Cardio 3 Flashcards
Management of patients with MS and Afib?
Treat all patients with Warfarin regardless of CHADSVASC
- Pt presents with diastolic rumble, opening snap, JVD, edema, and progressive dyspnea. Dx?
- Rx in Symptomatic?
- When to treat the Asymptomatic?
- When is this contraindicated?
- When is Repair/Replacement Surgery indicated?
- Pregnant?
- MS
- Percutaneous Balloon Mitral commissurotomy
- Asymptomatic when valve area < 1.5cm2
- When pt is Concomitant MR or Left Atrial Appendage seen on TEE
- Only When Balloon Commissurotomy is unavailable or Patient Fails Balloon Method
- Metoprolol beta-blocker (allow for greater filling time and relief of PH)
Name 6 causes of MR?
- Infection (Endocarditis)
- Ischemia (Papillary muscle ruption
- MVP
- HCM
- Marfan syndrome (also cases TAA and TR)
- Ventricular Dilatation
Elevated JVD, peripheral edema, holosystolic murmur heard left sternal border Increases during Inspiration due to increase Venous Return. Dx? Test? Rx?
TR
Due TTE to confirm and determine Size and Assess Severity
Surgery when Severe, Symptomatic and NON responsive to Medical Management
The rate is 50 bpm> but < 120bpm
Accelerated idoventricular rhythm
Name that Rhythm: Associated with SOB and Hypotension
S1Q3T3 PE
Name the Rhythm
First Degree AV Block
Name that Rhythm
Mobitz Type I Second Degree Heart Block
Name that rhytm
AVNRT
Name that Rhythm
Right Ventricular Hypertrophy
Shows R ventricular Strain pattern with downward concave ST-T wave abnormality V1-V3
Name That Rhythm
Lead Reversal
Opposite deflections in Lead I, II, AVL and AVF
Name that Rhythm
What is the treatment?
Long QT Syndrome
Men > 440 Women > 460
Beta Blocker therapy (Propanolol)
ICD for VT or Syncope
Name that Rhythm:
Where is this present?
M shaped/Notched P wave in one or more of the mitral leads I, II, AVL
Significant for Mitral Stenosis due to Left atrial Enlargement
Name that Rhythm
WPW
Delta Wave Before QRS
Name that rhythm, Electrolyte abnormality.
Hypocalcemia, prolongation of QT
Name that Rhythm
3rd Degree Heart Block
Name that Rhythm
Non acute posterior inferior MI
There are Q waves in lead II, III, AVF
Name that Rhythm
Inferior Wall MI
Name that Rhythm
Junctional Rhythm
When the P wave is negative in lead II preceding or following the QRS
Name That Rhythm
Mobitz II Second Degree Heart Block
Name that rhythm:
Hyperkalemia, K+ > 8
Peak T waves
Loss of P wave
Next step in management with patient who has Symptomatic Paroxysmal Atrial Fibrillation who failed treatment with at least 1 Class I or Class II anti-arrhythmic.
Catheter Ablation
Next step in management for patient who presents with new onset A flutter?
Radiofrequency Ablation
Autosomal Dominant disorder presents with Incomplete RBBB, ST elevation in precordial leads and T wave inversions. Pt presents with Syncope or Sudden Cardiac Death?
Brugada Syndrome
- Management of a WPW with Afib?
- Management of WPW w/o Afib? What to avoid and Why?
- Ablate
- Ibulitide or Flecainide. Avoid CCB and BB which will block the AV node and send the impulse down the accessory pathway
Management of Aortic Stenosis:
- Indications for Asymptomatic?
- Indications for Symptomatic?
How to tell the difference when there is Severe LV Dysfunction (Pseudostenosis) Vs True Aortic Stenosis?
Who gets TAVI?
Rx for Heyde Syndrome?
50%-4.0m/s-40mmg, <1.0cm2
- AS < 1.0cm2, LVEF < 50% with Velocity > 4.0m/s, Mean graditent > 40mmHg
- Symptomatic (Angina,Syncope) + AS < 1.0cm2, Velocity > 4.0 m/s, Gradient > 40mmHg
Cardiac Catherization
NON Surgical Candidates
(AS + AVM = GI bleeding) SAVR or TAVI
Rhythm?
Electrical Alterans in Cardiac Tamponade
