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Dallas Criteria for Myocarditis — EECC MCQ

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HardCardiomyopathyDallas Criteria for MyocarditisEECC

A 58-year-old has a proximal right-coronary chronic total occlusion, CCS class III angina despite two anti-anginal drugs, viable inferior myocardium and no prognostically important left-main or LAD disease. What benefit should be used when discussing CTO PCI?

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Correct answer: E — CTO PCI for angina and quality-of-life improvement

The best answer is “CTO PCI for angina and quality-of-life improvement”. In a suitable symptomatic patient, CTO PCI is principally a symptom and quality-of-life intervention; randomised evidence has not established a survival advantage. “A proven reduction in all-cause mortality compared with medical therapy” is less appropriate because a mortality reduction has not been proven for routine CTO PCI “Guaranteed recovery of normal left-ventricular function” is less appropriate because viability permits recovery but does not guarantee normal function “Elimination of the need for secondary-prevention medication” is less appropriate because revascularisation does not replace lipid, blood-pressure and antithrombotic prevention “Prevention of every future ventricular arrhythmia” is less appropriate because opening one artery cannot abolish all future arrhythmic mechanisms

Reference: 2024 ESC Guidelines for chronic coronary syndromes. https://academic.oup.com/eurheartj/article/45/36/3415/7743115