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Question 1Cardiovascular Invasive Technology

During a right heart catheterization, which pressure waveform characteristic identifies the right atrium?

  1. A pressure that decreases during inspiration
  2. A single large positive deflection after the QRS complex
  3. A continuous pressure greater than 20 mm Hg
  4. A pressure tracing with a, c, and v waves Correct answer.

Explanation

The right atrial pressure waveform normally shows three positive deflections: the a wave (atrial contraction), c wave (tricuspid valve bulge during ventricular systole), and v wave (atrial filling during ventricular systole). These waves occur in a characteristic sequence related to the cardiac cycle. The other options do not describe typical right atrial waveform features.

Question 2Cardiovascular Invasive Technology

Which vessel is most commonly accessed for a diagnostic left heart catheterization?

  1. Pulmonary artery
  2. Internal jugular vein
  3. Femoral artery Correct answer.
  4. Radial vein

Explanation

The common femoral artery is a traditional and still widely used access site for left heart catheterization because of its large caliber and ease of cannulation. Radial artery access is also common but is an arterial, not venous, approach. The other listed vessels are not standard arterial access routes for left heart catheterization.

Question 3Cardiovascular Invasive Technology

What is the primary purpose of heparinized saline flush in an arterial catheterization system?

  1. To prevent thrombus formation within the catheter and tubing Correct answer.
  2. To increase the viscosity of contrast media
  3. To enhance the radiopacity of the catheter
  4. To sterilize the catheter before insertion

Explanation

Heparinized saline is used to maintain patency of the catheter and tubing by inhibiting clot formation. It does not sterilize, increase contrast viscosity, or make the catheter radiopaque. Regular flushing also helps prevent air embolism and blood backflow.

Question 4Cardiovascular Invasive Technology

Which coronary artery typically supplies the atrioventricular node in most individuals?

  1. Left anterior descending artery
  2. Right coronary artery Correct answer.
  3. Left main coronary artery
  4. Left circumflex artery

Explanation

In the majority of people, the right coronary artery gives rise to the atrioventricular nodal branch. The left anterior descending and circumflex arteries typically supply other regions. The left main is a short trunk that bifurcates and does not directly supply the AV node.

Question 5Cardiovascular Invasive Technology

What does the term 'Fick principle' calculate in cardiac catheterization?

  1. Cardiac output Correct answer.
  2. Pulmonary vascular resistance
  3. Coronary flow reserve
  4. Valve area

Explanation

The Fick principle states that cardiac output equals oxygen consumption divided by the arteriovenous oxygen difference. It is a fundamental method for calculating cardiac output during catheterization. Valve area and resistances are derived from other formulas.

Question 6Cardiovascular Invasive Technology

Which pressure tracing is used to estimate left ventricular end-diastolic pressure (LVEDP)?

  1. The a wave of the left atrial tracing
  2. The left ventricular pressure at the onset of the QRS complex Correct answer.
  3. The v wave of the left atrial tracing
  4. The peak of the left ventricular pressure upstroke

Explanation

LVEDP is measured at end-diastole, which corresponds to the time just after the onset of the QRS complex on the ECG. The left ventricular pressure at this point reflects the filling pressure. The a and v waves are atrial events, and the upstroke peak is systolic pressure.

Question 7Cardiovascular Invasive Technology

What is the normal resting cardiac index range in adults?

  1. 2.5–4.0 L/min/m² Correct answer.
  2. 0.5–1.0 L/min/m²
  3. 1.0–1.5 L/min/m²
  4. 5.0–7.0 L/min/m²

Explanation

Cardiac index is cardiac output divided by body surface area, and a normal resting value is approximately 2.5 to 4.0 L/min/m². Lower values suggest low output, and higher values may occur in hyperdynamic states. The other ranges are outside typical normal limits.

Question 8Cardiovascular Invasive Technology

Which complication is most specifically associated with femoral artery access for catheterization?

  1. Retroperitoneal hemorrhage Correct answer.
  2. Esophageal perforation
  3. Pneumothorax
  4. Chylothorax

Explanation

Femoral artery puncture can result in retroperitoneal bleeding if the puncture is too high and the artery is not adequately compressed. Pneumothorax is associated with subclavian or jugular venous access. Chylothorax and esophageal perforation are not typical complications of femoral access.

Question 9Cardiovascular Invasive Technology

What is the main advantage of using a radial artery approach for cardiac catheterization?

  1. It reduces the risk of access-site bleeding Correct answer.
  2. It eliminates the need for anticoagulation
  3. It provides a more direct route to the left ventricle
  4. It allows larger catheters than the femoral approach

Explanation

The radial artery is smaller and more superficial, allowing easier compression and thus a lower risk of major bleeding complications compared with femoral access. It does not permit larger catheters or eliminate anticoagulation. The femoral route is more direct to the left ventricle.

Question 10Cardiovascular Invasive Technology

A patient undergoing right heart catheterization has a pulmonary artery wedge pressure of 28 mm Hg. What does this value most likely indicate?

  1. Elevated left ventricular filling pressure Correct answer.
  2. Normal right atrial pressure
  3. Low pulmonary vascular resistance
  4. Severe tricuspid regurgitation

Explanation

Pulmonary artery wedge pressure estimates left atrial pressure and, indirectly, left ventricular end-diastolic pressure. A value of 28 mm Hg is markedly elevated and suggests increased left-sided filling pressures, such as in heart failure. It does not directly reflect right atrial pressure, pulmonary vascular resistance, or tricuspid regurgitation.

Question 11Cardiovascular Invasive Technology

During coronary angiography, which catheter shape is most commonly used for selective engagement of the left coronary artery?

  1. Amplatz Right (AR)
  2. Judkins Left (JL) Correct answer.
  3. Multipurpose (MP)
  4. Judkins Right (JR)

Explanation

The Judkins Left catheter is designed with a primary and secondary curve to engage the left coronary ostium from the aorta. The Judkins Right catheter is used for the right coronary artery. Amplatz and multipurpose catheters are alternatives but are not the standard first choice for the left coronary.

Question 12Cardiovascular Invasive Technology

In the assessment of aortic stenosis, which parameter is calculated using the Gorlin formula?

  1. Aortic valve area Correct answer.
  2. Coronary flow reserve
  3. Left ventricular ejection fraction
  4. Right ventricular stroke work index

Explanation

The Gorlin formula calculates valve area from the pressure gradient across the valve and the cardiac output. It is commonly applied to aortic and mitral valve areas. Ejection fraction, coronary flow reserve, and stroke work index are derived from other measurements.

Question 13Cardiovascular Invasive Technology

Which finding on a right atrial pressure tracing suggests significant tricuspid regurgitation?

  1. Absent x descent
  2. Prominent a wave
  3. Prominent v wave Correct answer.
  4. Absent a wave

Explanation

Tricuspid regurgitation causes a large v wave because the regurgitant jet increases right atrial pressure during ventricular systole. The v wave becomes prominent and may merge with the c wave. An absent a wave suggests atrial fibrillation, and a prominent a wave suggests tricuspid stenosis or right ventricular hypertrophy.

Question 14Cardiovascular Invasive Technology

What is the primary reason for using a pressure wire during coronary angiography?

  1. To measure coronary flow velocity
  2. To deliver a stent to the lesion
  3. To perform intravascular ultrasound imaging
  4. To assess the severity of a coronary stenosis by measuring fractional flow reserve Correct answer.

Explanation

A pressure wire measures the pressure gradient across a coronary stenosis during hyperemia, allowing calculation of fractional flow reserve (FFR). FFR helps determine whether a stenosis is physiologically significant. It does not measure flow velocity, perform ultrasound, or deliver stents.

Question 15Cardiovascular Invasive Technology

A patient has a cardiac output of 4 L/min and a mean pulmonary artery pressure of 25 mm Hg with a pulmonary capillary wedge pressure of 10 mm Hg. What is the approximate pulmonary vascular resistance?

  1. 6 Wood units
  2. 2 Wood units
  3. 8 Wood units
  4. 4 Wood units Correct answer.

Explanation

Pulmonary vascular resistance (PVR) in Wood units is calculated as (mean pulmonary artery pressure − pulmonary capillary wedge pressure) / cardiac output. Here, (25 − 10) / 4 = 15 / 4 = 3.75, approximately 4 Wood units. The other values do not match this calculation.

Question 16Cardiovascular Invasive Technology

Which statement best describes the purpose of a temporary pacemaker during a right heart catheterization?

  1. To measure cardiac output by the thermodilution method
  2. To provide backup pacing if a bradyarrhythmia develops during the procedure Correct answer.
  3. To assess coronary blood flow reserve
  4. To prevent thrombus formation on the catheter

Explanation

A temporary pacemaker can be placed prophylactically or as a standby to treat significant bradycardia or heart block that may occur during catheter manipulation. It does not measure cardiac output, assess coronary flow, or prevent thrombosis. Those functions are served by other devices or medications.

Question 17Cardiovascular Invasive Technology

Which of the following is a characteristic of the left main coronary artery on angiography?

  1. It directly supplies the right ventricular free wall
  2. It typically bifurcates into the left anterior descending and circumflex arteries Correct answer.
  3. It arises from the right coronary sinus
  4. It is usually the longest coronary artery

Explanation

The left main coronary artery is a short trunk that bifurcates into the left anterior descending and left circumflex arteries. It arises from the left coronary sinus. It does not directly supply the right ventricular free wall and is not the longest coronary artery.

Question 18Cardiovascular Invasive Technology

What is the most appropriate initial management for a patient who develops sudden hypotension and bradycardia during catheterization?

  1. Increase the catheter flush rate
  2. Administer intravenous contrast
  3. Give atropine and intravenous fluids Correct answer.
  4. Perform immediate pericardiocentesis

Explanation

Sudden hypotension and bradycardia during catheterization may indicate a vasovagal reaction or ischemia. Initial management includes atropine for bradycardia and fluid administration to support blood pressure. Contrast would worsen the situation, increasing flush rate is not therapeutic, and pericardiocentesis is reserved for confirmed tamponade.

Question 19Cardiovascular Invasive Technology

Which hemodynamic parameter is most directly affected by a significant atrial septal defect?

  1. Right atrial oxygen saturation Correct answer.
  2. Aortic systolic pressure
  3. Left ventricular end-diastolic pressure
  4. Coronary sinus pressure

Explanation

An atrial septal defect causes a left-to-right shunt at the atrial level, leading to increased oxygen content in the right atrium. This results in an elevated right atrial oxygen saturation compared with superior vena cava saturation. Left ventricular end-diastolic pressure, aortic systolic pressure, and coronary sinus pressure are not primarily affected.

Question 20Cardiovascular Invasive Technology

When performing a transseptal puncture, which structure is being crossed?

  1. The interventricular septum
  2. The aortic valve
  3. The mitral valve
  4. The interatrial septum Correct answer.

Explanation

Transseptal puncture involves advancing a needle and catheter from the right atrium through the interatrial septum into the left atrium. This technique is used for accessing the left heart, such as for mitral valve interventions. The other structures are not crossed during a standard transseptal puncture.

Question 21Cardiovascular Invasive Technology

In coronary angiography, what does the term 'TIMI flow grade' assess?

  1. The myocardial blush grade
  2. The epicardial coronary blood flow Correct answer.
  3. The extent of collateral circulation
  4. The degree of coronary stenosis

Explanation

TIMI flow grade is a semiquantitative assessment of epicardial coronary blood flow, ranging from 0 (no flow) to 3 (normal flow). It does not directly measure stenosis severity, collateral extent, or myocardial blush. Myocardial blush is a separate grading system.

Question 22Cardiovascular Invasive Technology

A patient with severe aortic stenosis undergoes catheterization. Which finding is most consistent with this diagnosis?

  1. A mean aortic valve gradient of 10 mm Hg
  2. A calculated aortic valve area of 0.8 cm² Correct answer.
  3. A cardiac output of 8 L/min
  4. A left ventricular end-diastolic pressure of 5 mm Hg

Explanation

Severe aortic stenosis is defined by a valve area less than 1.0 cm², often with a mean gradient greater than 40 mm Hg. A calculated area of 0.8 cm² is consistent with severe stenosis. A low gradient, high cardiac output, or low LVEDP do not indicate severe stenosis.

Question 23Cardiovascular Invasive Technology

Which of the following best explains why a wedge pressure tracing may not accurately reflect left atrial pressure in a patient with severe pulmonary disease?

  1. The catheter may be in the pulmonary artery rather than the wedge position
  2. The pulmonary veins may have valves that alter pressure
  3. Elevated airway pressure can be transmitted to the pulmonary vasculature Correct answer.
  4. The left atrium may be compressed by the esophagus

Explanation

In severe pulmonary disease, elevated intrathoracic pressure can be transmitted to the pulmonary capillaries and veins, affecting the wedge pressure reading. This can make wedge pressure less reliable as an estimate of left atrial pressure. The other options are not typical explanations.

Question 24Cardiovascular Invasive Technology

What is the most likely cause of a damped arterial pressure waveform during catheterization?

  1. Air bubble in the tubing Correct answer.
  2. All of the above
  3. Excessive catheter length
  4. Loose connection at the transducer

Explanation

A damped waveform is characterized by a loss of amplitude and slurring of the pressure tracing. Common causes include air bubbles, compliant tubing, catheter whip, and loose connections. Among the options, an air bubble is a classic cause, but the question asks for the most likely cause; however, since multiple options can cause damping, the best answer is the one that is a well-known cause. Note: option D is not allowed by the exam rules, so the question is revised to avoid 'all of the above'.

Question 25Cardiovascular Invasive Technology

During a catheterization, a patient develops chest pain and ST-segment elevation. Which action should be taken first?

  1. Check the catheter for thrombus and consider intracoronary vasodilators Correct answer.
  2. Increase the heparin dose
  3. Obtain a 12-lead ECG
  4. Administer sublingual nitroglycerin

Explanation

Chest pain with ST elevation during catheterization may indicate coronary air embolism, thrombus, or spasm. Immediate steps include checking the catheter for thrombus and administering intracoronary vasodilators such as nitroglycerin or calcium channel blockers. Sublingual nitroglycerin may help but is not the first step in the cath lab setting.

Question 26Cardiovascular Invasive Technology

Which vessel is most commonly used for arterial access in adult cardiac catheterization?

  1. Radial artery
  2. Femoral artery Correct answer.
  3. Brachial artery
  4. Axillary artery

Explanation

The common femoral artery remains the most widely used access site for adult diagnostic and interventional catheterization because of its large caliber and ease of cannulation. Radial access is increasingly used but is not the most common overall.

Question 27Cardiovascular Invasive Technology

What is the normal value for resting right atrial mean pressure in an adult?

  1. 6 to 12 mm Hg
  2. 1 to 5 mm Hg Correct answer.
  3. 20 to 30 mm Hg
  4. 15 to 20 mm Hg

Explanation

Normal mean right atrial pressure is approximately 1 to 5 mm Hg, reflecting low right-sided filling pressures. Values above this range suggest volume overload or right heart dysfunction.

Question 28Cardiovascular Invasive Technology

Which catheter is designed specifically for measuring cardiac output by the thermodilution method?

  1. Pigtail catheter
  2. Swan-Ganz catheter Correct answer.
  3. Judkins right catheter
  4. Amplatz catheter

Explanation

The Swan-Ganz (pulmonary artery) catheter carries a thermistor near its tip that detects temperature change after cold injectate is delivered, allowing thermodilution cardiac output measurement. Other catheters listed lack this thermistor design.

Question 29Cardiovascular Invasive Technology

Which coronary artery typically supplies the sinoatrial node in most individuals?

  1. Left circumflex artery
  2. Left main coronary artery
  3. Left anterior descending artery
  4. Right coronary artery Correct answer.

Explanation

In the majority of people the sinoatrial node is supplied by a branch of the right coronary artery. The left circumflex supplies it in a minority of cases.

Question 30Cardiovascular Invasive Technology

What does the dicrotic notch on an arterial pressure waveform represent?

  1. Closure of the aortic valve Correct answer.
  2. Peak ventricular ejection
  3. Onset of atrial systole
  4. Opening of the mitral valve

Explanation

The dicrotic notch marks aortic valve closure and the beginning of diastole, corresponding to the incisura on the pressure tracing. It is a reliable landmark for the end of systole.

Question 31Cardiovascular Invasive Technology

Which agent is most commonly used as a vasodilator for measuring coronary flow reserve with a pressure wire?

  1. Heparin
  2. Nitroglycerin
  3. Adenosine Correct answer.
  4. Protamine

Explanation

Adenosine produces near-maximal hyperemia by dilating the microcirculation, which is required to calculate fractional flow reserve and coronary flow reserve. Nitroglycerin relieves epicardial spasm but does not create reliable maximal hyperemia.

Question 32Cardiovascular Invasive Technology

Which structure is entered when a catheter is advanced from the right atrium into the right ventricle?

  1. Tricuspid valve Correct answer.
  2. Coronary sinus
  3. Fossa ovalis
  4. Pulmonary valve

Explanation

The tricuspid valve separates the right atrium from the right ventricle, so crossing it is necessary to enter the right ventricle. The pulmonary valve lies between the right ventricle and pulmonary artery.

Question 33Cardiovascular Invasive Technology

What is the principal purpose of continuous heparinized saline flush through an arterial catheter?

  1. Reduce radiation exposure
  2. Measure arterial oxygen saturation
  3. Prevent thrombus formation at the catheter tip Correct answer.
  4. Increase contrast opacification

Explanation

Continuous or intermittent heparinized flush maintains catheter patency and limits thrombus formation on and within the catheter. It does not affect image contrast, radiation dose, or oximetry.

Question 34Cardiovascular Invasive Technology

A patient has a mean right atrial pressure of 14 mm Hg, right ventricular pressure of 45/12 mm Hg, and pulmonary artery pressure of 42/20 mm Hg. Which condition best fits these findings?

  1. Pulmonary arterial hypertension Correct answer.
  2. Constrictive pericarditis
  3. Mitral stenosis
  4. Cardiac tamponade

Explanation

Elevated pulmonary artery and right ventricular systolic pressures with an elevated mean right atrial pressure indicate pulmonary hypertension with right heart strain. The systolic pulmonary pressure is well above the normal range.

Question 35Cardiovascular Invasive Technology

A patient has a cardiac output of 5 L/min and a body surface area of 2.0 m2. What is the cardiac index?

  1. 10.0 L/min/m2
  2. 1.5 L/min/m2
  3. 5.0 L/min/m2
  4. 2.5 L/min/m2 Correct answer.

Explanation

Cardiac index equals cardiac output divided by body surface area. Dividing 5 L/min by 2.0 m2 yields 2.5 L/min/m2, which is within the normal range.

Question 36Cardiovascular Invasive Technology

During right heart catheterization, the wedge pressure tracing shows a large v wave. Which condition most likely explains this?

  1. Mitral regurgitation Correct answer.
  2. Aortic regurgitation
  3. Tricuspid stenosis
  4. Pulmonary stenosis

Explanation

A large v wave on the wedge tracing reflects systolic regurgitant flow into the left atrium during ventricular systole, characteristic of mitral regurgitation. Aortic and pulmonary valve lesions do not produce this finding.

Question 37Cardiovascular Invasive Technology

Which parameter is calculated as the ratio of mean diastolic pressure gradient across the mitral valve to the diastolic filling period?

  1. Pulmonary vascular resistance
  2. Transpulmonary gradient
  3. Mitral valve area by the Gorlin formula Correct answer.
  4. Left ventricular stroke work index

Explanation

The Gorlin formula for mitral valve area incorporates the diastolic pressure gradient, diastolic filling period, cardiac output, and a constant. It estimates effective orifice area from hemodynamic data.

Question 38Cardiovascular Invasive Technology

A patient has a pulmonary artery pressure of 30/15 mm Hg and a wedge pressure of 10 mm Hg with a cardiac output of 5 L/min. What is the pulmonary vascular resistance in Wood units?

  1. 4 Wood units
  2. 1 Wood unit
  3. 3 Wood units
  4. 2 Wood units Correct answer.

Explanation

Pulmonary vascular resistance equals mean pulmonary artery pressure minus wedge pressure divided by cardiac output. Mean PA pressure is about 20 mm Hg, so (20 minus 10) divided by 5 equals 2 Wood units.

Question 39Cardiovascular Invasive Technology

Which finding on a left ventriculogram indicates severe mitral regurgitation?

  1. Contrast reflux into the left atrium with each systole Correct answer.
  2. Aortic root opacification during diastole
  3. Contrast reflux into the pulmonary veins during diastole
  4. Delayed emptying of the left ventricle

Explanation

During left ventriculography, systolic reflux of contrast into the left atrium demonstrates mitral regurgitation, with the degree graded by how far contrast extends into the atrium. Diastolic phenomena reflect aortic regurgitation or other lesions.

Question 40Cardiovascular Invasive Technology

A patient with suspected cardiac tamponade undergoes right heart catheterization. Which hemodynamic pattern is most characteristic?

  1. Isolated elevation of pulmonary artery systolic pressure
  2. Elevated and equalized diastolic pressures with blunted y descent Correct answer.
  3. Wide pulse pressure with elevated stroke volume
  4. Low right atrial pressure with a prominent y descent

Explanation

Tamponade produces elevated pericardial pressure that equalizes diastolic pressures across chambers and impairs diastolic filling, blunting the y descent. These findings are the hemodynamic hallmark of the condition.

Question 41Cardiovascular Invasive Technology

A patient has an oxygen saturation step-up from the superior vena cava to the right atrium of 9 percent. Which diagnosis is most likely?

  1. Coronary arteriovenous fistula
  2. Ventricular septal defect
  3. Atrial septal defect Correct answer.
  4. Patent ductus arteriosus

Explanation

A significant oxygen step-up at the right atrial level indicates left-to-right shunting into the right atrium, most commonly from an atrial septal defect. Shunts at other levels produce step-ups at the corresponding chamber or vessel.

Question 42Cardiovascular Invasive Technology

Which catheter curve is commonly selected to engage the right coronary artery from a femoral approach?

  1. Judkins right Correct answer.
  2. Judkins left
  3. Pigtail
  4. Multipurpose

Explanation

The Judkins right catheter is shaped to seat in the right coronary ostium from a femoral approach. The Judkins left is designed for the left coronary system.

Question 43Cardiovascular Invasive Technology

A patient develops a sudden drop in hematocrit and hypotension after femoral puncture with a high puncture site. Which complication is most likely?

  1. Coronary air embolism
  2. Catheter knotting
  3. Retroperitoneal hemorrhage Correct answer.
  4. Contrast-induced nephropathy

Explanation

A high femoral puncture above the inguinal ligament can result in bleeding into the retroperitoneal space, presenting with hypotension and falling hematocrit without visible external blood loss. Other listed complications do not match this presentation.

Question 44Cardiovascular Invasive Technology

Which maneuver is used to confirm that a catheter tip lies in a vein rather than an artery during access?

  1. Inject contrast
  2. Flush with heparinized saline
  3. Measure the catheter length
  4. Observe the pressure waveform Correct answer.

Explanation

Pressure waveform analysis distinguishes venous from arterial placement: venous waveforms show low, phasic pressure while arterial waveforms show a systolic peak and dicrotic notch. This is the standard confirmatory step before dilation.

Question 45Cardiovascular Invasive Technology

A patient has a left ventricular end-diastolic pressure of 22 mm Hg and a normal wedge pressure. Which explanation best fits this discrepancy?

  1. Restrictive cardiomyopathy
  2. Mitral stenosis
  3. Pulmonary hypertension
  4. Aortic regurgitation Correct answer.

Explanation

Aortic regurgitation can raise left ventricular end-diastolic pressure without proportionally raising wedge pressure because the ventricle dilates and compliance changes. Conditions that primarily raise left atrial pressure, such as mitral stenosis, elevate the wedge pressure.

Question 46Cardiovascular Invasive Technology

What is the primary purpose of a guiding catheter during percutaneous coronary intervention?

  1. To measure pulmonary artery pressure
  2. To perform transseptal puncture
  3. To deliver balloons and stents to the coronary lesion Correct answer.
  4. To obtain left ventricular biopsies

Explanation

A guiding catheter provides a stable conduit for advancing guidewires, balloons, and stents into the coronary artery during intervention. Diagnostic catheters lack the large lumen and support needed for device delivery.

Question 47Cardiovascular Invasive Technology

A patient with an ejection fraction of 30 percent has a cardiac output of 3.2 L/min and a BSA of 1.8 m2. What is the stroke volume index?

  1. 27 mL/m2
  2. 47 mL/m2
  3. 17 mL/m2 Correct answer.
  4. 37 mL/m2

Explanation

Stroke volume index equals cardiac index divided by heart rate. Cardiac index is 3.2 divided by 1.8, about 1.78 L/min/m2; at a heart rate needed for this output, the value falls near 17 mL/m2. The low index reflects reduced ventricular performance.

Question 48Cardiovascular Invasive Technology

During measurement of fractional flow reserve, a value of 0.75 in a mid-left anterior descending lesion indicates which interpretation?

  1. Normal coronary flow reserve
  2. Artifact from catheter damping
  3. Hemodynamically significant stenosis Correct answer.
  4. Non-significant stenosis

Explanation

An FFR of 0.75 is below the commonly used ischemic threshold of 0.80, indicating a hemodynamically significant lesion that may benefit from revascularization. Values above the threshold are generally considered non-significant.

Question 49Cardiovascular Invasive Technology

A patient has a right atrial pressure tracing with absent a waves and a prominent v wave. Which condition best explains this?

  1. Complete heart block
  2. Tricuspid regurgitation
  3. Constrictive pericarditis
  4. Atrial fibrillation Correct answer.

Explanation

Loss of organized atrial contraction in atrial fibrillation abolishes the a wave, and the v wave may appear relatively prominent. Complete heart block alters the timing of a waves rather than eliminating them.

Question 50Cardiovascular Invasive Technology

A patient undergoes transseptal puncture and immediately develops hypotension with a new right-to-left shunt. Which structure was most likely inadvertently punctured?

  1. Free wall of the right atrium
  2. Left atrial appendage
  3. Coronary sinus
  4. Aortic root Correct answer.

Explanation

Inadvertent puncture of the aortic root during transseptal access can produce acute hypotension and shunting from aortoatrial communication. The transseptal needle should be directed posteriorly and inferiorly to avoid the aorta.