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CTCA for Bypass Graft Assessment — EECC MCQ

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HardCardiac ImagingCTCA for Bypass Graft AssessmentEECC

Six weeks after an uncomplicated STEMI, a patient has no angina but remains fatigued. Echocardiography shows LVEF 41%. Before a structured exercise programme, which assessment most directly quantifies functional capacity and identifies exercise-related ischaemia or arrhythmia?

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Correct answer: B — Cardiopulmonary exercise testing with ECG and pressure monitoring

The best answer is “Cardiopulmonary exercise testing with ECG and pressure monitoring”. Cardiopulmonary exercise testing provides peak oxygen uptake, ventilatory efficiency, symptoms, ECG rhythm and blood-pressure response in one controlled assessment. “Exercise echocardiography with regional wall-motion assessment” is less appropriate because resting imaging does not quantify integrated exercise capacity “Six-minute walk testing with continuous oxygen saturation” is less appropriate because ambulatory pressure monitoring does not reproduce exertional physiology “Exercise electrocardiography without respiratory-gas analysis” is less appropriate because calcium scoring cannot test functional limitation after infarction “Vasodilator stress CMR with myocardial perfusion imaging” is less appropriate because angiography is not a routine functional-capacity test in a stable asymptomatic patient

Reference: 2023 ESC Guidelines for acute coronary syndromes. https://academic.oup.com/eurheartj/article/44/38/3720/7243210