Cardiavascular Flashcards
Classic ECG finding in atrial flutter
“Sawtooth” P waves
Definition of unstable angina
Angina that is new or worsening with no raising in troponin level
Antihypertensive for a diabetic patient with proteinuria
Angiotensin-converting enzyme ingibitor
Beck triad for cardiac tamonade
Hypotension, distant heart sounds and jugular venous distention (JVD)
Drugs that slow heart rate
Beta blockers, calcium channel blockers , digoxin amiodarone
Hypercholesterolemia treatment that leads to flushing and pruritius
Niacin
Murmur —hypertrophic obstructive cardiomyopath
A systolic ejection murmur heard along the lateral sternal border that elevated with lowered preload (Valsalva maneuver)
Murmur — aortic insufficiency
Austin Flint murmur, a diastolic, decrescendo, low-pitched, blowing murmur that is best heard sitting up; elevated with elevated afterload (handgrip maneuver)
Murmur — aortic stenosis
A systolic crescendo / decrescendo murmur that radiates to the neck; elevated with elevated preload (squatting maneuver)
Murmur — mitral regurgitation
A holosystolic murmur that radiates to axilla: raised with elevated afterload (handgrip maneuver)
Murmur —- mitral stenosis
A diastolic , mid- to late, low-tiched murmur preceded by an opening snap
Treatment for atrial fibrilation and atrial flutter
If untable, cardiovert. If stabele or chronic, rate control with CCBs or beta-blokkers
Treatment for ventricular fibrilaltion
Immediate cardioversion
Drssler syndrome
An autoimmune reaction with fever, pericarditis, and elevated ESR occurring 2-4 weeks post -MI
IV drug use with JVD and a holosystiolic murmur at the left sternal border. Treatment?
Treat existing heart failure, and replace the tricuspid valve.
Diagnostic test for hypertrophic cardiomyopathy
Echocardiogram (showing a thickenend left ventricular wall and outflow obstruction)
Pulsus paradoxus
A lowering in systolic BP of > 10 mmHg with inspiration; seen in cardiac tamponade
Classic ECG findings in pericarditis
Low-voltage diffuse ST-segment elevation
Eight surgically correctable causes of hypertension
Renal artery stenosis, coarctation of the aorta, pheochromocytoma, Conn syndrome, Cushing syndrome, unilateral rnal parenchymal disease, hyperthyroidism, hyperparathyroidism
Evaluation of a pulsatile abdominal mass and bruit
Abdominal ultrasound and CT
Indications for surgical repair of abdominal aortic aneurysm
> 5,5 cma, rapidly enlarging, symptomatic, or ruptured
Treatment for acute coronary syndrome
ASA, heparin clopidogrel, morphine, Oé, sublingual nitroglycerin, IV beta-blockers
Metabolic syndrome
Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states
Appropirate diagnostic test?
* A 50 - year old man with stable angina can exercise to 85% of maximum predicted heart rate
Exercise stress treadmill with ECG
Appropirate diagnostic test?
* A 65-year - old woman with left bundle branch block and severe osteoarthritis has unstable angina
Pharmacologic stress test (eg, dobutamine echo)
Signs of active ischemia during stress testing
Angina, ST-segment changes on ECG, or lowered BP
ECG findings suggesting MI
ST - segment elevation (depression meands ischemia), flattened T wqaves ,and Q waves
Coronary territories in MI
Anterior wall (LAD / diagonal), inferior (PDA), posterior (left circumflex/ oblique, RCA/largubak) n seotyl (LAD/ diagonal)
A young patient with angina at rest and ST-segment elevation with normal cardiac enzymes
Prinzmetal angina
Common symptoms associated with silent MIs
CHF, shock, and altered mental status
Diagnostic test for pulmonary embolism
Spiral CT with contrast
Protamine
Reversses the effects of heparin
Prothrombin time
The coagulation parameter affected by warfarin
A young patient with a family history of sudden death collapses and dies while exercising
Hypertrophic cardiomyopathy
Endocarditis prophylaxis regimens
Oral surgery–amoxicillin for certain situations; GI or GU procerdures — not recommended
Virchow triad
Stasis hypercoagulability, endotherlial damage
The most common cause of hypertension in young woman
OCPs
The most common cause of hypertension in young men
Excessive EtOH
Figure 3 sign
Aortic coarctation
Water bottle-shaped heart
Pericardial effusion. Look for pulses paradoxus
Ekg kenmerk bij longproblemen (“P”ulmonair)
“P”eaked P waves
Ekg kenmerk bij “M”itralis oorzaken
“M”- shaped P waves
Hart auscultatie locaties: mnemonic
All Physcisians Take Money (aorta, pulmonair, triscupidalis, mitralis)
Management options for atrial fibrilation: mnemonic
ABCD : anticoagulate; Beta-blokkers to controle rate; Cardiovert/Calcium channel blockers; Digoxin (in refractory cases)
Welk nut hebben diuretica en digoxin bij CHF vnl.
symptomatisch verlichten, geen levensreddend voordeel
Acute CHV management Mnemonic
LMNOP: Lasix; Morphine; Nitraten; O2; Position (rechtop)
S3 galop associatie?
gedilateerde Cardio myopathie
S4 galop mogelijks associatie?
hypertrofisch Cardio Myopathie
Common causes of chesgt pain
include GERD, angina, esophageal pain, musculoskeletal disorders (costochondritis, trauma) and pneumonia
Welke 2 medicatie vertonen levensreddende eigenschappen bij angina pectoris
ASA en beta-blockers
Enzymen in bloed bij onstabiele angina? Mnemonic
U Aint got enzymes with Unstable Angina
Mnemonic: When your “MOAN”ing from an MI, remember
Morphine, O2, Asa, Nitrogen
Wanneer spreek je van dyslipidemia in bloed?
LDL > 130 mg/dl of HDL< 40mg/dL
Behandeling Hypertensie: mnemonic
ABCD: ACEs/ARBs ; Beta-blockerz; CCBs; Diuretics
Oorzaken secund. hypertensiemnemonic
CHAPS: Cushing; Hyperaldosteronism; Aortic coarctation; Pheochromocytoma; Stenosis of renal arteries
Hypertensie - emergencies : op welke basis worden ze gediagnosticeerd
Op basis van end - organ damage , niet op basis van bloeddruk
Oorzaken van pericarditis: mnemonic
CARDIAC RIND: Collagen vascular disease; Aortic dissection; Radiation; Drugs; Infections; Acute Renal failure Cardiac (MI) Rheumatic fever Injury Neoplasms Dressler syndrome
ST-segment verhogingen in pericarditis onderscheiden zich van MI door?
dat ze niet gelocaliseerd zijn in 1 regio van het hart
Beck triad can diagnose cardiac tamponade
JVD
Hypotensie
Distant heart sounds
Onderscheid aorta aneurisma en aortic dissection
aortic aneurism often associated with arteriosclerose, aortic dissection is offen associated with HTN
Emergency ascending against descending aortic dissections
ascending are surgical emergencies, descending are still emergencies, but can often be treated medicaly
6 P’s of acute ischemia
Pain Pallor Paralysis Pulse deficit Paresthesias Poikilothermia