Questions
Ask the room.
0votes
1ans
159
views
What are the indications and absolute contraindications for thrombolytic therapy in STEMI?
STEMI patient in a hospital without PCI facility. Door-to-balloon time will exceed 120 min. Patient has no prior stroke, no active bleeding, no recent surgery. Is thrombolysis appr…
0votes
1ans
99
views
What is the management of complete (3rd degree) AV block with hemodynamic instability?
75-year-old presents with syncope. ECG: HR 38 bpm, P waves dissociated from QRS. BP 80/50. No reversible cause found. What are the immediate and definitive management steps?
0votes
1ans
89
views
How does cardiac tamponade present clinically and what is the emergency treatment?
Post-cardiac surgery patient develops hypotension, raised JVP, muffled heart sounds, and pulsus paradoxus. Echo shows pericardial effusion with RV diastolic collapse. What is the i…
0votes
1ans
88
views
What are the Modified Duke Criteria for diagnosing infective endocarditis?
Patient with fever, new murmur, and positive blood cultures for Streptococcus viridans x2. How do I apply the Duke Criteria to confirm or rule out infective endocarditis?
0votes
1ans
67
views
When is coronary angiography indicated in patients with stable angina on optimal medical therapy?
60-year-old with exertional chest pain, positive stress test, on aspirin, statin, and long-acting nitrates. Symptoms persist. Should I proceed with coronary angiography? What are t…
0votes
1ans
65
views
What are the preferred drugs for rate control in atrial fibrillation and when is rhythm control preferred?
Patient with new-onset AF, HR 130 bpm, mildly symptomatic. No structural heart disease. Should I use beta-blocker, CCB, or digoxin for rate control? When would I consider rhythm co…
0votes
1ans
76
views
How is hypertensive emergency managed differently from hypertensive urgency?
BP 210/120 mmHg with papilledema and mild confusion. No prior history. Is this a hypertensive emergency or urgency? What is the target BP reduction and timeline?
0votes
1ans
63
views
What are the current indications for ICD implantation in patients with heart failure with reduced EF?
Patient with HFrEF (EF 28%) has been on optimal medical therapy for 6 months. When is ICD indicated vs CRT-D? What EF cutoff and NYHA class criteria apply?
0votes
1ans
73
views
How do you differentiate STEMI from NSTEMI on a 12-lead ECG?
A patient presents with chest pain. ECG shows changes in multiple leads. How do I distinguish STEMI requiring immediate cath lab activation from NSTEMI that can be managed medicall…
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1ans
76
views
What is the first-line treatment for acute decompensated heart failure with pulmonary edema?
A 68-year-old patient presents with severe breathlessness, SpO2 88%, bilateral crackles, and elevated JVP. CXR shows pulmonary congestion. What is the immediate management priority…
0votes
1ans
70
views
Sustained monomorphic VT in ischemic cardiomyopathy — amiodarone vs catheter ablation, which is first-line?
60M with ischemic cardiomyopathy (EF 30%), has ICD. Three ICD shocks in the past 6 months for sustained monomorphic VT at 180 bpm. Currently on amiodarone 200mg OD. Electrophysiolo…
0votes
1ans
87
views
Cardiac tamponade diagnosis — when does pulsus paradoxus rule in and how urgent is pericardiocentesis?
52F with known lung adenocarcinoma presents with progressive dyspnea and hypotension (BP 88/60). Echo shows large circumferential effusion with RV collapse. Pulsus paradoxus is 18 …
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0ans
76
views
Cardiogenic shock post-MI — norepinephrine vs dobutamine vs IABP: which to start first?
65M post-anterior STEMI with primary PCI done. Now in ICU with BP 82/50, HR 118, lactate 4.5, cold extremities, urine output 10ml/hr. Echo shows EF 20%, no mechanical complication.…
0votes
0ans
90
views
Drug-induced long QT — which medications are highest risk and how do you monitor?
48F with schizophrenia on haloperidol, recently started azithromycin for community-acquired pneumonia. Routine ECG shows QTc 520ms (up from baseline 440ms). She is also on ondanset…
0votes
0ans
90
views
Recurrent pericarditis — is colchicine enough or should we add corticosteroids?
32M with third episode of pericarditis in 18 months. CRP 45, ESR elevated, echo shows trace pericardial effusion. ANA, RF, anti-dsDNA negative. First two episodes resolved with NSA…
0votes
0ans
88
views
Severe aortic stenosis with low gradient and preserved EF — when to proceed with TAVR vs SAVR?
78M with exertional dyspnea and syncope. Echo shows AVA 0.7 cm2, mean gradient 28 mmHg (low-gradient pattern), EF 60%. CT calcium score of aortic valve is 3200 AU. STS score is 4.5…
0votes
1ans
90
views
Hypertensive emergency vs urgency — BP 220/130 with headache, when to use IV nicardipine vs oral agents?
55M comes to ED with BP 220/130, severe headache, no focal neuro deficits, fundoscopy normal, no chest pain, ECG normal, troponin negative, creatinine 1.1. Is this hypertensive eme…
0votes
1ans
81
views
Rate control vs rhythm control in new-onset AF — when do you choose cardioversion?
62F with palpitations and mild dyspnea for 6 hours. ECG shows AF with HR 130 bpm. BP 118/78, no hemodynamic compromise. Echo last year was normal. No prior AF history. CHA2DS2-VASc…
0votes
1ans
81
views
Optimizing GDMT in HFrEF — sequencing of ACEi/ARB, beta-blocker, MRA, and SGLT2i?
45M newly diagnosed with HFrEF, EF 30%. Currently on low-dose metoprolol succinate started by a referring physician. BP is 110/70, HR 72, eGFR 58, K+ 4.2. The 2022 AHA/ACC guidelin…
0votes
1ans
81
views
Door-to-balloon time targets in STEMI — when is fibrinolysis preferred over primary PCI?
58M presents with 45-minute chest pain, anterior ST elevation in V1–V4. We are a non-PCI capable center. Nearest cath lab is 2 hours away. ACC/AHA guidelines recommend primary PCI …
67votes
6ans
127
views
NEET PG 2025 — High-yield cardiology mnemonics for valve disorders?
Looking for the best mnemonics for valvular heart disease patterns. Specifically for murmurs, timing, and associated signs in MS, MR, AS, AR.
124votes
14ans
1023
views
Differentiating Takotsubo cardiomyopathy from anterior STEMI — when is urgent cath truly indicated?
35F, post-emotional stress, anterior ST elevation V1-V4, troponin 3.2, echo shows apical ballooning. Cardiology pushing for immediate cath. What do current ACC/AHA criteria say?
For peer discussion only — not a substitute for clinical judgment. Verify with authoritative sources.