CSP Exam Prep Course: Cardiology

Vocabulary study cards covering cardiac specialty disease states, clinical thresholds, mechanisms of action, and medications for heart failure, cardiomyopathy, amyloidosis, and hyperlipidemia based on the NASP CSP Exam Prep Course.

Heart Failure (HF)

A complex clinical syndrome resulting from structural or functional impairment of the heart that leads to impaired ventricular filling, reduced ejection fraction, diastolic dysfunction, and/or systolic dysfunction.

New York Heart Association (NYHA) Classification

A subjective functional classification system for HF symptoms ranging from Class I (no limitation during ordinary physical activity) to Class IV (symptoms present at rest with inability to carry on any physical activity without discomfort).

Heart Failure with Reduced Ejection Fraction (HFrEF)

Symptomatic heart failure characterized by a left ventricular ejection fraction (LVEF) of $\le 40\%$.

Heart Failure with Improved Ejection Fraction (HFimpEF)

Symptomatic heart failure with a baseline LVEF of $\le 40\%$, a $\ge 10$-point increase from baseline LVEF, and a subsequent measurement of LVEF $> 40\%$.

Heart Failure with Mildly Reduced Ejection Fraction (HFmrEF)

Symptomatic heart failure characterized by a left ventricular ejection fraction (LVEF) of $41\%\text{--}49\%$.

Heart Failure with Preserved Ejection Fraction (HFpEF)

Symptomatic heart failure characterized by a left ventricular ejection fraction (LVEF) of $\ge 50\%$.

Sodium-Glucose Transport Protein 2 (SGLT2) Inhibitors

A class of therapies that block glucose and sodium reabsorption in the kidney to promote osmotic diuresis and natriuresis, reduce preload/afterload, improve ventricular loading, and lower BP and weight.

Empagliflozin (Jardiance)

An SGLT2 inhibitor indicated for heart failure dosed at $10\,mg$ once daily in the morning with or without food; patients are instructed to hold therapy at least $3\text{ days}$ prior to surgery.

Sotagliflozin (Inpefa)

An SGLT inhibitor indicated for heart failure dosed initially at $200\,mg$ once daily and titrated to $400\,mg$ daily after $\ge 2\text{ weeks}$; must be administered no more than $1\text{ hour}$ before the first meal of the day.

Sacubitril/Valsartan (Entresto)

An angiotensin receptor-neprilysin inhibitor (ARNI) combination that blocks the angiotensin II type 1 receptor and inhibits neprilysin breakdown of natriuretic peptides to reduce cardiovascular death and HF hospitalization.

Entresto ACE Inhibitor Washout Period

A required waiting period of $36\text{ hours}$ after discontinuing an ACE inhibitor before initiating sacubitril/valsartan to minimize the risk of angioedema.

Vericiguat (Verquvo)

An oral soluble guanylyl cyclase (sGC) stimulator that increases intracellular cyclic GMP to promote vasodilation and decrease remodeling; carries a boxed warning for embryo-fetal toxicity requiring effective contraception.

Furosemide On-Body Infusor (Furoscix)

A wearable subcutaneous delivery system providing an outpatient fixed dose of $80\,mg$ of furosemide over approximately $5\text{ hours}$ to treat fluid overload in chronic HF or CKD and help prevent hospitalizations.

Hypertrophic Cardiomyopathy (HCM)

A primary genetic cardiomyopathy caused by an autosomal dominant mutation, characterized by left ventricular hypertrophy (LVH) defined by a ventricular wall thickness $> 15\,mm$.

Mavacamten (Camzyos)

A cardiac myosin inhibitor that inhibits actin-myosin interaction, thereby reducing cardiac contractility and left ventricular outflow tract obstruction (LVOTO) in symptomatic NYHA Class II–III obstructive HCM.

Camzyos Boxed Warning

A warning specifying that mavacamten reduces LVEF, causes HF due to systolic dysfunction, and is contraindicated with strong CYP2C19 inhibitors, moderate-to-strong CYP2C19 inducers, or moderate-to-strong CYP3A4 inducers.

Camzyos LVEF Initiation and Interruption Thresholds

Therapy initiation is not recommended if baseline LVEF is $< 55\%$, and therapy must be interrupted if LVEF drops to $< 50\%$ at any clinical visit or if the patient develops worsening HF symptoms.

Transthyretin Amyloidosis (ATTR)

A restrictive cardiomyopathy caused by unstable liver-synthesized transthyretin proteins dissociating, misfolding, and forming amyloid fibrils in the myocardium; divided into hereditary (hATTR) and wild-type (wtATTR).

V122I Variant

The most common hereditary gene variant associated with hereditary transthyretin amyloidosis (hATTR) in the United States.

Tafamidis Formulations Equivalence Rule

Tafamidis ($61\,mg$ once daily, Vyndamax) and tafamidis meglumine ($80\,mg$ once daily, Vyndaqel) are bioequivalent but are not substitutable on a milligram-per-milligram ($mg\text{-to-}mg$) basis.

Acoramidis (Attruby)

A TTR tetramer stabilizer that mimics the structural action of the protective T119M variant to inhibit tetramer dissociation, dosed at $712\,mg$ orally twice daily for ATTR-CM.

Vutrisiran (Amvuttra)

A transthyretin-directed small interfering RNA (siRNA) administered subcutaneously at $25\,mg$ every $3\text{ months}$ for ATTR-CM and ATTR-PN; requires monitoring and daily supplementation for vitamin A deficiency.

Inclisiran (Leqvio)

A small interfering RNA (siRNA) that degrades PCSK9 mRNA to upregulate LDL receptors and lower LDL-C; administered subcutaneously by a healthcare professional at $284\,mg$ initially, at $3\text{ months}$, and every $6\text{ months}$ thereafter.

Evinacumab-dgnb (Evkeeza)

A monoclonal antibody ANGPTL3 inhibitor administered at $15\,mg/kg$ IV every $4\text{ weeks}$ as an adjunct to lower LDL-C in pediatric ($\ge 5\text{ years}$) and adult patients with homozygous familial hypercholesterolemia (HoFH).

Olezarsen (Tryngolza)

An antisense oligonucleotide (ASO) GalNAc3 conjugate dosed at $80\,mg$ subcutaneously monthly that degrades apoC-III mRNA to reduce triglycerides in adults with familial chylomicronemia syndrome (FCS).

Lomitapide (Juxtapid)

A microsomal triglyceride transfer protein inhibitor for HoFH that carries a boxed warning and REMS program for hepatotoxicity and steatosis; must be taken on an empty stomach at least $2\text{ hours}$ after the evening meal.