Ischemic Heart Disease & Heart Failure — Cardiovascular

Ischemic Heart Disease & Heart Failure MCQs: practice questions

Sample Ischemic Heart Disease & Heart Failure multiple-choice questions from Cardiovascular.

1. BNP (B-type natriuretic peptide) is released in heart failure primarily in response to which stimulus?

   • A. Isolated hepatic dysfunction
   • B. Ventricular wall stretch from overload
   • C. Isolated renal dysfunction with no cardiac involvement
   • D. Direct bacterial infection
   • E. Isolated skeletal muscle injury

2. Pulmonary edema in left heart failure produces which classic histologic finding in the lungs?

   • A. Granulomatous inflammation
   • B. Complete absence of any histologic change
   • C. Isolated squamous metaplasia
   • D. Purely neutrophilic infiltration with no macrophage involvement
   • E. Hemosiderin-laden macrophages ("heart failure cells")

3. Coronary artery bypass grafting is generally indicated in which clinical scenario?

   • A. mainly in patients with largely normal coronary arteries
   • B. mainly for patients with normal ejection fraction
   • C. Significant multivessel disease unmanaged by other therapy
   • D. rarely indicated in ischemic heart disease
   • E. mainly for isolated single-vessel disease

4. Reperfusion injury after successful revascularization of an infarcted vessel results primarily from which mechanism?

   • A. ROS generation and calcium overload on reoxygenation
   • B. Direct mechanical damage from the catheter alone
   • C. Complete absence of any further injury after reperfusion
   • D. Isolated bacterial contamination
   • E. Direct allergic reaction to contrast dye mainly

5. Chronic ischemic heart disease, in the absence of a discrete infarction, can still progressively lead to which condition?

   • A. Complete resolution of any cardiac dysfunction
   • B. Isolated valve calcification with no myocardial effect
   • C. Guaranteed normalization of ejection fraction over time
   • D. Complete absence of any long-term consequence
   • E. Progressive ischemic cardiomyopathy and heart failure

6. Subendocardial infarction preferentially affects which region of the ventricular wall, and why?

7. A ventricular pseudoaneurysm differs from a true ventricular aneurysm in which key structural way?

8. Left ventricular remodeling after a large myocardial infarction can lead to which long-term structural change?

9. Cardiogenic pulmonary edema differs from non-cardiogenic pulmonary edema primarily by which underlying mechanism?

10. Dressler syndrome, a complication occurring weeks after myocardial infarction, is best explained by which mechanism?

11. Papillary muscle rupture following myocardial infarction most directly causes which acute complication?

12. Heart failure with reduced ejection fraction (systolic dysfunction) is best characterized by which mechanism?

13. Congestive heart failure is best defined as which of the following?

14. Unstable angina differs from stable angina primarily because of which change?

15. Left-sided heart failure classically produces congestion in which organ system?

16. Acute decompensated heart failure with severe pulmonary edema and hypotension may require which class of inotropic support?

17. Silent myocardial infarction, occurring without classic chest pain symptoms, is more commonly seen in which patient population?

18. Sudden cardiac death in the setting of coronary artery disease most commonly results from which mechanism?

19. Within minutes of coronary occlusion, myocardial cells first show which change?

20. A transmural myocardial infarction, as opposed to a subendocardial infarction, typically results from which pattern of occlusion?

21. Prinzmetal (vasospastic) angina results from which underlying mechanism?

22. Right-sided heart failure classically produces congestion in which locations?

23. On light microscopy, the earliest visible changes of myocardial infarction typically appear at which time point?

24. Which best explains why the right ventricle is generally more resistant to infarction than the left ventricle?

25. Compensatory neurohormonal activation in chronic heart failure, involving the renin-angiotensin-aldosterone system, ultimately contributes to which harmful long-term effect?

26. The period of highest risk for free wall rupture after myocardial infarction corresponds to which time frame?

27. Stable angina is best explained by which underlying pathophysiology?

28. Heart failure with preserved ejection fraction (diastolic dysfunction) most commonly results from which underlying change?

29. Which cardiac biomarker is considered the most specific and sensitive for diagnosing acute myocardial infarction?

30. Which enzyme elevation pattern is classically used to help identify infarction, given its later, more prolonged rise?