Board Review Flashcards
S3 suggests
Dilated ventricle in CHF
Risk factors for dilated cardiomyopathy
Men, alcohol, adriomycin (chemo), thyroid, pregnancy, infections
A pregnant woman is short of breath, what is it?
Dilated cardiomyopathy (insidious) or PE (acute)
S4 suggests
Hypertrophic ventricle. Either hypertrophic cardiomyopathy or from hypertension
Who gets hypertrophic obstructive cardiomyopathy (HOCUM)?
Kids playing sports
How to treat HOCUM?
With funnel drugs (chronotropic beta blockers like metop)
How does HOCUM present diagnostically?
Kid passes out. Pathological q waves on wig, large septum on echo. Rate control then surgery
Pericarditis presents how?
Positional chest pain (laying down) and symptoms like restrictive cardiomyopathy. Friction rub. EKG will show diffuse ST elevations without reciprocal changes.
Triad of cardiac tamponade
JVD, muffled heart sounds, hypotension/pulsus paradoxus
Becky triad
Three causes of JVD
Tension pneumothorax, cardiac tamponade, CHF
Systolic murmurs
S-MIAS
Mitral insufficiency or aortic stenosis
Diastolic murmurs
D-AIMS
AOrtic insufficiency, mitral stenosis
What does “blowing” murmur mean?
Insufficiency- either mitral or aortic
Diastolic murmur that radiates inferiorly, maybe pistol shot
Aortic insufficiency
What do prostaglandins do?
Protect mucus membranes, small blood vessels
Baby less than 2 weeks is tanking, sepsis is ruled out, what is the prob and how do you treat it?
VSD or other major congenital defect (TET). Treat initially by opening ductus arteriosis with prostaglandins
When and How do you treat PDA?
Treat it when the kid is ok! Wth indomethacin
Causes of AFib
Stressed heart (HTN, valves CAD), hyper-sympathetic (thyrotoxicosis, Etoh), lung stress to heart (COPD)
How to treat AFib?
Keep rate slow, prevent clots, convert rhythm.
Funnel drugs- beta blockers, calcium channel blockers, dig
Anticoagulation- heparin, Coumadin, lovenox, xarelto
Convert rhythm before anticoagulant of unstable, or have had AFib
CHADS 2 score
Risk of clot after AFib. If score is over 2, keep INR>2. CHF HTN Age > 75 Diabetes Stroke
Treat AFlutter?
Usually transient, going into or coming out of AFib.
Tx is rate control or waiting
Treatments for SVT
Adenosine (d for down) or vagal maneuvers
VTach treatment
Bon Jovi rhythm- is the pt dead ( no pulse) or alive (pulse).
Alive, ok-no funnel drugs because it’s a v rhythm not through AV nose. Use amiodarone.
Unstable but pulse present- cardiovert
Dead- defibrillate
Torsades treatment
Magnesium sulfate