Ujian Kardiovaskuler

A 55-year-old woman comes with complaints of chest pain. What relevant questions regarding the quality of chest pain need to be asked to the patient?

• Does the chest pain feel in the middle of the chest? (location)

• Does the chest pain occur only during heavy activity? (which aggravates)

• Does the chest pain persist continuously or come and go? (onset)

• Does the chest pain feel heavy like being pressed by an object?

• Does the chest pain decrease with rest or with sublingual ISDN 5 mg? (which alleviates)

The patient complains of retrosternal chest pain like being squeezed during activities such as climbing stairs, lasting less than 3 minutes, and disappearing with rest. What is the underlying pathological mechanism of this complaint?

• Erosion of the atheroma plaque causes thrombosis

• Decreased coronary blood flow due to decreased diastolic blood pressure

• Rupture of the plaque causing activation, adhesion, and aggregation of platelets

• Imbalance of supply and demand in the myocardium due to left ventricular hypertrophy

• Imbalance of supply and demand in the myocardium due to fixed stenosis of the epicardial coronary artery

Which of the following is a non-ischemic cardiac chest pain that can lead to a life-threatening condition?

• Chest pain feels heavy like being pressed by an object lasting more than 20 minutes which can sometimes be accompanied by gallop sound

• Retrosternal chest pain like being squeezed during activities such as climbing stairs, lasting less than 3 minutes and disappearing with rest

• Retrosternal chest pain like being pressed with a systolic ejection sound radiating to the neck area

• Chest pain like burning that decreases with food or antacids

• Sudden chest pain like being cut that can occur in patients with Marfan syndrome

Which of the following is an ischemic chest pain originating from cardiac causes?

• Pericarditis

• Mitral valve prolapse

• Coronary vasospasm

• Aortic dissection

• Esophageal rupture

The pathological mechanism of dyspnea due to mechanical disturbances in the ventilation process with impaired lung expansion can occur in which disease?

• Bronchial asthma

• Metabolic acidosis

• Pleural and pericardial effusion

• Left heart failure

• Endobronchial tumor

Dyspnea with paroxysmal nocturnal dyspnea (PND) or orthopnea with the apex shifting caudolaterally is likely originating from which source?

• Cardiac

• Pulmonary

• Esophageal

• Musculoskeletal

• Psychogenic

Paroxysmal nocturnal dyspnea (PND) or orthopnea with apex shifted to caudolateral may originate from ...

• Cardiac

• Pulmonary

• Esophageal

• Musculoskeletal

• Psychogenic

The following are more specific signs of heart failure, except ...

• Elevated jugular venous pressure

• Third heart sound (gallop rhythm)

• Laterally displaced apical impulse

• Cardiac murmur

• Paroxysmal nocturnal dyspnea

Which statement is true regarding the management principles of acute heart failure, namely ...

• Identification of the patient's hemodynamic profile is done after the patient is stable

• Evaluation of congestion is a diagnostic modality not for therapy

• In patients with 'wet and warm' heart failure, diuretics and vasodilators are recommended pharmacological therapies

• In patients with 'wet and warm' heart failure, inotropic drugs are the main therapy → should be cold and wet

• Acute heart failure in acute coronary syndrome can be caused by aortic dissection

Which statement is true regarding the epidemiology of heart failure:

• 50% of patients die within 1 year after diagnosis

• Main cause of hospitalization in patients over 40 years old

• Most heart failure patients have other comorbidities

• Mortality rate in HfrEF patients is higher than in HfpEF

• Almost half of heart failure patients will be readmitted within 3 months after the last treatment