Cardiac/Thoracic Emergencies

Question 1

What are the three categories used in the initial approach of the evaluation of chest pain?

Answer 1

Chest wall pain. Pleuritic or respiratory chest pain. Visceral chest pain

Question 2

35 y/o male presents complaining of palpations that started while playing basketball 2 hrs ago. Now feels like his heart is racing. He has no chest pain or SOB. Vitals are stable. What is initial management of this patient with SVT?

Answer 2

vagal maneuvers and start IV adenosine

Question 3

If the condition of a patient who is experiencing SVT develops chest tightness with worsening vitals after initial treatment, what’s your next course of action?

Answer 3

Cardioversion

Question 4

What is the most important predisposing factor to an aortic dissection?

Answer 4

hypertension

Question 5

What might an CXR look like for a patient who presents with ripping pain between scapula who is also hypertensive and tachycardic?

Answer 5

widened mediastinum or loss of the demarcation of the aortic knob

Question 6

Medical therapy used in the management of aortic dissections of either type to reduce blood pressure

Answer 6

beta blockers (labetalol, metroprolol, esmolol) and vasodilators (nitroprusside)

Question 7

Vasopressors of choice for a patient with an aortic dissection who is hypotensive because of their limited effect on shear force

Answer 7

norepi and phenylephrine

Question 8

Radiographic finding that indicates pulmonary edema

Answer 8

kerley B lines

Question 9

used for the management of patients with pulmonary edema who are not in cardiogenic shock. acts immediately to decrease preload and afterload

Answer 9

IV nitroglycerin

Question 10

Name two causes of pulmonary edema mentioned

Answer 10

massive MI and valve disease