Quiz 9

Question 5

Cardiology Quiz

Student:

Question 9

The cineangiograms of the patient's left and right coronary angiograms and the left internal mamary artery (LIMA) graft to the left anterdior descending (LAD) are shown below. You can cycle through the various cine views by clicking the "next cine" and "prior cine" buttns. The latter button will appaer after you move to the second cine. Please answer the question below after you have reviewed the five views.

[ Click Here to Enlarge the Video size ]

FOR AUDIO: Click the Speaker Icon to "unmute" Audio

Based upon the five angiograms shown above, what would you expect to see in the next angiogram of the reversed saphenous vein graft (SVG) to the right coronary artery (RCA):

A. Totally occluded SVG to RCA
B. Signigficant lesion in either the SVG or native RCA with collaterals to the circumflex (Cx)
C. Signigficant lesion in either the SVG or native RCA without collaterals to the Cx
D. Total occlusion of the RCA, distal to the graft anastamosis
E. Hemodynamically insignificant lesion in the SVG to RCA

Please check the box that is the most likely correct answer.

Answer A

No, this is not the correct answer. Please click on the Retry button

Answer B

You selected the correct answer.
The isotope stress test revealed a reversible inferior and posterolateral deficit. This finding is consistent with viable muscle being supplied either via antegrade flow from a grafted vessel or via collaterals. The above angiograms revealed total occlusion of the proximal RCA and Cx with collateral flow to the RCA (via the LIMA to the LAD). There were no cillaterals to the Cx. This would suggest that the Cx must be supplied by the only remaining vessel (SVG to the RCA). Thus, this vessel would be expected to have some patency. A significant associated lesion would also be anticipated to account for the ischemia in the distribution of the RCA (inferior wall) and Cx (posterolateral wall).
Please click on the arrow here or on the top and bottom right to move to the next question

Answer C

No, this is not the correct answer. Please click on the Retry button

Answer D

No, this is not the correct answer. Please click on the Retry button

Answer E

No, this is not the correct answer. Please click on the Retry button

Student:

Question 10

Quiz

Based upon the five angiograms shown above, what would you expect to see in the next angiogram of the reversed saphenous vein graft (SVG) to the right coronary artery (RCA):

Menu