CARDIO Flashcards by Alison Nash

MC valve affected by infective endocarditis

Mitral (tricuspid if IVDA)

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MC organism to cause acute infective endocarditis

staph aureus (esp IVDA)

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MC organism to cause subacute infective endocarditis

streptococcus viridans

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MC organism in early prosthetic valve endocarditis

staph epidermidis

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Endocarditis in men >50 years old with recent GI or GU procedure, likely caused by this organism

enterococcus

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Suspect these organisms in pt with endocarditis and negative bcx

HACEK organisms
Haemophilus aphrophilus
Actinobacillus
Cardiobacterium hominis
Eikenella corrodens
Kingella kingae

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Dx for endocarditis

Modified Duke criteria

Rq. +2 major, +1 major and +3 minor, or +5 minor
–major: pos bcx, pos echo
–minor: predisposing condition (recent procedure, ivda, etc), fever, vascular or embolic phenomena (janeway lesions, septic arterial or pulmonary embolic, etc), immunologic phenomena (Osler’s node, Roth spots, +RF, acute glomerulonephritis), +BCx or +TTE not meeting major criteria

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Tx for endocarditis

anti-staphylococcal pcn (nafcillin or oxacillin) and ceftriaxone or gentamicin x4-6 weeks

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Tx for prosthetic endocarditis

Vancomycin, gentamicin, and rifampin x4-6 weeks

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Endocarditis ppx indications

predisposing cardiac condition (prosthetic valve, h/o endocarditis, congenital heart disease, cardiac valvulopathy in heart transplant pt) AND 2. Routine dental, respiratory, or skin procedure (includes I&D)

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Endocarditis ppx tx

amoxicillin 2g 30 min preop (clinda 600mg if allergic)

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2 MC causes of pericarditis

idiopathic and viral (enterovirus, coxsackie virus)

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Triad in Dressler syndrome:

post-MI pericarditis, fever, pleural effusion

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electrical alternans is seen in this condition

pericardial effusion
(alternating QRS complex amplitude)

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Dx of cardiac tamponade:

TTE w/ pericardial effusion and diastolic collapse of chambers

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Tx of cardiac tamponade:

immediate pericardiocentesis

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Dx for constrictive pericarditis:

TTE w/ pericardial thickening or calcifications (CT scan or MRI more sensitive than TTE)

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pericardial knock may be heard in this condition

constrictive pericarditis

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Tx for constrictive pericarditis:

sxs: diuretics
definitive mgmt: pericardiectomy

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MC valvular disease

aortic stenosis

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MC innocent physiologic murmur

still murmur

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MC continuous benign murmur

cervical venous hum

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Congenital heart disease that can lead to paradoxical embolic or cryptogenic strokes

PFO, ASD

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MC type of ASD

ostium secundum

congenital narrowing of the aortic lumen at the distal arch, often associated w/ bicuspid aortic valve

COA

MC cyanotic congenital heart disease

TOF "blue baby syndrome"

MC cyanotic congenital heart disease presenting in neonatal period

TOGA

MC type of congenital heart disease in childhood

VSD

MC type of VSD

perimembraneous

Most common RF for CAD

DM (considered anginal equivalent)

Most common modifiable RF for CAD

smoking

CI to myocardial perfusion imaging

severe bronchospastic disease

MC cause of MI

atherosclerosis

Drug of choice for HTN in post-MI

ACEi, BB

Drug of choice for HTN in HF

ACEi, ARB, BB

Drug of choice for HTN in BPH

alpha1 blockers (prazosin, terazosin, doxazosin)

Drug of choice for HTN in DM

ACEi, ARB

Drug of choice for HTN in AA

TZDs, CCB

Drug of choice for HTN in gout

CCB

Drug of choice for HTN with concurrent afib/flutter

BB, CCB

CI to CCB

CHF and 2nd/3rd AVB

CI to BB

CHF and 2nd/3rd AVB (nonselective CI in asthma/copd)

MC cause of syncope

vasovagal (includes prodomal phase)

Beck's triad is seen in this condition

pericardial tamponade (increased JVP, hypotension, muffled heart sounds)

Define SIRS:

Rq 2/4: 1- Temperature (>38 or <36) 2- Pulse >90 3- RR > 20 or PaCO2 <32mmHg 4- WBC >12k or <4k

Define sepsis:

SIRS + source of infx (often lactate >4mmol/L)

Define severe sepsis:

sepsis + end organ damage

Define septic shock:

sepsis + refractory hypotension despite fluids (SBP <90, MAP <65, or drop in SBP 40mmHg from baseline)

only major type of shock associated with increased cardiac output

distributive

Best meds to lower LDL

Statins

Best meds to lower Tg

Fibrates

Best meds to increase HDL

Niacin

MC cause of ventricular tachycardia and fibrillation

ischemic disease

Define CHADS2-VAS:

CHF HTN Age > 75 (+2) DM Stroke (+2) Vascular (prior MI, PAD) Age >65 Sex (female)

sinus arrest w/ alternating paroxysms of atrial tachyarrhythmias and bradyarrhythmias

sick sinus syndrome (Brady-tachy syndrome)

Initiate statin in patients with: (5)

1. Age 40-75 yo with diabetes 2. Age 40-75 yo with >7.5% CVD risk for MI or CVA in 10 years 3. Age >21 with LDL >190 4. Age <19 yo with fam hypercholesteremia 5. Clinical CVD

MC cause of primary HTN

idiopathic

MC cause of secondary HTN

renovascular

MC cause of ESRD