Phys Vivas · cardiovascular
Cardiovascular Prevention and Rehabilitation — Viva Defence
Structured DCE viva for cardiovascular prevention: long-case defence of a 62-year-old post-NSTEMI patient with statin-associated muscle symptoms — the secondary prevention bundle defended, the SAMS protocol, and rehabilitation adherence.
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Target exams
Opening statement (SASPOP, delivered aloud)
"Mr Halloran is a 62-year-old man four months into recovery from an NSTEMI treated with a drug-eluting stent to the LAD. His main problems are: established secondary-prevention pharmacotherapy now partly self-ceased, with statin-associated muscle symptoms that need structured assessment; ongoing smoking, the single largest modifiable driver of his next event; non-attendance at cardiac rehabilitation, which forfeits a mortality-reducing intervention; and an information problem — he is making decisions from internet material rather than from a conversation with us. I would like to restore the full secondary prevention bundle using a validated statin protocol, engage him with rehabilitation and smoking cessation, and rebuild his trust in the plan." [1] [5]
You have read the opening of this viva. The complete unit — every section and its primary-source references — is part of the Physician Medicine fellowship atlas.
References7Show ledgerHide ledger
- [1]Nelson MR, Banks E, Brown A, et al. 2023 Australian guideline for assessing and managing cardiovascular disease risk Med J Aust, 2024.PMID 38623719
- [2]Wood FA, Howard JP, Finegold JA, et al. N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects N Engl J Med, 2020.PMID 33196154
- [3]Cannon CP, Blazing MA, Giugliano RP, et al. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes N Engl J Med, 2015.PMID 26039521
- [4]Nissen SE, Lincoff AM, Brennan D, et al. Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients N Engl J Med, 2023.PMID 36876740
- [5]Anderson L, Oldridge N, Thompson DR, et al. Exercise-based cardiac rehabilitation for coronary heart disease Cochrane Database Syst Rev, 2016.PMID 26730878
- [6]Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins Lancet, 2005.PMID 16214597
- [7]Schwartz GG, Steg PG, Szarek M, et al. Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome N Engl J Med, 2018.PMID 30403574