Adult - Cardiology II Flashcards
What is “normal” blood pressure?
< 120
< 80
Prehypertension starts at
120
80
Stage 1 HTN starts at
140
90
Stage 2 HTN starts at
160
100
Which type of HTN represents 95% of cases?
primary - idiopathic cause
What is the leading cause of secondary HTN?
renal artery stenosis
others -
pregnancy
endocrine
renal failure
What are exacerbating factors for HTN? (4)
smoking
obesity
excessive alcohol
NSAIDs
What is the typical headache of severe HTN?
suboccipital
pulsating
worse in the morning, resolving thru the day
HTN goes with which heart sound?
S4
related to LVH
Workup for new HTN includes - hugemonguous list because determining if primary or secondary HTN -
renovascular diease studies CXR - r/o cardiomegaly aldosterone - r/o aldosteronism cortisol - r/o cushing UA CBC BMP ECG
BP should be treated no later than which stage?
stage 1
140
90
First step in HTN management (non-pharm)
lifestyle changes
Which antihypertensive class works particularly well in those with migraine and angina?
beta blockers (-lol)
“If you don’t know what you are doing and its not a diabetic” which antihypertensive class is a good choice?
beta blockers (-lol)
What is the best antihypertensive class to use with a diabetic?
ACE inhibitors (-pril)
Which antihypertensive class is not usually used as monotherapy and is effective for prinzmetal’s angina?
CCB (-dipine)
Which antihypertensive class may cause a cough?
ACE inhibitors (-pril)
if so, switch to ARB
Which antihypertensive class may cause a wheeze?
beta blockers (-lol)
Which antihypertensive class may cause erectile dysfunction?
beta blockers (-lol)
Which antihypertensive class may cause angioedema?
ARB (-sartan)
What BP is considered to be a HTN urgency? Time frame for treatment?
180
110
hours to days
What is the treatment for HTN urgency?
oral therapy
clonidine (Catapres)
captopril (Capoten)
nifedipine (Procardia)
loop diuretics
What BP is considered to be a HTN emergency? Time frame for treatment?
diastolic BP > 130
treat within 1 hour to prevent target organ damage
What is the treatment for a hypertensive emergency?
sodium nitroprusside (Niapride) drip
What fundoscopic changes are associated with malignant hypertension?
flame shaped retinal hemorrhages
papilledema
What is papilledema?
swelling of the optic disk with blurred margins
What is a common complaint with dissecting aortic aneurysm?
back pain
eventually the BPs in each arm will be different
What is the most common type of angina?
stable angina
exertional
What is unstable angina?
tends to be pre-infarction
can happen at rest
Which angina is related to vasospasm?
Prinzmetal’s angina
What medication class treats Prinzmetal’s angina?
CCB
What sign is often present in angina?
Levine’s sign - clenched fist on chest
What is the expected ECG change in angina?
DOWNsloping of ST segment
this indicates ISCHEMIA
What is the expected ECG change in MI?
PEAKED T waves and ST ELEVATION
What are the 3 most common meds for angina?
nitrates
beta blockers
calcium channel blockers
What is the progression of meds for hypercholesterolemia?
Statin
Niacin added
Fibrates
What is a side effect of niacin?
facial flushing
