Cert Cardiology(SA) Phys Practice Questions - Sub-specialty Certificate In Cardiology Of The College Of Physicians Of South Africa Exam

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On day 4 post-inferior STEMI, a 62-year-old male suddenly develops severe dyspnea, hypotension (BP 82/50 mmHg), and pulmonary edema. Physical exam reveals a new pan-systolic murmur at the apex radiating to the axilla. Echocardiogram demonstrates hyperdynamic left ventricle with severe acute mitral regurgitation and a flail posteromedial mitral leaflet. What is the definitive management?

Intravenous furosemide, high-dose nitroglycerin, and outpatient cardiology follow-up Percutaneous coronary intervention to the right coronary artery followed by conservative monitoring Thrombolytic therapy to dissolve suspected prosthetic thrombus Emergency cardiac surgery for mitral valve repair or replacement with intra-aortic balloon pump (IABP) stabilization

Correct Answer:

Emergency cardiac surgery for mitral valve repair or replacement with intra-aortic balloon pump (IABP) stabilization

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