In this episode, we review the large vessel vasculitides, medium-vessel vasculitides, ANCA-associated small-vessel vasculitides, and immune complex associated small-vessel vasculitides. What is the difference in the population of patients affected by Takayasu's arteritis of the aorta and its branches versus giant cell arteritis of the temporal artery? What about subcranial giant cell arteritis, which affects the aorta instead of the temporal artery? Which disease is characterized by corkscrewing, inflammation, and thrombosis of vessels of the upper and lower limbs, leading to reduced pulses and gangrenous ulcers, which cannot resolve without smoking cessation? What are the criteria for diagnosing Kawasaki disease? What percent of Kawasaki disease patients will go on to develop coronary artery aneurysms? Tune in for answers to these questions.

Difficulty Level: Easy

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In this episode, we review carotid artery stenosis (CAS), including its presentation, diagnosis, medical management, and intervention. Do dizziness, presyncope, or syncope count as symptomatic CAS? What is the definition of nondisabling stroke and transient cerebral ischemic symptoms? What risk factors permit ordering a carotid duplex ultrasound before coronary artery bypass graft surgery? What peak systolic velocity on ultrasound correspond to >=50% and >=70% stenosis of a carotid artery? What antiplatelet regimen is recommended for CAS? In patients with symptomatic CAS, in what time window after the non-disabling stroke or TIA should you perform revascularization? Is there any role for revascularization of severe CAS that is asymptomatic? Tune in for answers to these questions.

Difficulty Level: Easy

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In this episode, we review limb peripheral artery disease (PAD). What is the difference in management of a marginally threatened limb vs immediately threatened limb? In whom can you order ankle brachial index (ABI) testing on? When do you reach for toe brachial index (TBI) or exercise ABI? Is there a role for cilostazol or pentoxifylline? Who should be given low-dose rivaroxaban therapy? Tune in for answers to these questions.

Difficulty Level: Easy

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In this episode, we review aortic intramural hematoma (IMH), penetrating aortic ulcer (PAU), infectious aortitis and aortic atheroemboli. What condition is characterized by a crescentic aortic wall thickening and echolucency within the aortic wall with no intimal flap on transesophageal echocardiogram? What percent of IMH progresses to aortic dissection?What imaging findings distinguish IMH from dissection on non-contrast CT, contrast CT, and TEE? What are the criteria for complicated IMH, and when is emergent surgical repair recommended? How does the management of type A IMH differ from that of type B IMH? How are grades 1, 2, 3, 4, and 5 aortic plaques defined? What features on imaging of PAU designate PAU as high-risk? When should PAU be repaired? Which organisms are responsible for infectious aortitis? Tune in for answers to these questions.

Difficulty Level: Easy

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In this episode, we review aortic dissection, its risk factors, presentation, physical exam findings, imaging findings, and management. Other than aortic dissection, what other cardiovascular conditions can present with unequal arterial pulsations? How do gender and age affect the risk of aortic dissection? What are risks for aortic dissection for women, especially during pregnancy, and for patients with conditions such as Marfan syndrome or a bicuspid aortic valve? How do you distinguish between a true and false lumen on imaging studies? What target blood pressure and heart rate should be achieved within 10 minutes of presentation for aortic dissection? When is surgery or percutaneous intervention indicated? Tune in for answers to these questions.

Difficulty Level: Easy

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In this episode, we review abdominal aortic aneurysm (AAA), including its diagnosis, screening, and management. What are the current guidelines for screening and surveillance of AAA, and how do they differ for men and women? At what size does the risk of rupture significantly increase, and what surveillance intervals are recommended based on the size of the aneurysm? What does Laplace's Law say about how the rate of expansion of AAA correlates with its size? What are the key differences between endovascular aneurysm repair (EVAR) and open surgical repair, and what are the long-term complications associated with EVAR? What is an endoleak? Tune in for answers to these questions.

Difficulty Level: Easy

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In this episode, we review ascending aorta dilation and ascending aorta aneurysm, including the key syndromes associated. What is cystic medial degeneration? Which diseases cause dilation of the aortic root versus dilation of the ascending aorta? In which diseases is ascending aorta dilation defined by diameter (cm) versus body surface area-indexed diameter (cm/m^2) versus aortic root cross sectional area to height ratio (cm^2/m)? In which diseases is the cutoff for surgical intervention ≥5.5cm, ≥5.0cm, ≥4.5cm, and ≥4.0cm? What is the definition of rapid growth in 1 year and in 2 years? Among the sinotubular junction, sinuses of Valsalva, aorto-ventricular junction, aortic annulus, and left ventricular outflow tract, which lengths should be measured leading edge to leading edge, and which should be measured inner edge to inner edge on echocardiography? Which should be measured in end-diastole and which should be measured in mid-systole? In what situation is echo sufficient for monitoring ascending aorta dilation instead of CT/MRI? How often should you perform serial imaging for monitoring of ascending aorta dilation that has not yet met the cutoff for surgical intervention? What does medical management consist of? What are manifestations of Marfan's syndrome other than aortic root dilation, and how are they similar or different than the manifestations of Ehlers-Danlos' syndrome? What does bifid uvula suggest? Which syndrome presents with foot pain, multiple food allergies, and bifid uvula? Tune in for answers to these questions.

Difficulty Level: Intermediate

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In this episode, we review left ventricular (LV) thrombus, including its pathophysiology, imaging characteristics, and treatment. How are the components of Virchow's triad disrupted by myocardial infarction, predisposing to formation of LV thrombus? What are the echocardiographic features of LV thrombus? How can LV thrombus be distinguished from myxoma on cardiac MRI and angiogram? Can the chronic versus acute nature of LV thrombus be discerned on imaging? Is there a role for transesophageal echocardiogram for assessing LV thrombus? What anticoagulation agents are allowed in the treatment of LV thrombus? What evidence supports continuing anticoagulation beyond three months, and when is it reasonable to discontinue therapy? Tune in for answers to these questions.

Difficulty Level: Easy

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In this episode, we review deep vein thrombosis (DVT). What are the ultrasound features of a DVT? What counts as a proximal DVT? Why are patients with proximal DVT at higher risk, and how does this impact management? What are the recommended anticoagulation strategies, including the use of DOACs versus VKAs? How long should anticoagulation continue for provoked versus unprovoked DVT? When is indefinite anticoagulation recommended, and in what situations might aspirin be a reasonable alternative? What counts as provoked versus unprovoked? How do you approach testing for thrombophilia, and when is it appropriate? Tune in for answers to these questions.

Difficulty Level: Easy

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In this episode, we review how to calculate pulmonary artery pressures (PASP) on echocardiography. How does the simplified Bernoulli equation relate the velocity of flow through the tricuspid valve (tricuspid regurgitant velocity, V_TR) to the right ventricular systolic pressure (RVSP)? When is it permissible and not permissible to assume that PASP is equivalent to RVSP? How can the maximal tricuspid regurgitant velocity (V_max TR), maximal pulmonic regurgitant velocity (V_max PR), and end pulmonic regurgitant velocity (V_end PR) be used to calculate systolic, mean, and diastolic pulmonary artery pressure? What are five ways to calculate mean pulmonary artery pressure from non-invasive imaging? Tune in for answers to these questions.

Difficulty Level: Intermediate

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