Cardiac Flashcards
On arterial blood pressure monitoring where is the systolic and diastolic notch?
Systolic is peak, diastolic is valley
What congenital heart defect is a harsh loud mid systolic murmur at the left sternal border that radiates to the neck?
Aortic stenosis
Hypovolemia, anaphylaxis, distributive shock cause high or low CVPs?
Low low
What grade of murmur can be heard without a stethoscope?
Grade six
What are the three components of an AV canal defect?
ASD, inlet VSD, abnormal formation of the AV valves with left to right shunting
What is the most useful diuretic in lowering BP?
Thiazides
What are the four findings of tetralogy of fallot?
VSD, right ventricular out tracked obstruction, overriding aorta, right ventricular hypertrophy
What criteria are you used to diagnose endocarditis?
The Duke criteria either two major or one major plus two minor or five minor criteria
What are symptoms of cardiac tamponade?
Friction rub, cold extremities, poor perfusion, absent peripheral pulses
What are classic symptoms of a coarctation of the aorta?
Upper extremity hypertension, brachial femoral pulse lag absent or weak pulses in lower extremities
What is the management of cardiac tamponade?
Pericardial thoracentesis
What defines pulmonary hypertension?
Pulmonary arterial pressure greater than 25 at rest
What is diagnostic for a kylo thorax?
Triglyceride level greater than 110 in pleural fluid
What is the treatment of long QT syndrome?
Beta blockers
What is the benefit of doing a trans esophageal echo?
Better picture of aorta pulmonary artery other valves, and atrial septum
What is the acute management of cardiomyopathy?
Increase cardio output with inotropes, vasodilators, diuretics
How are vascular rings or slings diagnosed?
Barium swallow or CT if needed
What is the treatment of pericarditis?
Emergent pericardiocentesis and antibiotics for staph in h flu
Where is a VSD murmur heard?
Left lower sternal border
Where is peripheral pulmonic stenosis best heard?
Left upper sternal border
What post operative complication presents with fever, pericardial effusion, fatigue, chest pain, poor po intake?
Post pericardiotomy syndrome
What blood pressure medication can cause hyperkalemia when there’s volume depletion?
Ace inhibitors such as Lisinopril
What is rheumatic fever
Vasculitis that occurs two to four weeks falling group a strep pharyngitis
What is the goal reduction of blood pressure in the first 12 hours?
25 to 30%
What are osler nodes and what are they a sign of?
Finger oddities caused by endocarditis
What murmur is obliterated by rotating the head to the side or including the neck veins?
Venus hum
For treatments for tet spells?
Oxygen as a pulmonary vasodilator, morphine for sedation, bicarb to correct acidosis, phenylephrine which selectively increases systemic vascular resistance
What is the most common bacteria responsible for endocarditis?
Staph and strep
What are normal PA pressures?
Less than 30
During a hypertensive emergency what is your most concerning outcome?
P r e s or hypertensive encephalopathy
What does a child with tricuspid atresia need at birth to survive?
ASD
What category of defect has blood flowing from left to right?
A cyanotic
What are indications for an echo?
Suspected congenital or acquired heart disease or arrhythmias
Why do we care about long QT syndrome?
Can lead to syncope, cardiac arrest, or sudden death
Is the usual cause of myocarditis?
Virus
What murmur transmits to the right and left trust, axilla, and back?
Peripheral pneumonic stenosis
A widely split fixed S2 murmur heard best at the left upper stone border is the Hallmark sound for what a cyanotic heart defect?
ASD
What are symptoms of congestive heart failure?
Crackles, respiratory distress, diaphoresis, hepatomegaly, failure to thrive, exercise intolerance
What is the most common innocent murmur?
Stills murmur
What x-ray marking show up on a patient with co-workation of the aorta?
Three sign, rib notching
What is the classic murmur of an AV canal?
Systolic regurgitant murmur heard at the left lower sternal border
Where is mitral stenosis heard?
Optical murmur
Who’s the most common cyanotic defect in newborns?
Transposition of the great vessels
What is the most deadly and least common type of cardiomyopathy?
Restrictive
What is Beck’s triad?
JVD, muffled heart sounds, hypotension
What type of cardiomyopathy results in diastolic dysfunction and atrial issues as large amount of blood is not able to leave the ventricle?
Restrictive
What congenital heart defect will have discrepancies in four extremity blood pressures?
Corruption of the aorta
What does rheumatic fever lead to?
Vasculitis, possibly mitral valve disease
TR, TS, high IT pressures, and heart failure cause high or low CVPs?
Hi
What congenital heart defect is a continuous machinery like murmur heard at the left infraclavicular area or upper left sternal border?
Pda
What will a chest x-ray look like of someone with cardiomyopathy?
Cardiomegaly, pulmonary edema
What are other symptoms of endocarditis?
Fever, septic emboli, myalgias, malaise, petechiae
What is a hypersonic event?
Lack of preload and extreme left to right shunting causing hyperpnea
What is the treatment of myocarditis?
Supportive care with digoxin, ACE inhibitors, diuretics, IVIG
What is treatment for pulmonary atresia?
Needs PGE at birth and emergent BT shunt
What are signs of mitral stenosis?
Atrial fib, pulmonary edema, blood clots
Baby canal defect is associated with what genetic disorder?
Trisomy 21
What is used to prevent unrestricted pulmonary blood flow and prevent pulmonary over circulation?
PA band
What type of cardiomyopathy causes systolic dysfunction resulting in decrease contractility and very poor function?
Dilated
What is the long-term management for post-operative SVT?
Digoxin, propranolol, amiodarone
What is the most common congenital heart defect?
VSD
Where is a stills murmur best herd?
Mid-left sternal border when the patient is supine
What murmur is best heard at the left upper sternal border, mid systolic and is innocent?
Pulmonary ejection murmur
What is a sign that a syncopal episode is more likely a severe etiology?
Loss of consciousness greater than 1 minute
The classic x-ray finding of a child with tetralogy of fellow?
Boot-shaped heart
What diuretics are used in CHF?
Chlorothiazide
What is the treatment of total anomalous pulmonary veinous return?
Atrial subtoped me if obstructive surgical repair within first few years of life
What is the treatment for post-pericardiotomy syndrome?
And sets 5 to 7 days or systemic steroids
What is a cardiac reason for syncope?
Arrhythmias or outflow tract obstruction causing cerebral hypoperfusion
What is the gold standard to diagnose myocarditis?
Biopsy
What does t a p v r look like on an x ray?
Snowman sign
What is the treatment for hypertrophic obstructive cardiomyopathy?
Beta blockers, avoid catecholamines
Common arrhythmias that occur after cardiac surgery?
Jet and SVT
How is rheumatic fever treated?
Penicillin, aspirin and bed rest until fever and symptoms resolve
What sign out a heart disease has a hololysystolic murmur at the left sternal border?
Tetrology of fallot
What is good treatment for dilated cardiomyopathy?
Beta blockers
What medications are used to help with cardiac contractility in CHF?
Digoxin enalapril middle of renowned other vasodilators
What is a normal CVP?
2:00 to 6:00
What is diagnostic for rheumatic fever?
Two major or one major and two minor of the Jones criteria
What is a good blood pressure medication and asthma patients?
Calcium channel blocker such as amlodipine
What are the three types of cardiomyopathy?
Dilated, hypertrophic, restrictive
What blood pressure medication needs to be avoided in diabetes, asthma, and heart block?
Beta blockers such as atenolol
What shows up on an echo of someone with cardiomyopathy?
Decreased CO and global function
What is the staged surgery order for hypoplastic left heart syndrome?
Norwood, bidirectional Glenn, fontan
What is the treatment for endocarditis?
4 to 6 weeks of antibiotics surgery if abscess or emboli
What are the seven s’s of innocent murmurs?
Small, single, short, sensitive, soft, sweet, systolic
What is the difference between venoarterial and venovenous ECMO support?
VA- heart and lungs
VV- respiratory only
What are three ways of pacing the heart?
Esophageal, epicardial, transvenus, transcutaneous
What is the treatment for TGA?
Atrial substance to me and PGE to keep the duct open
What is the leading cause of acquired heart disease?
Kawasaki disease
Just the first second and third letter in pacing modes represent?
Chamber paced so either a atrial ventricular or dual
Chamber sensed either atrial ventricular or dual
Response too sensed event so either trigger or inhibited
What is post pericardiotomy syndrome?
Federal illness secondary to a cell mediated immune inflammatory reaction 1 to 2 weeks after tissue injury to myocardium
What shunt increases pulmonary blood flow inductal dependent legions? And is an artificial PDA?
BT shunt
What is the treatment of choice for arrhythmias related to cardiomyopathy?
Amiodarone
What are the major Jones criteria?
Migratory arthritis, carditis and valvulitis, chorea, erythema marginatum, subcutaneous nodule
What are the minor Jones criteria?
Arthralgia, fever, elevated ESR or CRP, prolonged PR interval
What are the early reasons for failure of a cardiac transplant?
Raft failure and right heart failure that is associated with elevated pulmonary vascular resistance
Becks triad is really to what cardiac emergency?
Cardiac tamponade
What is the most common cause of mitral stenosis?
Rheumatic fever
What grade of murmur has a thrill?
Grade four
What medication is used in CHF for heart remodeling?
Aldactone
What maneuver do children naturally do during touch spells?
Need a chest which increases the pulmonary vascular resistance
What condition does pericarditis sometimes present like?
Tamponade
What is the treatment for SVT?
Bagel maneuvers, synchronized cardioversion, adenosine 1 mg per kg per dose
What is the physiological consequence of right ventricular pressure overload and ventricular dysfunction?
Pulmonary hypertension
What are characteristics of a pathologic murmur?
Holosystolic, diastolic, greater than grade 3 or with a click, harsh, increases in intensity withstanding
What is the acronym for location of heart sounds?
APT M
AORTIC, pulmonic, tricuspid, mitral / apex
What is the definition of hypertension?
Blood pressure consistently above 95th percentile for age measured on three separate occasions
Cardiac tamponade, dehydration, asthma cause wide or narrow arterial blood pressures?
Narrow
What cardiomyopathy has rare syncope but malignant?
Hypertrophic obstructive cardiomyopathy
When does low cardiac output syndrome occur?
Predictable falling cardiac output after bypass at 6 to 18 hours
What is the management of jet arrhythmia?
Immunodrome or cardiac pacing
Differentiate between essential and secondary hypertension
Essential is multifactorial and related to genetic familial or dietary factors
Secondary is usually a renal vascular in origin or some other systemic or metabolic or endocrine process
What is the treatment for tet spells?
Increase systemic vascular resistance, decrease impedance to pulmonary blood flow
Gold standard to diagnose pulmonary hypertension?
Cardiac catheterization
How does wolf parkinson white present?
chest pain and palpiations
