The Correct Answer is C!

Knowledge to Practice, in collaboration with Mayo Clinic, offers online board review and lifelong learning products in Cardiovascular Medicine. With a full pre-assessment, you can identify the topics you’ve mastered and focus your time on topics where you need it the most. Our products have been shown to increase knowledge 75% more than traditional methods in less time.1

Question:

A patient presents with severe heart failure and BP 90/60 mmHg with underlying severe aortic stenosis and EF 33%. His cardiac index is 1.8 l/min/m².

What is the drug that will optimally improve his myocardial performance?

  1. Phenylephrine
  2. High dose dopamine (15 μg/kg/min)
  3. Nitroprusside
  4. Norepinephrine

Answer Rationale:

This patient has a high peripheral vascular resistance despite his low systemic pressure. All vasoconstrictors will decrease myocardial performance, which will negate the effect of the added B1 effect with high dose dopamine and norepinephrine.

1.  Source: "Comparative Analysis of Pre/Post Assessments of Live/Didactic Course Attendees when compared to Mico-Learning/Online Course Users., "Knowledge to Practice, 2017.