cardio 3 Flashcards
What Is AAA?
When the AA size more than 3 cm
Risk factor for formation and progression?
Age >60
Smoking (The strongest one)
Male sex
Hypertension
History of atherosclerotic disease
Connective Tissue disease
How smoking affects it?
Activate protease activity
Increase chronic inflammation
smooth muscle dysfunction
Cause for initiation and progression of the aneurysm
clinical presentation?
Mostly asymptomatic
Rapid expansion–Dull abdominal/back pain and distal embolization
Rapture–shock, back and Abd pain and flank hematoma
Indiction to repair
size more than 5.5 cm and rapid expansion >=1 cm per year growth symptomatic patient(as urgent for HS and emergency repair for HUS patients
If asymptomatic jut do lifestyle modification and smoking cessation
PAD diagnosis?
intermittent claudication with ABI<0.9
Management?
Risk modification
Antiplatelet
statin
Exercise (3/week-30-45 min/12 weeks)–goal is to follow symptom persistency
If the symptom persists–Do revascularization and cilostazol
S3 (V.gallop)?
Heard after S2 Normal in children, young adult, and pregnant abnormal-Age>40,HF,RCMP,High output state
S4 (A.gallop)?
Heard just before S1 Normal in healthy aged people Abnormal in Young adult, children, acute phase of MI and myocardial hypertrophy
What type of splitting can see in MI?
paradoxical
Pulses paradoxes?
Decrease SBP >10 during inspiration Can be seen in asthma, COPD, Hypovolemic shock, and constrictive pericarditis.
AR finding?
Early Diastolic, Decretiendo, Blowing murmur If due to valvular will be heard in left 3rd and 4th ICS
a normal systolic murmur in young adults?
mid systolic and not require further education
What is atrial premature beat(PAC)?
Premature atrial activation of atria other than SA node
An atrial premature beat is an extra heartbeat caused by electrical activation of the atria
Criterion. (normal QRS, Different looking P wave, and premature atrial activation(atrial activation before expected time)
Precipitating factor?
Smoking, caffeine, alcohol, and stress
Diagnosis?
Early P waves in ECG
Symptom?
skipped beat and Palpitation sometimes precede AF
When echocardiography needed?
Occur in a patient without any precipitating factor?
Management?
Beta-Blocker if persistent symptom. stop precipitating factor
Cyanide toxicity symptom?
Altered MS, coma, seizure, and lactic acidosis
Risk factors?
NP treatment(used for hypertension emergency) Renal insufficiency is a risk
How we reduce severe hypertension?
Mean arterial reduction 10-20 % in first 1 hr then 5-10 % in next 23 hour.
Stage of alcohol withdrawal?
mild withdrawal symptom, seizure, hallucination, and delirium tremens
Mild withdrawal symptom?
6-12 Hr Intact orientation,anxiety,palpitation,GI symptom,insominia,treamer and diaphoresis
seizure
12-48
hallucination
12-48
Delirium Tremens?
48-96hr fever, tachycardia, Hytn, diaphoresis, confusion, agitation, and hallucination.
Symptom of cocaine toxicity?
S.H(hypertension, tachycardia, and dilated pupil) chest pain due to coronary vasoconstriction Psychomotor agitation and siezure
Complication?
Myocardial Infarction
Intracranial hemorrhage
Aortic Dissection
Pulmonary infarction
Mgt?
manage ATP
Benzodiazepine (for B/P and anxiety) Asprin(decrease thrombosis) Nitrogreceline and CCB(for pain)
C/I In managment?
Beta-blocker(exacerbate ischemia and fibrinolytic(increase ICH risk).
Viral myocarditis symptom?
Relatively young<55 Viral prodrom Chest pain and symptom of heart failure heart failure SCD
Diagnosis
Echo(biventricular enlargement) with diffuse hypokinesis MRI-late enhancement of epicardium Biopsy:lymphocyic infiltration ECG–not specific
management.
Medication(ACE,BB and diuretic) Temporary assisting device transplant if not help.
RV infarction symptom?
Chest pain Autonomic symptom (diaphoresis and vomiting) Raised JVP and Kussmaul sign Clear chest transient Bradycardia AV block due to vagal tone. hypotension
ECG finding?
St elevation in II, III, and avf or rt precordial led 4-6 Depression in I and avL
Management
Normal saline infusion Avoid nitrate and diuretics
Manifestation of heatstroke?
Temperature >40 with CNS dysfunction tachycardia, tachypnea, and hypotension flushing and diaphoresis end-organ dysfunction hemoconcentration
Risk factors?
Elderly, obese, and poor physical fitness Alcohol and medication High to, high humidity and lack of ventilation
Management
Stabilization(ABC) Cooling(antipyretic is not indicated) management of organ complication
