Block 58: Cardio Flashcards
Intermittent claudication and positive ankle-brachial index indicates what disease
peripheral arterial disease
most useful intervention to improve functional capacity and reduce claudication in PAD patients
supervised graded exercise program
what medications can you start with a patient with peripheral artery disease
aspirin and statin
when does ventricular aneurysm occur in MI ? EKG show?
Late complication
- persistent ST-segment elevation along with deep Q waves
when does papillary muscle rupture occur after an MI
2-7 days post MI
important factors in improving patient survival in sudden cardiac arrest ar
- adequate bystander compression only CPR
- prompt rhythm analysis
- defibrillation
most common cause of mitral regurgitation in developed countries
Mitral valve prolapse
Displaced apical impulse, holosystolic murmur and 3rd heart sound, diagnosis
severe mitral regurgitation
what does mild mitral regurgitation cause
mid-systolic click
mid-to-late systolic murmur
what does severe mitral regurgitation cause
holosystolic murmur
what does chronic severe mitral regurgitation cause
- left arterial and ventricular enlargement leading to a-fib
- left ventricular dysfunction
- CHF
transient loss of consciousness accompanied by loss of postural or motor tone with a spontaneous return to baseline neurologic function
syncope
orthostatic (postural) hypotension
dpop in systolic blood pressure greater than 20 or diastolic greater than 10 within 2-5 min of standing from a supine position
Difference between arrhythmic cause of syncope and vasovagal or neurocardiogenic syncope
- arrhythmic: no prodromal
immediate effects of cocaine on the heart
sympathomimetic
- hypertension
- tachycardia
- pupillary dilation
- psychomotor agitation
doing cocaine puts at risk for
causes coronary vasoconstriction
promotes thrombus formation
increases risk of MI and infarction
EKG for acute pericarditis
diffuse ST-segment elevation
PR-segment depression
intermittent claudication, diminished pulses and abnormal (<1) ankle brachial index suggests
peripheral artery disease
what is the major cause of morbidity and mortality in patients with peripheral artery disease
cardiovascular disease
RA pressure Pulmonary capillary wedge pressure Cardiac index ( pump function) Systemic vascular resistance Mixed venous oxygen saturation
cardiogenic shock
RA: increased PCWP: Increased CI: Decrease decease SVR: Increase MvO2: decrease
RA pressure Pulmonary capillary wedge pressure Cardiac index ( pump function) Systemic vascular resistance Mixed venous oxygen saturation
hypovolemic shock
RA: decrease PCWP: decrease CI: decrease SVR: increase MvO2: decrease
RA pressure Pulmonary capillary wedge pressure Cardiac index ( pump function) Systemic vascular resistance Mixed venous oxygen saturation
septic shock
RA: normal or decrease PCEP: normal or decrease CI: increase SVR: decrease MvO2: increase
how does CHF impact kidney
preferential vasoconstriction of efferent renal arterioles which increases intraglomerular pressure in order to maintain adequate glomerular filtration rate
wide-complex tachycardia with 2 fusion beats is diagnostic for
sustained monomorphic ventricular tachycardia
treatment for sustained monomorphic ventricular tachycardia
IV amiodarone
carotid sinus massage is useful vagal maneuver to terminate
paroxysmal supra ventricular tachycardia
what is esmolol and what is it used for
ultra-short-acting beta blocker
- rapid rate control in atrial flutter or fibrillation
symptomatic sinus bradycardia should be treated how? patients with inadequate response with sinus bradycardia should further be treated with
IV atropine
- IV epinephrine and dopamine or transcutaneous pacing
Holosystolic murmur best heard at the apex with radiation to the axilla
mitral regurgitation
how does inelastic pericardium cause right sided heart failure
prevents venous return to the right heart during inspiration
patient has progressive peripheral edema, elevated jugular venous pressure, haptomegaly and ascites. has
Constrictive pericardtitis
what can cause constrictive pericarditis
medastinal irradtion
how is hypertrophic cardiomyopathy inherited? what is mutated
autosomal dominant genetic disorder
- cardiac myosin binding protein C gene
- cardiac beta-myosin heavy chain gene
aortic dissection involving the carotid or vertebral arteries can cause
cerebral hypo perfusion
Ascending aortic dissection can cause
cardiac tamponade: hypotension, pulses paradoxus, elevated JVD,
acute aortic regurgitation
Loop diuretics can cause what electrolyte abnormality
hypokalemia
hypomagnesemia
class of drug for metolozone
thiazide
when do you not use a beta blocker in MI
presence of pulmonary edema and bradycardia
CHADSVASC score of what should start anticoagulation? which anticoags should be started
2
- Warfarin or non-vitamin-K antagonist oral anticoagulants
Cilostazol is what and what is it used for
phophodiesterase inhibitor
- symptomatic management of intermittent claudication
diagnose headache, dyspnea, and blurred vision
hypertensive emergency
hypertensive urgency
hypertension without symptoms of end-organ damage
PE findings for malignant hyperension
papilledema and retinal hemorrhages
hypertensive encephalopathy
cerebral edema due to break through vasodilation
hypertensive emergency
hypertension with malignant hypertension or hypertensive encephalopathy
Kussmaul’s sign
lack of typical inspiratory decline in central venous pressure
Pericardial knock
early heart sound after S2
in developing and endemic areas what is the common cause of constrictive pericarditis
tuberculosis
Psittacosis disease, transmission? and organ is impacted
bird to human
lung
pericardial calcifications seen in X-ray indicates
constrictive pericarditis
