The bypass conduit with the highest patency rate is the:
The most important criterion in conduit selection is graft patency. The conduit with the highest patency rate (98% at 5 years and 85-90% at 10 years) is the internal thoracic artery which is most commonly left attached proximally to the subclavian artery (although occasionally used as a free graft) and anastomosed distally to the target coronary artery. The use of both internal thoracic arteries has been shown to increase event-free survival in a number of studies.
Which of the following is true about angina pectoris?
Angina pectoris is the pain or discomfort caused by myocardial ischemia and is typically substernal and may radiate to the left upper extremity, left neck, or epigastrium. The variety of presentations can make myocardial ischemia difficult to diagnose. Characteristics of chest pain that make myocardial ischemia less likely include: pleuritic chest pain, pain reproducible by movement or palpation, or brief episodes lasting only seconds. Typical angina is relieved by rest and/or use of sublingual nitroglycerin. Differential diagnoses to be considered include, but are not limited to, musculoskeletal pain, pulmonary disorders, esophageal spasm, pericarditis, aortic dissection, gastroesophageal reflux, neuropathic pain, and anxiety.
A holosystolic murmer that is accompanied by a ventricular septal defect is associated with the following etiology:
Classification of cardiac murmurs:
AI = aortic insufficiency; ASD = atrial septal defect; MR = mitral regurg itation; MS = mitral stenosis. MVP = mitral valve prolapse; PDA = patent d uctus arteriosus; PR = pulmonic regurg itation; Tl = tricuspid insufficiency; TS = tricuspid stenosis;VSD = ventricular septal defect.
The following is NOT true ofleft ventricular aneurysms:
Symptoms of left ventricle (LV) aneurysms include angina, congestive heart failure (CHF), ventricular arrhythmias, and rarely embolic phenomenon. Rupture is extremely uncommon. Patients generally present for coronary artery bypass or during evaluation of CHF or arrhythmias. While transthoracic echocardiography gives pertinent information regarding LV function, size, mitral valve function, and the presence of thrombus, it is generally accepted that cardiac magnetic resonance imaging (MRI) is the best diagnostic modality to accurately identify areas of scar and viable tissue, and to best define ventricular geometry.
The most common arrhythmia worldwide is:
Atrial fibrillation (AF) remains the most common arrhythmia in the world with an overall incidence of 0.4 to 1% that increases to 8% in those older than 80 years. The most serious complication of AF is thromboembolism with resultant stroke, but serious morbidity and mortality may also result from hemodynamic compromise due to loss of atrial contraction, exacerbations of CHF from atrioventricular asynchrony and tachycardia-induced cardiomyopathy.
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