cardio 11 Flashcards
First-degree AV block management?
Observatory
When we need a further evaluation?
When symptomatic(24 hour ECG monitoring)
Why?
since highly associated with HF and AFib
When will be patient with a previous diagnosis of MI will have a high risk of SCD?
When a patient has systolic cardiac dysfunction which not respond to medication.
What will be the MCC of SCD in these patients?
Ventricular tachycardia
How we manage?
Intracardiac defibrilator.
WPWS pathophysiology?
abnormal electrical conduction from atria to ventricle that bypass AV node called bendele of kent.
ECG future?
Short PR interval < 120(ventricular preexitation)
Delta waves(Ventricular preexitation)
QRS widening(VP)
ST and T wave abnormality(Change in 2ndary depolarization)
This ECG future may not visible when patient have in episode of RSVT as complication.
Complication?
Supraventricular re-enteratnt tachycardia
SCD
Management?
If the patient has AFib or Aflu with rapid ventricular response give amiodarone/Procainamide and avoid drug slow AV nodal activity.
cardioversion in hemodynamically unstable patient
do risk stratification
Risk stratification Importance?
High-risk patient (When have the accessory way have lower repolarization time done with cardiac stimulation in cardiac electrophysiology testing)–They need catheter ablation of a bundle of kent.
If have high repolarization time and reappearance of delta wave during stimulation—low risk–observe
Definition of QT prolongation?
> 450 in males
>470 in females
When we do pharmacologic stress test?
For diagnosis of stable angina when patient not able to do ECG exercise stress test like patient with lower extremity and joint problems LBB Pacemaker Patient unable to get target HR
What pharmacologic agent used for stress tests?
Adenosin(analog:regadenoson and regadenoson)
Dipyiridamol(PDE inhibitor)
Mechanism?
No effect in HR/BP unlike EST
Coronary artery vasodilation-Increase B/F to non obstructed area several-fold to that of the ischemic area(detected by radioisotope)–induce ischemia
Contraindication to PST?
Reactive airway disease
Patient taking dipyridamole or methylxanthines
Exercise ST mechanism?
Increase HR
Increase B/P
EST best for
Patient able to reach target HR(Which is 85%, of (220 -age patient))
Dobutamine-induced echocardiography used for?
Patient with reactive airway disease and
Patient unable to reach the target HR
Goal?
Increase HR/BP
Not Used?
Patient with tachyarrhythmia
What do we see?
wall motion abnormality in echo after dopamine administration
MCC of AR in a developed nation?
BAV(Sporadic or Autosomal dominant)
Clinical menifestation?
If cause valvular AR(Murmur in LSB)
If vause aortic root (murmur in R@ICS)
Age presentation(30-40), lower than when it causes AS
