Cardiac Hotshots

Question 1

Cardiac output equation (include all components)

Answer 1

CO = HR x SV
SV- preload, afterload, contractility

Question 2

Electrical alternans

Answer 2

Increased/ decreased amplitude of QRS on an ECG indicative of cardiac tamponade.

Question 3

CHF SO

Answer 3

Rales, dyspnea, no fever
O2, CPAP as needed
SBP ≥ 90 : NTG x 1 0.4 mg SL
SBP ≥ 100 NTG x 5
SBP < 90 Levophed (norepinephrine gtt) 4 mg/ 500 ml, 0.5 ml/ minute titrate [8mcg/ml]

Question 4

Patient describes burning chest discomfort and shortness of breath. BP 92/56

Answer 4

Inferior MI

Question 5

Patient with alcohol dependence. He had some withdrawal symptoms yesterday. Woken in the night with palpitations and inner unrest.

Answer 5

Controlled A fib

Question 6

Patient with aortic stenosis. Increasing shortness of breath over the last weeks, waking up with respiratory distress. What is abnormal in this rhythm?

Answer 6

LBBB

Question 7

Pronounced palpitations.

Answer 7

SVT

Question 8

Tendency to angina pectoris pain over the last two weeks. The patient has now had 30 minutes of intense chest pain. You suspect:

A. Anterior MI
B. Inferior MI
C. NSTEMI
D. Pericarditis

Answer 8

NSTEMI

Question 9

A patient presents with swelling of the upper lip, fever, hypertension, and new onset L facial droop. You note:

Answer 9

A fib with LBBB

Question 10

A patient with a history of hypertension and is a former smoker. Acute onset of oppressive chest pain that radiates to the jaw.

Static Cardiology:
- Interpretation
-Management
-Occlusion if relevant

Answer 10

Anterolateral MI
-ASA 162 mg PO
-NTG SBP > 100
-LAD

Question 11

Previously underwent CABG. An hour ago sudden onset of crushing chest pain radiating to the left shoulder.

Static Cardiology:
-Interpretation
- Management
-Occlusion if relevant

Answer 11

Inferior MI
-ASA 162 mg PO
-NTG relative contraindication
-RCA

Question 12

Found somnolent in his armchair.

Static Cardiology:
- Interpretation
-Management
-Management

Answer 12

Sinus Bradycardia
-TCP
- set rate (70-80)
- set mA
- check electrical capture on ECG
- check for mechanical capture
-increase mA by 10%
-reassess

Question 13

A patient saw a cardiologist for suspected tachycardia. He started metoprolol and reports palpitations for two days.

Static Cardiology:
-Interpretation
-Management

Answer 13

(Uncontrolled/ RVR) A Fib WPW
- maintain SpO2 94-99%, 12 lead
- How long, has this been going on
- IV NS fluid bolus
-monitor
- AV node blockers should be avoided in atrial fibrillation and atrial flutter with Wolff Parkinson White syndrome (WPW). —- avoid adenosine, diltiazem, verapamil, and other calcium channel blockers and beta-blockers.

They can exacerbate the syndrome by blocking the heart’s normal electrical pathway and facilitating antegrade conduction via the accessory pathway.

Question 14

A patient presents with what they describe as a tearing pain in their chest radiating to the back. You note altering BP in each arm. You suspect:

Answer 14

Dissecting aortic aneurysm