Offer your diagnosis of a 39-year-old man with severe pulmonary hypertension and markedly variable pulmonary capillary wedge pressures among lung segments.

A 63-year-old male smoker with type 2 diabetes presents for the first time with chest pain and shortness of breath at rest. He has no recent history of viral infection and no family history of heart failure or sudden cardiac death. Initial laboratory testing documents negative troponin, normal calcium, normal serum angiotensin-converting-enzyme (ACE) activity, and…

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How do you handle a patient with pheochromocytoma who is not absorbing antiplatelet therapy adequately after placement of a bare-metal stent?

A 91-year-old man with mild drug-controlled hypertension and atrial fibrillation has long-term, well-managed stability on warfarin anticoagulation. After developing problems with his balance and some gait instability, a physical exam reveals a carotid bruit. Carotid ultrasound and magnetic resonance angiography (MRA) confirm >95% stenosis of the right internal carotid artery. Brain CT is negative. Questions:…

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Does your institution use the LifeVest strategy routinely during the waiting period after an MI?

A drug-eluting stent is successfully implanted after an acute inferior MI in a fit 70-year-old man. What do you do for the bystander disease detected at the LAD/D1 junction?

Is cardioversion without a repeat transesophageal echocardiogram appropriate when an initial TEE revealed a small thrombus and the patient has already undergone 3 weeks of anticoagulation?

A 75-year-old woman presents to a general cardiology clinic for the first time. She has a history of atrial fibrillation, sick-sinus syndrome requiring a permanent pacemaker, hypertension, and dyslipidemia. She has no specific complaints other than shortness of breath on exertion. Her medications include aspirin (81 mg daily), carvedilol (25 mg twice daily), lisinopril (5…

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An 89-year-old woman with severe aortic stenosis is referred to a cardiologist at a major academic center that offers transcatheter aortic valve implantation (TAVI). A widow for 20 years, the patient lives alone and does well with the assistance of her daughter, who lives nearby. She has two more children in the same town, as…

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A 22-year-old white man presented to the ER with acute non-ST-segment-elevation MI, after playing basketball. He had experienced chest pain on and off for more than 10 hours before presentation. His initial EKG showed T-wave inversions in leads III and avF (see image), and his troponin T level was 1.2 ng/mL. The patient’s initial pain…

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