Cardio Flashcards
Differentials for narrow QRS
-Sinus
-Atrial
-AV nodal
Differentials for wide/bizarre QRS
-Ventricular
-Conduction abnormality (BBB)
Differentials for no P for every QRS
-A fib
-Ventricular complex
Differentials for no QRS for every P
-AV block (2nd and 3rd)
-Atrial flutter
Class I antiarrhythmics
Na+ channel blockers
-lidocaine
-mexiletine
Class II antiarrhythmics
Beta-blockers
-Uses: supraventricular and less commonly ventricular arrhythmias
-Side effects: Negative inotrope, bradycardia, hypotension
-Atenolol
-Propanolol
Class III antiarrhythmics
K+ channel blockers
-Uses: ventricular arrhythmias, supraventricular arrhythmias, a-fib (amiodarone)
-Sotalol
-Amiodarone
Class IV antiarrhythmics
Ca2+ channel blockers
-Diltiazem
-Slows AV node conduction
-Uses: a-fib, supraventricular arrhythmias
-Side effects: negative inotrope, weakness, hypotension
Miscellaneous antiarrhythmics
Digoxin
Antiarrhythmic Drug Actions
Lidocaine/Mexiletine
Class 1b
Na2+ blocker
Shortens AP duration
Uses: Ventricular arrhythmias
Procainamide
Class 1a
Na2+ blocker, affects some K+ channels
Prolonged AP
Uses: ventricular arrhythmias, a-fib, +/- supraventricular tachyarrhythmias
Sotalol
Class III
K+ channel blocker
Increases AP duration
Non-selective beta blocker at higher doses
Uses: chronic ventricular arrhythmias
Contraindications: prolonged QT
Amiodarone
Class III
K+ channel blocker - increases AP duration
Uses: ventricular arrhythmias, a-fib, other supraventricular arrhythmias
Diltiazem
Class IV
Ca2+ ch blocker- slows conduction through AV node, increases refractory period of AV node
Uses: supraventricular tachyarrhythmias (a-fib, sustained supraventricular tachyarrhythmias)
Digoxin
Antiarrhythmics
Inhibits Na+/K+/ATPase -> increases intercellular Na2+ -> exchanged for extracellular Ca2+ -> increased intracellular Ca2+ = forceful contraction
Uses: a-fib
Atenolol
Class II
Beta blocker- decreases autimacity, slows conduction through AV node, increases refractory period through AV node
Uses: supraventricular tachyarrhythmias, feline supraventricular tachyarrhythmias
Indications for temporary pacing
-Transient bradyarrhythmias
-Toxicities/overdosing in chronotropic incompetence (diltiazem overdosing)
-Emergency stabilization of critical bradyarrhythmias (high grade 2 AV block, 3rd degree AV block, sinus arrest, persistent atrial standstill)
What bacteria can cause endocarditis?
-Strep canis and bovis
-Bartonella
-Staph. spp
-E. Coli, pseudomonas, salmonella, citrobacter, klebsiella, proteus, pasteurella
-Actinomyces, mycobacterium, corynebacterium, enterococcus
Tree of Life
Diagnosis of FATE with 5p rule
-pallor (purple or pale toes)
-polar (cold extremities)
-pulselessness
-paralysis
-pain
BLASTT study
Prospective randomized study comparing thrombolysis with tissue plasmatogen activator (tPA) two placebo had an overall discharge rate of 37.5% for bilateral FATE
Pulmonary hypertension classification
1- pulmonary arterial hypertension
2- secondary to left heart disease
3- secondary to respiratory disease, hypoxia, both
4- secondary to pulmonary embolism combo thrombo embolism, thrombosis
5- secondary to parasitic infections (ie: heartworm disease)
6- multifactorial or unclear mechanisms
