1. A 45-year-old man with a history of hypertrophic cardiomyopathy presents with syncope during exercise. Echocardiography reveals severe left ventricular outflow tract obstruction. Which of the following is the most appropriate next step in management?
A. Initiate beta-blocker therapy
B. Initiate disopyramide therapy
C. Perform septal myectomy
D. Perform alcohol septal ablation
E. Recommend implantable cardioverter-defibrillator (ICD) placement
2. A 60-year-old woman with a history of dilated cardiomyopathy presents with progressive dyspnea and lower extremity edema. Echocardiography reveals a severely reduced left ventricular ejection fraction of 25%. Which of the following is the most appropriate medication to initiate?
A. Angiotensin-converting enzyme (ACE) inhibitor
B. Angiotensin II receptor blocker (ARB)
C. Diuretic
D. Beta-blocker
E. Hydralazine and nitrate
3. A 35-year-old man presents with chest pain, shortness of breath, and palpitations. Electrocardiography reveals diffuse ST-segment elevation, and cardiac biomarkers are elevated. Cardiac magnetic resonance imaging (MRI) shows patchy late gadolinium enhancement in the myocardium. Which of the following is the most likely diagnosis?
A. Acute myocardial infarction
B. Myocarditis
C. Takotsubo cardiomyopathy
D. Hypertrophic cardiomyopathy
E. Arrhythmogenic right ventricular cardiomyopathy
4. A 40-year-old woman with a history of infiltrative cardiomyopathy presents with progressive dyspnea and peripheral edema. Echocardiography reveals a thickened, bright left ventricular myocardium with restrictive filling patterns. Which of the following is the most likely underlying condition?
A. Amyloidosis
B. Sarcoidosis
C. Hemochromatosis
D. Fabry disease
E. Endomyocardial fibrosis
5. A 55-year-old man with a history of hypertrophic cardiomyopathy presents with recurrent episodes of syncope. Electrocardiography reveals non-sustained ventricular tachycardia. Which of the following is the most appropriate next step in management?
A. Initiate antiarrhythmic drug therapy
B. Perform alcohol septal ablation
C. Perform implantable cardioverter-defibrillator (ICD) placement
D. Refer for cardiac transplantation
E. Recommend lifestyle modifications and close monitoring
6. A 65-year-old man with a history of dilated cardiomyopathy presents with worsening dyspnea and lower extremity edema. Echocardiography reveals a severely reduced left ventricular ejection fraction of 20%. Which of the following is the most appropriate medication to initiate?
A. Angiotensin-converting enzyme (ACE) inhibitor
B. Angiotensin II receptor blocker (ARB)
C. Diuretic
D. Beta-blocker
E. Hydralazine and nitrate
7. A 50-year-old woman with a history of arrhythmogenic right ventricular cardiomyopathy (ARVC) presents with sustained ventricular tachycardia. Which of the following is the most appropriate initial management?
A. Initiate antiarrhythmic drug therapy
B. Perform catheter ablation
C. Perform implantable cardioverter-defibrillator (ICD) placement
D. Refer for heart transplantation
E. Recommend lifestyle modifications and close monitoring
8. A 30-year-old man with a history of dilated cardiomyopathy presents with chest pain, shortness of breath, and fever. Electrocardiography reveals diffuse ST-segment elevation, and cardiac biomarkers are elevated. Which of the following is the most appropriate next step in management?
A. Initiate antibiotic therapy
B. Initiate immunosuppressive therapy
C. Perform endomyocardial biopsy
D. Perform cardiac magnetic resonance imaging (MRI)
E. Refer for heart transplantation
9. A 45-year-old woman with a history of hypertrophic cardiomyopathy presents with exertional dyspnea and syncope. Echocardiography reveals severe left ventricular outflow tract obstruction. Which of the following is the most appropriate treatment?
A. Initiate disopyramide therapy
B. Perform septal myectomy
C. Perform alcohol septal ablation
D. Recommend implantable cardioverter-defibrillator (ICD) placement
E. Refer for heart transplantation
10. A 55-year-old man with a history of ischemic cardiomyopathy presents with worsening dyspnea and lower extremity edema. Echocardiography reveals a left ventricular ejection fraction of 25% and severe mitral regurgitation. Which of the following is the most appropriate next step in management?
A. Initiate angiotensin-converting enzyme (ACE) inhibitor therapy
B. Perform percutaneous mitral valve repair
C. Perform surgical mitral valve repair or replacement
D. Refer for cardiac resynchronization therapy
E. Recommend palliative care
11. A 40-year-old woman with a history of Fabry disease presents with progressive left ventricular hypertrophy and heart failure symptoms. Cardiac magnetic resonance imaging (MRI) shows diffuse late gadolinium enhancement in the myocardium. Which of the following is the most appropriate treatment?
A. Enzyme replacement therapy
B. Initiate angiotensin-converting enzyme (ACE) inhibitor therapy
C. Perform septal myectomy
D. Refer for heart transplantation
E. Recommend palliative care
12. A 60-year-old man with a history of dilated cardiomyopathy presents with recurrent episodes of sustained ventricular tachycardia. Which of the following is the most appropriate next step in management?
A. Initiate antiarrhythmic drug therapy
B. Perform catheter ablation
C. Perform implantable cardioverter-defibrillator (ICD) placement
D. Refer for cardiac resynchronization therapy
E. Recommend palliative care
13. A 50-year-old woman with a history of arrhythmogenic right ventricular cardiomyopathy (ARVC) presents with recurrent episodes of ventricular tachycardia. Cardiac magnetic resonance imaging (MRI) shows significant right ventricular dilatation and dysfunction. Which of the following is the most appropriate treatment?
A. Initiate antiarrhythmic drug therapy
B. Perform catheter ablation
C. Perform implantable cardioverter-defibrillator (ICD) placement
D. Refer for heart transplantation
E. Recommend lifestyle modifications and close monitoring
14. A 35-year-old man with a history of dilated cardiomyopathy presents with progressive dyspnea and lower extremity edema. Echocardiography reveals a severely reduced left ventricular ejection fraction of 15%. Which of the following is the most appropriate next step in management?
A. Initiate angiotensin-converting enzyme (ACE) inhibitor therapy
B. Initiate cardiac resynchronization therapy
C. Perform left ventricular assist device (LVAD) implantation
D. Refer for heart transplantation
E. Recommend palliative care