ESM 1. Survey questionnaire sent to French GPs. Correct answers are in bold. Part 2: Clinical cases: (Good answer are in bold) Clinical Case 1:

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1 ESM 1. Survey questionnaire sent to French GPs. Correct answers are in bold. Part 2: Clinical cases: (Good answer are in bold) Clinical Case 1: to your office at 2 pm for a feeling of weakness and numbness in her left upper limb and her left hemiface which appeared suddenly in the morning at 7 am and lasted for 30 minutes. There is no reported headache or pain. Since then, there have been no further symptoms, your clinical examination is normal. a. Transient ischemic attack b. Subarachnoid hemorrhage c. Myocardial infarction d. Cervicobrachial neuralgia e. Multiple Sclerosis Q2. According to the latest recommendations, what is the definition of a transient ischemic attack? a. Brief episode of neurological dysfunction lasting not more than one hour b. Absence of signs of ischemia in imagery c. Systemic neurological deficit not exceeding 24 hours d. Electrocardiogram should be normal e. Requires cerebral imagery Q3. Finally, you suspect a transient ischemic attack: a. You address her to a neurologist urgently b. You address her to a private emergency unit c. You address her to a public emergency department d. You prescribe various additional tests to be performed in ambulatory care e. Other (specify): Q4. Do you prescribe further investigations? If you do, what would they be? a. A CT scan in ambulatory care b. An MRI in ambulatory care c. Ultrasonography of supra-aortic vessels in ambulatory care

2 d. An electrocardiogram e. Additional investigations to be conducted in emergency department or in the hospital department where the patient is hospitalized Q5. The diagnosis established at the hospital is a transient ischemic attack with right internal carotid artery stenosis. The blood pressure is 120/75 mmhg. The patient had carotid endarterectomy. The LDLc is 1.3 g/l. What long-term therapy should there be? b. Antiplatelet therapy Q6. What is your LDLc objective in the case of a transient ischemic attack? a. 0.7 g / L b. 1 g / L c. 1.3 g / L d. 1.6g / L e. 1.9 g / L Q7. According to you, what is the risk for a patient who has had an ischemic stroke of being polyvascular (at least one other location : coronary or lower limbs)? b. About 25 % c. About 33 % d. About 50 % Clinical Case 2 to your office for dyspnea associated with epigastric burns which appeared on that day. It occurred during exercise and yielded at rest. There is no headache reported. Since then, she has had no symptoms. She has had the same symptoms for a few weeks, occurring during exertion of the same intensity. Your clinical examination is completely normal. The pulse reaches 70 beats per minute. a. Gastric ulcer b. Myocardial infarction c. Pericarditis d. Stable Angina e. Chronic obstructive pulmonary disease

3 Q2. Concerning typical pain in stable angina: a. It can occur during exertion, after stress, but also after eating (postprandial) b. It rapidly yields after stopping the effort or following glyceryl trinitrate administration c. It is a retrosternal pain or discomfort that can radiate to the left arm and jaw d. It can last more than twenty minutes after cessation of exertion e. It is favored by cold Q3. Finally, you suspect typical stable angina: a. You address her to a cardiologist within a short time (ideally less than two weeks) b. You address her to a private emergency department c. You address her to a public emergency department d. You prescribe various additional tests to be performed in ambulatory care settings e. Other (specify): Q4. The electrocardiogram performed at the office is normal and there is no sign of heart failure. In this context of suspicion of stable angina, which tests do you prescribe (the last blood test prescribed [complete blood count, lipid profile, fasting blood glucose] 2 years ago was normal)? a. Troponins b. NT pro BNP c. Lipid profile (total cholesterol, LDLc, HDLc, triglycerides) d. HbA1c e. None, examinations will be performed in the emergency department or in the hospital department where the patient is hospitalized Q5. Do you have an ECG in your office: a. Yes b. No Q6. In this context, do you think you should perform an ECG in your office: a. Yes b. No Q7. The diagnosis established by the cardiologist is stable angina without any sign of severity in a patient with a 120 / 75 mmhg blood pressure. The echocardiography finds a conserved ejection fraction. The LDLc level is 1.3 g/l. What should be her long-term therapy? b. Antipatelet therapy Q8. What is your LDLc objective in case of stable angina? a. 0,.7 g/l b. 1,0 g/l c. 1,3 g/l d. 1,6g/L e. 1,9 g/l

4 Q9. According to you, what is the risk of a patient with stable angina being polyvascular (at least one other location [carotids or lower limbs])? b. 25 % c. 33 % d. 50 % Clinical Case 3 to your office for a calf pain that occurs after a few minutes walk and disappears at rest. There is no edema. a. Sciatica b. Muscle tear c. Peripheral Artery Disease d. Left popliteal cyst e. Sural phlebitis Q2. According to the latest recommendations, what is the definition of intermittent claudication? a. It occurs during effort b. It can be located in the calf area c. It can be located in the buttocks area d. It stops in less than 10 minutes e. It can manifest itself in the form of fatigue or discomfort in the lower limbs Q3. Finally you suspect peripheral artery disease with left limb lesion. Where do you refer the patient? a. Cardiologist b. Radiologist c. Emergency department d. Vascular surgeon e. Angiologist / vascular specialist f. Other (specify): Q4. Do you have a hand-held Doppler for measuring the ankle-brachial pressure index? Yes No Q5. In this context, in your opinion, should you measure the ankle-brachial pressure index in the office? Yes No

5 Q6. Which further investigation(s) would you prescribe in this context of suspected Peripheral Artery Disease? a. Contrast tomography angiography of the aorta and lower limbs b. Ultrasonography of the lower limb arteries c. A blood test d. A treadmill test e. None of the above Q7. The diagnosis established at the hospital is Peripheral Artery Disease with a non-surgical stenosis in a patient with 120/75 mmhg blood pressure; the LDLc level is 1.3 g/l. What should be her long-term therapy? b. Antiplatelet therapy Q8. What is your LDLc objective in case of Peripheral Artery Disease? a. 0.7 g / L b. 1 g / L c. 1.3 g / L d. 1.6g / L e. 1.9 g / L Q9. According to you, what is the risk of a patient with Peripheral Artery Disease being polyvascular (at least one other location [coronary or carotids])? b. 25 % c. 33 % d. 50 % Q10. According to you, what is the percentage of patients suffering from Peripheral Artery Disease who have intermittent claudication? a % b % c % d. >70 %