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A 51-year-old man who yesterday underwent left - darkhorse - Printable Version +- USMLE Forum - Largest USMLE Community (https://www.usmleforum.com) +-- Forum: USMLE Forum (https://www.usmleforum.com/forumdisplay.php?fid=1) +--- Forum: Step 2 CK (https://www.usmleforum.com/forumdisplay.php?fid=3) +--- Thread: A 51-year-old man who yesterday underwent left - darkhorse (/showthread.php?tid=276801) |
A 51-year-old man who yesterday underwent left - darkhorse - ArchivalUser - 03-03-2008 A 51-year-old man who yesterday underwent left anterior descending coronary artery stenting for an acute anterior wall ST-elevation myocardial infarction begins having frequent premature ventricular contractions (PVCs). All of the following are correct, except: a) Frequent PVCs and ventricular couplets signify an increased mortality risk in the peri-infarct time period. b) Suppression of frequent PVCs in the peri-infarct period with a Class I anti-arrhythmic reduces mortality. c) β blockers reduce the risk of postinfarction ventricular fibrillation. d) Amiodarone has been shown to reduce postinfarction arrhythmias but it has not been shown to reduce mortality. 0 - ArchivalUser - 03-03-2008 ccccccc 0 - ArchivalUser - 03-03-2008 cccccccc 0 - ArchivalUser - 03-03-2008 B Isolated premature ventricular contractions (PVCs) are common after a myocardial infarction (MI). Frequent or complex PVCs in the post-MI period have been shown to signify increased mortality, especially in patients with reduced left ventricular function. The Cardiac Arrhythmia Suppression Trial (CAST) tested the hypothesis that suppression of asymptomatic or mildly symptomatic ventricular arrhythmias after acute MI with the Class IC antiarrhythmics encainide or flecainide would decrease mortality during long-term follow-up. The results from CAST showed that encainide and flecainide caused an increased cardiovascular mortality with a relative risk of 2.5. As a result, antiarrhythmic suppression of frequent or complex PVCs after an MI is no longer recommended. |