257.2 📚 國考版

257.2.0.1 必背 — 4 Categories of CVD

  1. Atherosclerotic (CAD, stroke, PAD)
  2. Heart Failure (HFrEF, HFpEF, HFmrEF)
  3. Arrhythmias (bradycardia, SVT, VT/VF)
  4. Structural / Valvular / Cardiomyopathies / Congenital
  5. Vascular (aortic, peripheral, venous, pulmonary HTN)

257.2.0.2 必背 — 4 Cardinal Symptoms

  • Chest pain (angina, MI, PE, dissection, pericarditis, GERD, MSK)
  • Dyspnea (HF, ischemia, valvular, PE, pulmonary)
  • Palpitations (arrhythmia, ectopy, hyperthyroid, anxiety)
  • Syncope (arrhythmia, structural, vasovagal, orthostatic, neurologic)

257.2.0.3 必背 — Biomarkers

  • hs-cTn: MI diagnosis; 0/1-hr algorithms
  • BNP / NT-proBNP: HF diagnosis + prognosis
  • D-dimer: PE / DVT / dissection exclusion (low pretest)
  • LDL + Non-HDL + ApoB + Lp(a): lipid risk

257.2.0.4 必背 — Risk Stratification

  • ASCVD risk calculator (USA, 10-yr ASCVD)
  • PREVENT (AHA 2023+) — newer, includes CKD + metabolic
  • SCORE2 (Europe)
  • Risk enhancers: family hx, ethnicity, CKD, inflammatory, premature menopause, pregnancy complications, high Lp(a), high CAC

257.2.0.5 必背 — Treatment Targets

  • LDL:
    • Primary prevention high-risk: < 100 mg/dL (high-intensity statin)
    • Secondary / very high risk: < 70 mg/dL (some < 55)
  • BP: most adults < 130/80
  • HbA1c: individualized; 6.5-7% typical
  • Lifestyle: Mediterranean / DASH + exercise + tobacco cessation + weight

257.2.0.6 必背 — Atypical Presentations

  • Women + diabetics + elderly: often atypical chest pain (dyspnea, fatigue, nausea)
  • Lower threshold for workup
  • Silent ischemia common

257.2.0.7 必背 — 2024 CKM Syndrome

  • AHA 2023+ framework: Cardiac-Kidney-Metabolic
  • Stages 0-4
  • Integrated therapy: SGLT2i + GLP-1 RA + finerenone + statin

257.2.0.8 必背 — Syncope Red Flags

  • During exertion
  • Family hx of sudden death
  • Structural heart disease
  • Abnormal ECG
  • Without prodrome
  • Older age + comorbidities