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Clinical questions, answered by the people who see them every day. For medical students, residents and the consultants who teach them.

Questions

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Cardiology
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…
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adminOther
129d ago
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97
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Cardiology
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?
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129d ago
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1ans
87
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Cardiology
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…
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adminOther
129d ago
0votes
1ans
86
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Cardiology
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?
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129d ago
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1ans
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Cardiology
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…
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adminOther
129d ago
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1ans
64
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Cardiology
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…
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adminOther
129d ago
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1ans
75
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Cardiology
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?
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adminOther
129d ago
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62
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Cardiology
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?
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129d ago
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71
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Cardiology
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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adminOther
129d ago
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1ans
75
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Cardiology
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…
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129d ago

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