CARDIO Flashcards
tetralogy of fallot (TOF)
- “PROVe” = pulmonic stenosis, right hypertrophy, overriding aorta, ventricular septal defect (VSD)
overriding aorta
flat blocking aorta
- blue (cyanosis), LOW O2, tet/blue spells
- LOW blood flow = crying, stress, large meals, long breastfeeding
- small frequent meals + less stress!
- Tx: knee-to-chest, soothe/calm child (sucrose, sucking, swaddle, skin-to-skin), + surgery!
patent ductus arteriosus (PDA)
opening bw duct of arteries = bypasses utero lungs
- MACHINE-LIKE MURMUR
- normal in FIRST 3 days!
- abnormal = after 3 days (72 hrs) = Tx: NSAIDs or Acetaminophen (if pregnant)
coarctation of aorta (COA)
kinking / narrowing of aorta
- systolic murmur
- diminished / weak pulses
- different pulses (upper and lower extremities)
- more than 3 sec capillary refill
- Turner’s syndrome! = “WIBSS” = webbed/wide neck, infertile, breast buds, short stature, streak ovaries
transposition of great arteries (TGA)
ALPROSTADIL infusion!
heart sounds
“All People Enjoy Times Magazine”
- Aorta = R sternal border - 2nd ICS
- Pulmonic = L sternal border - 2nd ICS
- Erb’s Point = L sternal border - 3rd ICS
- Tricuspid = L sternal border - 4th ICS
- Mital = L sternal border - 5th ICS
heart circulation
SVC/IVF → R. atrium → tricuspid valve (TV) → R. ventricle → pulmonary valve (PV) → pulmonary arteries → LUNGS →
pulmonary veins → L. atrium → bicuspid valve (BV) → L. ventricle → aortic valve (AV) → aorta → BODY
LEFT-sided HF
- L = LUNGS
- ALL HF = LOW O2, pale/apllor, cold/clammy, LOW UO, LOW BP
- LSHF = pulmonary edema, pink frothy sputum, crackles/rales, SOB, dyspnea, orthopnea (uncomfortable breathing when lying flat), cough, tachypnea
- can lead to RSHF → LSHF + RSHF = Complete HF!
RIGHT-sided HF
- R = rest of the body = NOT LUNGS
- ALL HF = LOW O2, pale/apllor, cold/clammy, LOW UO, LOW BP
- RSHF = ascites, JVD, edema, puffy face/cheeks, increased abdominal girth, hepatosplenomegaly, weight gain
COMPLETE HF
LSHF + RSHF
- ALL HF = LOW O2, pale/apllor, cold/clammy, LOW UO, LOW BP
- LSHF = pulmonary edema, pink frothy sputum, crackles/rales, SOB, dyspnea, orthopnea (uncomfortable breathing when lying flat), cough, tachypnea
- RSHF = ascites, JVD, edema, puffy face/cheeks, increased abdominal girth, hepatosplenomegaly, weight gain
confirming HF dx?
BNP!
- normal: < 100
- abnormal (HF): > 100
HF Treatment
- Diuretics = (-ide) (-thizide) (-one) = take in AM!
“DR BEEDS” - Diet = NO Na + IVF
- Risk for falls (orthostatic hypotension)
- BP + BNP (not elevated)
- Elevate with pillows in HIGH-Fowlers
- Exercise (cardiac rehab)
- Daily weights (monitor I&O)
- STOP SMOKING!
angina
chest pain
- stable = no tx
- unsatble = MONA (morphine, O2, nitroglycerin, aspirin)
CAD treatment
- Patient Education
- -Satins
- Nitrates
- Calcium Channel Blockers (-dipine)
- Stent
- CABG
-statins
Atorvastatin, Fluvastatin, Lovastatin
- increases HDL
- lowers LDL, triglycerides, total cholesterol
- check LFTs BEFORE
- SE: myopathy (rhabdomylysis)
- take in PM / BEDTIME!
nitrates
Nitroglycerin pacthes + Sublingual Nitroglycerin
- lowers BP!
- SE: headaches, flushing, orthostatic hypotension, fall risk
- sublingual Nitroglycerin = 1 patch every 5 min 3 times a day (call 911 if 1st pill does not work!)
- Nitroglycerin patches = 1 patch at a time for 12-14 hrs! (do not cut + fold patch when discarding)
calcium channel blockers (-dipine)
lowers BP!
- SE: orthostatic hypotension + peripheral edema!
- NEVER with -nafil drugs + GRAPEFRUIT!
PVD
ALL peripheral diseases!
- arteries, veins, lymph, extremities
PAD
artherosclerosis that slows/stops blood supply in periphery
- “PAD” = pale/pallor, absent/LOW HR, dry/clay/scaly skin
- cool + clammy
- peripheral neuropathy
- pAd = dAngle Arteries!
- NO elevating legs + NO compression socks!
venous insufficiency
insufficient vein
- risk factors: standing + obesity!
- bilateral peripheral edema = usually ankles and up
- ankles = ulcers, swollen, injury, discoloration (blue, dark brown)
- Venous inffuficiency = eleVate Veins!
- Elevate Legs + Compression socks!
cardiac tamponade
- Becks Triad (HIGH HR, LOW BP with narrow pulse pressure, muffled/distant heart tones)
- Tx: pericardiocentesis!
bacterial / infective endocarditis
inflammation of endocardium due to bacteria (inned lining of heart)
- #1 cause = IV drug use!
- Janeway lesions!
- can cause RSHF = JVD, puffy face, edema, ascites
- risk for PE!
- Tx: IV vancomycin, valve replacement + prophylactic antibiotics!
MI
“substernal crushing”
“elephant sitting on my chest”
- Dx: PCI
-
sinus BRADYCARDIA
< 60 bpm
- no symptoms = monitor!
- symptoms = trancutaneous pacing + IV atropine!
