15. Q: What is angina pectoris? ANSWER: Angina pectoris is chest pain
caused by insufficient oxygen supply to the myocardium, usually due to
coronary artery disease.
16. Q: What are the classic signs of myocardial infarction? ANSWER:
Classic signs include crushing chest pain, dyspnea, diaphoresis, nausea, and
pain radiating to the left arm, jaw, or back.
17. Q: What cardiac enzyme is most specific for myocardial infarction?
ANSWER: Troponin (troponin I and troponin T) is the most specific cardiac
biomarker for myocardial infarction.
18. Q: When do troponin levels typically peak after MI? ANSWER:
Troponin levels typically peak at 12-24 hours after myocardial infarction and
can remain elevated for 7-14 days.
19. Q: What is the difference between STEMI and NSTEMI? ANSWER:
STEMI (ST-elevation MI) shows ST-segment elevation on ECG indicating
complete coronary occlusion; NSTEMI shows no ST elevation but has elevated
cardiac markers.
20. Q: What is the primary treatment goal in acute MI? ANSWER: The
primary goal is rapid reperfusion to restore blood flow to the myocardium,
typically within 90 minutes (door-to-balloon time).
21. Q: What medication is given immediately for suspected MI? ANSWER:
Aspirin (chewable, 160-325 mg) is given immediately to inhibit platelet
aggregation.
22. Q: What does MONA stand for in MI treatment? ANSWER: MONA
stands for Morphine, Oxygen (if needed), Nitroglycerin, and Aspirin.
23. Q: What is the mechanism of action of nitroglycerin? ANSWER:
Nitroglycerin causes vasodilation, reducing preload and myocardial oxygen
demand, and dilates coronary arteries.
, 24. Q: What are contraindications for nitroglycerin? ANSWER:
Contraindications include hypotension (SBP <90 mmHg), use of
phosphodiesterase inhibitors (Viagra, Cialis) within 24-48 hours, and right
ventricular infarction.
25. Q: What is heart failure? ANSWER: Heart failure is the inability of the
heart to pump sufficient blood to meet the body's metabolic demands.
26. Q: What are the two main types of heart failure? ANSWER: Heart
failure with reduced ejection fraction (HFrEF) and heart failure with preserved
ejection fraction (HFpEF).
27. Q: What is a normal ejection fraction? ANSWER: Normal ejection
fraction is 55-70% (or 50-70% depending on the source).
28. Q: What is the ejection fraction in HFrEF? ANSWER: In HFrEF, the
ejection fraction is typically less than 40%.
29. Q: What are common symptoms of left-sided heart failure? ANSWER:
Symptoms include dyspnea, orthopnea, paroxysmal nocturnal dyspnea, fatigue,
and pulmonary congestion/crackles.
30. Q: What are common symptoms of right-sided heart failure?
ANSWER: Symptoms include peripheral edema, jugular venous distension,
hepatomegaly, ascites, and weight gain.
31. Q: What is the most common cause of right-sided heart failure?
ANSWER: Left-sided heart failure is the most common cause of right-sided
heart failure.
32. Q: What are the New York Heart Association (NYHA) classifications?
ANSWER: Class I (no symptoms), Class II (slight limitation), Class III (marked
limitation), Class IV (symptoms at rest).
33. Q: What medication class is first-line for HFrEF? ANSWER: ACE
inhibitors (or ARBs) combined with beta-blockers are first-line treatments for
HFrEF.
34. Q: How do ACE inhibitors help in heart failure? ANSWER: ACE
inhibitors reduce afterload by blocking conversion of angiotensin I to
angiotensin II, decreasing vasoconstriction and aldosterone secretion.
35. Q: What are common side effects of ACE inhibitors? ANSWER:
Common side effects include dry cough, hyperkalemia, hypotension, and
angioedema (rare but serious).
1. Q: What is afterload? ANSWER: Afterload is the resistance the left
ventricle must overcome to eject blood during systole, primarily determined by
systemic vascular resistance.
2. Q: Which heart valve prevents backflow from the left ventricle into the
left atrium? ANSWER: The mitral (bicuspid) valve prevents backflow from
the left ventricle into the left atrium.
3. Q: What is the primary pacemaker of the heart? ANSWER: The
sinoatrial (SA) node is the primary pacemaker of the heart, located in the right
atrium.
4. Q: What is the intrinsic rate of the SA node? ANSWER: The SA node
fires at an intrinsic rate of 60-100 beats per minute.
5. Q: What is the intrinsic rate of the AV node? ANSWER: The AV node has
an intrinsic rate of 40-60 beats per minute.
6. Q: What is the function of the AV node? ANSWER: The AV node delays
the electrical impulse from the atria to allow ventricular filling before
ventricular contraction.
7. Q: What does the P wave represent on an ECG? ANSWER: The P wave
represents atrial depolarization.
8. Q: What does the QRS complex represent on an ECG? ANSWER: The
QRS complex represents ventricular depolarization.
9. Q: What does the T wave represent on an ECG? ANSWER: The T wave
represents ventricular repolarization.
10. Q: What is the normal PR interval? ANSWER: The normal PR interval is
0.12-0.20 seconds (3-5 small boxes on ECG).
11. Q: What is the normal QRS duration? ANSWER: The normal QRS
duration is 0.06-0.10 seconds (1.5-2.5 small boxes).
,12. Q: What is the normal QT interval? ANSWER: The normal QT interval
is 0.36-0.44 seconds, but it varies with heart rate.
13. Q: Which coronary artery supplies the SA node in most people?
ANSWER: The right coronary artery supplies the SA node in approximately
60% of people.
14. Q: Which coronary artery supplies the left ventricle? ANSWER: The
left anterior descending (LAD) and left circumflex arteries supply the left
ventricle.
15. Q: What is angina pectoris? ANSWER: Angina pectoris is chest pain
caused by insufficient oxygen supply to the myocardium, usually due to
coronary artery disease.
16. Q: What are the classic signs of myocardial infarction? ANSWER:
Classic signs include crushing chest pain, dyspnea, diaphoresis, nausea, and
pain radiating to the left arm, jaw, or back.
17. Q: What cardiac enzyme is most specific for myocardial infarction?
ANSWER: Troponin (troponin I and troponin T) is the most specific cardiac
biomarker for myocardial infarction.
18. Q: When do troponin levels typically peak after MI? ANSWER:
Troponin levels typically peak at 12-24 hours after myocardial infarction and
can remain elevated for 7-14 days.
19. Q: What is the difference between STEMI and NSTEMI? ANSWER:
STEMI (ST-elevation MI) shows ST-segment elevation on ECG indicating
complete coronary occlusion; NSTEMI shows no ST elevation but has elevated
cardiac markers.
20. Q: What is the primary treatment goal in acute MI? ANSWER: The
primary goal is rapid reperfusion to restore blood flow to the myocardium,
typically within 90 minutes (door-to-balloon time).
21. Q: What medication is given immediately for suspected MI? ANSWER:
Aspirin (chewable, 160-325 mg) is given immediately to inhibit platelet
aggregation.
22. Q: What does MONA stand for in MI treatment? ANSWER: MONA
stands for Morphine, Oxygen (if needed), Nitroglycerin, and Aspirin.
23. Q: What is the mechanism of action of nitroglycerin? ANSWER:
Nitroglycerin causes vasodilation, reducing preload and myocardial oxygen
demand, and dilates coronary arteries.
, 24. Q: What are contraindications for nitroglycerin? ANSWER:
Contraindications include hypotension (SBP <90 mmHg), use of
phosphodiesterase inhibitors (Viagra, Cialis) within 24-48 hours, and right
ventricular infarction.
25. Q: What is heart failure? ANSWER: Heart failure is the inability of the
heart to pump sufficient blood to meet the body's metabolic demands.
26. Q: What are the two main types of heart failure? ANSWER: Heart
failure with reduced ejection fraction (HFrEF) and heart failure with preserved
ejection fraction (HFpEF).
27. Q: What is a normal ejection fraction? ANSWER: Normal ejection
fraction is 55-70% (or 50-70% depending on the source).
28. Q: What is the ejection fraction in HFrEF? ANSWER: In HFrEF, the
ejection fraction is typically less than 40%.
29. Q: What are common symptoms of left-sided heart failure? ANSWER:
Symptoms include dyspnea, orthopnea, paroxysmal nocturnal dyspnea, fatigue,
and pulmonary congestion/crackles.
30. Q: What are common symptoms of right-sided heart failure?
ANSWER: Symptoms include peripheral edema, jugular venous distension,
hepatomegaly, ascites, and weight gain.
31. Q: What is the most common cause of right-sided heart failure?
ANSWER: Left-sided heart failure is the most common cause of right-sided
heart failure.
32. Q: What are the New York Heart Association (NYHA) classifications?
ANSWER: Class I (no symptoms), Class II (slight limitation), Class III (marked
limitation), Class IV (symptoms at rest).
33. Q: What medication class is first-line for HFrEF? ANSWER: ACE
inhibitors (or ARBs) combined with beta-blockers are first-line treatments for
HFrEF.
34. Q: How do ACE inhibitors help in heart failure? ANSWER: ACE
inhibitors reduce afterload by blocking conversion of angiotensin I to
angiotensin II, decreasing vasoconstriction and aldosterone secretion.
35. Q: What are common side effects of ACE inhibitors? ANSWER:
Common side effects include dry cough, hyperkalemia, hypotension, and
angioedema (rare but serious).
