ABIM Cardiology key terms

A pressure-wire measurement comparing distal coronary pressure with aortic pressure during maximal hyperemia. An FFR of 0.80 or less identifies a stenosis likely to cause ischemia and benefit from revascularization.

A clinical syndrome caused by acute coronary plaque rupture or erosion with thrombosis, spanning unstable angina, non-ST-elevation myocardial infarction, and ST-elevation myocardial infarction. Diagnosis combines symptoms, ECG changes, and cardiac troponin.

An angiographic classification of epicardial coronary flow from 0, meaning no flow, to 3, meaning normal flow. Lower grades after reperfusion predict worse outcomes and are used in trials and procedural assessment.

Use of aspirin plus a P2Y12 inhibitor after acute coronary syndrome or coronary stenting. Duration depends on bleeding and ischemic risk; premature interruption increases stent thrombosis and recurrent ischemic events.

Heart failure with left ventricular ejection fraction of 40 percent or less. Guideline-directed therapy includes renin-angiotensin system inhibition, beta blockade, mineralocorticoid receptor antagonism, and SGLT2 inhibition.

Heart failure with left ventricular ejection fraction of 50 percent or greater and evidence of diastolic dysfunction or elevated filling pressures. It often accompanies hypertension, obesity, diabetes, and atrial fibrillation; SGLT2 inhibitors improve outcomes.

Hormones released by stretched myocardium, measured as BNP or NT-proBNP. Elevated values support heart failure diagnosis and prognosis but are confounded by age, renal function, obesity, and atrial fibrillation.

Biventricular pacing for selected patients with reduced ejection fraction and ventricular conduction delay, typically left bundle branch block with QRS duration of 150 ms or more. It improves symptoms and survival in appropriate candidates.

Inherited cardiomyopathy characterized by otherwise unexplained left ventricular hypertrophy, often from sarcomere gene variants. Dynamic left ventricular outflow tract obstruction, diastolic dysfunction, arrhythmia, and sudden death risk guide management.

Infiltrative cardiomyopathy from extracellular amyloid fibrils, commonly transthyretin or light-chain type. Findings include thickened ventricles, diastolic heart failure, low ECG voltage, and elevated troponin or natriuretic peptides.

Supraventricular arrhythmia with disorganized atrial activation and absent effective atrial contraction. It increases stroke and heart failure risk; management addresses anticoagulation, rate control, rhythm control, and precipitating conditions.

A tachycardia originating below the atrioventricular node, usually in ventricular myocardium, with wide QRS complexes. Sustained or hemodynamically unstable ventricular tachycardia requires urgent cardioversion; scar-related reentry is common.

Third-degree atrioventricular block with no conduction from atria to ventricles, producing AV dissociation. It can cause syncope, heart failure, or sudden death and usually requires permanent pacing unless reversible.

A congenital accessory pathway causing ventricular preexcitation, short PR interval, and delta waves. Atrial fibrillation can conduct rapidly over the pathway and degenerate into ventricular fibrillation; accessory-pathway ablation is definitive.

Abnormally long ventricular repolarization on ECG, predisposing to torsades de pointes. Causes include drugs, hypokalemia, hypomagnesemia, bradycardia, and congenital channelopathies; management removes triggers and may use magnesium or pacing.

Polymorphic ventricular tachycardia occurring with QT prolongation, showing twisting QRS complexes around the baseline. Management includes magnesium, correction of electrolytes, removal of offending drugs, and overdrive pacing when recurrent.

Narrowing of the aortic valve that obstructs left ventricular outflow. Severe symptomatic aortic stenosis warrants valve replacement; symptoms include angina, syncope, and dyspnea, and medical therapy does not alter the obstruction.

Retrograde blood flow from left ventricle to left atrium during systole due to leaflet, chordal, annular, or ventricular disease. Severe chronic mitral regurgitation can cause volume overload, pulmonary hypertension, heart failure, and atrial fibrillation.

Diastolic retrograde flow from aorta into left ventricle due to incompetent aortic leaflets or aortic root disease. Chronic severe regurgitation causes volume overload and eventually left ventricular dysfunction, often before symptoms appear.

Obstruction to left atrial emptying across the mitral valve, most often from rheumatic scarring. It causes dyspnea, atrial fibrillation, pulmonary hypertension, and thromboembolism; severe symptomatic cases may need balloon commissurotomy or surgery.

Pericardial fluid accumulation raising intrapericardial pressure enough to impair ventricular filling. Hypotension, elevated jugular venous pressure, pulsus paradoxus, and echocardiographic chamber collapse indicate urgent pericardiocentesis.

Pericardial scarring restricts cardiac filling, causing right-sided heart failure, elevated venous pressure, and preserved ventricular systolic function. Echocardiography and cardiac catheterization show ventricular interdependence and discordant respiratory pressure changes.

Inflammation of myocardium from viral infection, immune reaction, or toxin, presenting with chest pain, arrhythmia, or heart failure. Diagnosis uses troponin, ECG, imaging, and sometimes endomyocardial biopsy; treatment is largely supportive.

Blood pressure above goal despite adherence to three antihypertensive drug classes, including a diuretic, at optimal doses. Evaluation addresses adherence, secondary causes, and drug interactions; spironolactone is often added.

Tear in the aortic intima allows blood to track within the media, creating a false lumen. Sudden severe chest or back pain, pulse deficits, and imaging findings require urgent blood pressure control and surgery for type A.

Atherosclerotic obstruction of lower extremity arteries causing claudication, rest pain, or tissue loss. Ankle-brachial index supports diagnosis; management includes smoking cessation, exercise, lipid therapy, and revascularization for limb threat.

Adrenal aldosterone excess causing hypertension and often hypokalemia, suppressed renin, and metabolic alkalosis. Screening uses the aldosterone-to-renin ratio; adrenal imaging and adrenal vein sampling distinguish unilateral from bilateral disease.

A disease of small pulmonary arteries that raises pulmonary vascular resistance and mean pulmonary arterial pressure while left-sided filling pressures remain normal. Symptoms include exertional dyspnea; targeted vasodilators improve outcomes in selected patients.

Obstruction of pulmonary arteries by thrombus, usually from deep vein thrombosis. Presentation ranges from pleuritic pain to obstructive shock; risk stratification guides anticoagulation, thrombolysis, or catheter-directed therapy.

Reversal of a left-to-right shunt to right-to-left because pulmonary vascular disease raises pulmonary vascular resistance above systemic resistance. It causes cyanosis, erythrocytosis, and right heart failure; shunt closure is contraindicated.

A defect in the ventricular septum allowing left-to-right shunting. Small defects may close spontaneously; large defects cause heart failure and pulmonary overcirculation, requiring closure before pulmonary vascular disease becomes irreversible.

A congenital aortic valve with two leaflets, often predisposing to aortic stenosis, regurgitation, and ascending aortic aneurysm. Surveillance includes echocardiography and aortic imaging; valve replacement and aortic repair are timed by severity.

A computed tomography measure of calcified coronary plaque burden, reported as an Agatston score. It refines cardiovascular risk estimation, especially in asymptomatic adults with uncertain risk, but does not identify noncalcified plaque.

Sex- and race-specific equations from the American College of Cardiology and American Heart Association estimating 10-year atherosclerotic cardiovascular disease risk from routine factors. They guide statin and risk-factor decisions but may miscalibrate in some groups.

A lipoprotein consisting of an LDL-like particle covalently bound to apolipoprotein(a). Genetically determined high levels independently increase atherosclerotic and aortic valve disease risk and are not adequately treated by statins.

A statin regimen producing at least a 50 percent LDL cholesterol reduction, such as atorvastatin 40 to 80 mg or rosuvastatin 20 to 40 mg. It is used for established ASCVD and high-risk primary prevention.

A perioperative tool estimating major cardiac complications after noncardiac surgery using six clinical predictors: ischemic heart disease, heart failure, cerebrovascular disease, insulin-dependent diabetes, renal impairment, and high-risk surgery.

Inadequate tissue perfusion from cardiac pump failure, often after myocardial infarction, with hypotension, elevated filling pressures, and end-organ dysfunction. Treatment includes revascularization, vasopressors, inotropes, and mechanical circulatory support in selected patients.

Severe blood pressure elevation with acute target-organ damage such as encephalopathy, aortic dissection, pulmonary edema, or acute kidney injury. It requires controlled intravenous reduction, not rapid normalization, to avoid organ ischemia.