Cairo University – Faculty of Medicine

Cardiology Department

Examination of the Diploma in Cardiology

May,  2001. Paper II, Paper 2.

 

Answer all questions

Time: 3 hours

1- A 68 years old male was admitted to CCU with severe chest pain radiating to both shoulders and back and the condition started 2 hours ago. On examination his heart rate was 110 bpm, BP 190/110 mmHg, short basal precordial systolic murmur and a weak left carotid pulsation. The chest was clear and ECG showed wide complex tachycardia.
Immediate cardiac enzymes were CK 68 mg/dl and MB 18 mg/dl, random blood sugar was 180 mg/dl, blood urea and creatinine of 76 and 1.6 mg/dl.

     a- Discuss the possible differential diagnosis and management.

(20 marks)

     b- On the second day the patient was in acute pulmonary edema, aneuric with progressively elevated urea and creatinine.

Discuss the management.

(20 marks)

2- Indications and mechanism of action of the following:

     a- Angiotensin II antagonists in hypertension.

(15 marks)

     b- B-blockers in heart failure.

(15 marks)

3- Give a full account on the management of a 25 years old patient with an Echocardiographic mitral valve area of 1.3 cm2.

(30 marks)