Cardio 14 Flashcards by molla asnake

a common symptom of Chagas disease?

Megacolon

Dilated cardiomyopathy

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Pathophysiology of DCM?

chronic myocarditis

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most sensetive PE finding in renovasculer HYTN?

abdominal bruit

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common age of RVH?

> 55

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best time for hearing of pericardial cknock?

Early diastole

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What will be the cause of holosystolic murmur that heard on apex and disapear after duretic therapy with patients In decompensated HF?

Secondary MR due to LV dilitation

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Mechanism of MR in thise case?

LV papilary muscle displacement

Dilation of cusps

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Cause of cardiogenic syncop?

AS/HCM
Vtech
sick sinus syndrome
Advanced AV block
Torsades de Pointes

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AS/HCM

during exercise

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Vtach?

No preceding symptom

cardiomyopathy or previous MI

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sick sinus syndrome?

Preceding fatigue or dizziness

Sinus pause on ECG

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advanced AV block?

bifesicular block
increased PR interval
Dropped QRS complex

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Torsades de Pointes?

No preceding symptom
Medicmiya
Hypomagnisimiaation
Hypokalemia

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CVS sign of AS?

Narrow PP
Increase impulse of PMI
Ejection systolic murmure

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Niacin S/E

Pruritis

Flushing

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Mechanism?

Increase histamine and prostaglandin release

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Management?

Low dos Asprin.

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Approach for a patient with Chest pain?

Low risk–No further testing
Intermediate–stress test
High risk–Coronary angiography

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Positive stress test?

Coronary angiography

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For high risk?

Start management

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statin mediated myopathy mechanism/

inhibit COQ synthesis–affect energy production

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other S/E

liver toxicity

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A common manifestation of atheroembolism?

Dermatologic

–Blue toe syndrome(blue finger with an intact pulse)
—Livedo reticularis
—Gangreen
—Ulcer

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Commonly occur when?

vascular procedure like coronary stenting

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Which patients are at risk

``` Aged Obese HYN Smoking Hypercholesterolemia DM ```

Other symptoms?

``` RF Pancreatitis GI bleeding Mesenteric ischemia Stroke Hollenhorst plaque ```

Hollenhorst plaque?

Bright, yellow refractile plaque on the retinal artery(indicate proximal source like carotid)

Management?

suportive statin reuce risk Prevent recurence

when to occur?

Earley or lately >30 days

Amidadrone s/e in tyroid mechanism and treatment?

4 mehanism(2 hypotroid and 2 hypertyroidism)

1(hypo)

Inhibition of pheripherial T3 conversion Inc T4, Dec T3, normal or decreased TSH No treatment needed

2(Hypo)

Decrease synthesis low T3,T4 but high TSH Treat with levothyroxine

3(AIT type 1)

Increase synthesis(pt with nodular goiter or latent grave disease) HIgh T3, T4 but low TSH High RAIU and vascularity on U/S treat with antithyroid drug

4(AIT type 2)

Destruction HIgh T3,T4 but low TSH Low RAIU and vascularity on U/S treat with steroid

Most common cause of AS in young?

supravalvular aortic stenosis

CM of SVAS?

Systolic murmur at right 1st ICS(unlike AS) Unequal carotid pulse Unequal upper extremity B/P(due to high flow speed in ascending aorta) Palpable thril in suprasternal noch exercise-induced chest pain(due to LV hypertrophy which increases myocardial o2 demand or associated coronary artery congenital stenosis0

cause of HF with normal EF?

LV diastolic dysfunction Valvular disease Pericardial disease high output HF

LV diastolic dysfunction causes?

Concentric hypertrophy Hypertrophic cardiomyopathy Restrictive cardiomyopathy

Valvular disease cause?

AS/AR | MS/MR

pericardial disease cause?

Constrictive pericarditis | cardiac temponade

Pathophysiology in pericardial and LV dysfunction?

LV stiffness--increase LVEDP--P transmit to atria and pulmonary vein--Left side HF

The absence of an S3 gallop excludes what in MR?

Sever chronic MR(except in case of pt with HF)

What is the cause of Dyspnea in MR with clear lung?

decrease CO

What causes fixed splitting in AS?

Equalization of pressure in left and right atrium

common artery for RVI?

RCA

common artery for PMI?

RCA(PMPM)

common artery for VSD?

RCA(Basal) | LAD(Apical)

common artery for FWR?

LAD

common artery for Anurythm?

LAD

What does the murmur grade indicate In PMR?

mostly soft | the more low grade the more severe

What maneuvers can we teach patients with vasovagal syncope?

Counter pressure technique - -crossing leg with tensing muscle - -hand grip - -tensing muscle with clenching fist

When to do?

When prodromal symptom occur

mechanism?

Increase venous return--abort syncopal episode.

Digoxin toxicity treatment?

Drug discontinuation Hydration If sever Fab AB

A most sensitive measure of CHF?

BNP>400--High sensitivity | BNP<100 ---High NPP

ECG fuure of acut pericarditis/

``` PR depression(atrial myocardium) ST segment elevation(Ventricular myocardium0 ```

Management of acute pericardium?

NSAID(If Asprin it should be high dose) with colchicine in case of viral/idiopathic case. Corticosteroid if the patient fails to take this combination (e.g in case RF)

Skin manifestation amyloidosis?

Waxy skin thikning | Easy bruzing

Beta-blocker toxicity manifestation?

``` Bradycardia Heart block Hypotension Bronchospasm Seizure and delirium ```

Management?

- -IV fluid - -Atropine - -Glucagone - -NE/Epinephrin - - use successively

What glucagon can be used?

CCB

Treatment Dressler syndrome?

The same to the idiopathic one | Avoid anticoagulant--the risk of hemorrhagic pericarditis

When do we consider rhythm control medication in AF?

Unable to adequate HR control Recurrent symptom(dizziness, palpitation.....) Heart Failure

HR controlling medication?

Beta-blocker CCB Digoxin