skip to main content

Bicuspid Aortic Valve Surveillance — EECC MCQ

Instant feedback + full explanation. One question, done properly.

HardGeneral CardiologyBicuspid Aortic Valve SurveillanceEECC

TOE before cardioversion shows a left-atrial-appendage thrombus in a patient prescribed apixaban. She reports perfect adherence, but pharmacy records show several missed collections. What is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Defer cardioversion, restore verified therapeutic anticoagulation and repeat imaging

A visible left-atrial thrombus contraindicates elective cardioversion. Apparent DOAC failure requires checking adherence, dose, interactions and absorption; verified therapeutic anticoagulation is then established and imaging repeated after an appropriate interval. A single dose or procedural heparin does not resolve existing thrombus, and acute occlusion is not the immediate substitute.

Reference: 2024 ESC/EACTS Guidelines for atrial fibrillation. https://academic.oup.com/eurheartj/article/45/36/3314/7738779