Cardiovascular Concepts: Truths and Lies

Front

Two truths and a lie: Long-term uncontrolled hypertension increases the risk of stroke, heart failure, and kidney disease. Lifestyle modifications such as weight loss and sodium restriction can significantly reduce blood pressure. A single elevated blood pressure reading is sufficient to diagnose chronic hypertension.

Back

A single elevated blood pressure reading is sufficient to diagnose chronic hypertension.

Front

Two truths and a lie: CAD develops due to atherosclerotic plaque narrowing coronary arteries. CAD primarily affects the electrical conduction system rather than coronary blood flow. CAD can reduce myocardial oxygen supply during increased demand.

Back

CAD primarily affects the electrical conduction system rather than coronary blood flow.

Front

Two truths and a lie: NSTEMI causes full-thickness myocardial necrosis similar to STEMI. Both STEMI and NSTEMI can have elevated cardiac troponin levels. STEMI typically presents with ST-segment elevation on ECG.

Back

NSTEMI causes full-thickness myocardial necrosis similar to STEMI.

Front

Two truths and a lie: Cardiac chest pain may radiate to the left arm, jaw, neck, or back. Chest pain associated with diaphoresis and nausea is concerning for myocardial ischemia. Chest pain that improves with rest is always non-cardiac in origin.

Back

Chest pain that improves with rest is always non-cardiac in origin.

Front

Two truths and a lie: Chronic stable angina is predictable and relieved by rest or nitroglycerin. Chronic stable angina results from plaque rupture and thrombus formation. Unstable angina can occur at rest and represents a medical emergency.

Back

Chronic stable angina results from plaque rupture and thrombus formation.

Front

Two truths and a lie: Left-sided heart failure commonly causes pulmonary congestion and dyspnea. Right-sided heart failure may present with peripheral edema and ascites. Heart failure is defined as the heart’s inability to pump blood effectively at all times, regardless of demand.

Back

Heart failure is defined as the heart’s inability to pump blood effectively at all times, regardless of demand.

Front

Two truths and a lie: Blood flows from the right atrium to the right ventricle through the tricuspid valve. Oxygenated blood leaves the left ventricle through the aortic valve into the systemic circulation. Blood flows directly from the right ventricle into the left atrium during normal circulation.

Back

Blood flows directly from the right ventricle into the left atrium during normal circulation.

Front

Two truths and a lie: The SA node normally sets the heart rate at 60–100 bpm. The AV node delays conduction to allow ventricular filling. Purkinje fibers slow conduction to protect the ventricles from rapid atrial rates.

Back

Purkinje fibers slow conduction to protect the ventricles from rapid atrial rates.

Front

Two truths and a lie: S1 is caused by closure of the mitral and tricuspid valves. S2 is caused by closure of the aortic and pulmonic valves. An S4 heart sound is commonly heard in children and young adults.

Back

An S4 heart sound is commonly heard in children and young adults.

Front

Two truths and a lie: The sinoatrial (SA) node is the primary pacemaker of the heart. Electrical impulses travel from the AV node through the bundle of His and Purkinje fibers. The atrioventricular (AV) node initiates ventricular contraction before atrial depolarization.

Back

The atrioventricular (AV) node initiates ventricular contraction before atrial depolarization.