2018 Board Review Pre-Test:
Adult Congenital Heart Disease for the HF Specialist

Adult Congenital Heart Disease for the HF Specialist - Eric V. Krieger, MD

Please complete this brief Pre-Test to give a baseline for learning .

Question Title

* 1. A 48-year-old with L-loop transposition of the great arteries and no prior interventions presents for worsening exertional intolerance. BP 110/70, HR 85, SaO2 100%. A grade 3 holosystolic murmur is heard over the precordium. TTE shows mild (systemic) right ventricular dysfunction, visually estimated EF 42%, severe tricuspid regurgitation into a dilated left atrium, PASP 45 mmHg. Cardiopulmonary exercise test shows normal chronotropic response and a VO2max is 16 ml/kg/min.

What is the best next step?

A. Lisinopril

B. Carvedilol

C. Referral for transplantation

D. Tricuspid valve replacement

E. Placement of a BiV - ICD

Question Title

* 2. A 42-year-old man with an unrepaired VSD and Eisenmenger syndrome presents to clinic with increased dyspnea on exertion. BP is 102/65, SaO2 88%. He has a right ventricular lift, loud P2, no murmurs. Echocardiogram shows large VSD with low velocity bidirectional flow and moderate right ventricular dysfunction. 6-minute walk distance is 180 meters. Hematocrit is 61%, serum iron 110 mcg/dL, transferrin saturation 28%.

Which of the following is most likely to improve the patient’s symptoms?

A. Iron supplementation

B. Lisinopril

C. Phlebotomy

D. Bosentan

E. Continuous oxygen therapy

Question Title

* 3. Please provide your first and last name.
Pre-test questions will not be scored, your name is required solely to confirm completion.

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