Questions to Ask When Presenting Heart and Lung Anatomy to Senior Doctors

Blood Supply

What are the anatomical variants of coronary artery origins and their clinical significance? 1
How does wall tension (per Laplace's law) determine myocardial oxygen consumption, and what are the clinical implications for ischemic heart disease? 2
What is the relationship between coronary perfusion pressure and diastolic filling phases? 2
In congenital heart disease, what anomalous coronary patterns increase surgical risk? 1

How do pre-capillary and post-capillary components differ in pulmonary hypertension classification? 1
What hemodynamic values define normal pulmonary artery pressures versus pathologic states? 1
How does pulmonary vascular resistance change with mechanical ventilation and increased intrathoracic pressure? 3
What is the role of vasoreactivity testing in distinguishing pulmonary arterial hypertension subtypes? 1

How does elevated systemic venous pressure affect pulmonary lymphatic drainage and edema formation? 4
What are the hemodynamic consequences of superior vena cava occlusion on cardiac output? 1
In congenital heart disease, what abnormalities of systemic venous drainage require surgical correction (e.g., Glenn, Fontan procedures)? 1
How does central venous pressure waveform morphology change with arrhythmias and fluid status? 1

What congenital anomalies of pulmonary venous drainage exist, and how are they identified on imaging? 1
How does left atrial pressure elevation affect transvascular fluid filtration in the lungs? 4, 5
What is the relationship between pulmonary capillary wedge pressure and left ventricular end-diastolic pressure? 1

How does increased parasympathetic tone affect AV nodal conduction velocity and PR interval duration? 2
What is the mechanism by which sympathetic activation increases cardiac output in heart failure? 1
How do vasoactive and inotropic medications modulate autonomic tone in cardiogenic shock? 1
What are the pharmacologic effects of beta-blockade on heart rate variability and arrhythmia suppression? 1

What ECG findings distinguish right bundle branch block (rSR' in V1) from left bundle branch block (QS pattern in V1)? 2
How do pacemaker cells in the sinoatrial node generate spontaneous phase 4 depolarization? 2
What complications arise from temporary transvenous pacing systems? 1

How does the pulmonary lymphatic system drain from its formation site in the interstitium to the thoracic duct and systemic venous circulation? 5, 6
What is the maximum capacity for lymphatic drainage before pulmonary edema develops? 5
How do prelymphatics, reservoir lymphatics, and conduit lymphatics differ structurally around airways and blood vessels? 6
What role do lymphatics play in immune cell trafficking and antigen presentation in the lungs? 6

When systemic venous pressure exceeds 20 mmHg, how does this impair lymphatic drainage and promote pulmonary edema formation? 4
What distinguishes cardiogenic (hydrostatic) from noncardiogenic (increased permeability) pulmonary edema based on lymphatic function? 5
How does mechanical ventilation with positive end-expiratory pressure affect lymphatic flow? 4, 3

How does increased intrathoracic pressure during mechanical ventilation reduce venous return and cardiac output? 3
What is direct ventricular interaction, and how does high pulmonary vascular resistance limit left ventricular filling? 3
Does reduced left ventricular afterload during positive pressure ventilation result primarily from decreased preload? 3

In patients requiring mechanical circulatory support, how do anatomic considerations (aortic regurgitation, prosthetic valves) impact device selection? 1
What hemodynamic monitoring is essential for managing critically ill patients with heart failure or cardiogenic shock? 1
How do you calculate cardiac output using Fick and thermodilution methods, and when is each preferred? 1