Cardio 4 geriatrics Flashcards
Blood pressure stages
normal BP < 120 and < 80
elevated BP 120-129 and < 80
stage 1 130-139 or 80-89
stage 2 >/= 140 or >/= 90
MCC secondary HTN
renovascular
blood pressure goals
< 140/90
<150/90 for 60 and older
HTN emergency/urgency
SBP > 180 or DBP > 120
tx HTN emergency
IV BP agents - MAP reduced by 10-20% in the first hour and an additional 5-15% over the next 23 hours
tx HTN urgency
gradual reduction of MAP by 25% over 24-48 hours with clonidine or captopril
what is restrictive cardiomyopathy
diastolic dysfunction in a non-dilated, rigid ventricle –> impedes ventricular filling
causes of restrictive cardiomyopathy
amyloidosis (MC)
sarcoidosis
hemochromatosis
what heart sound is MC in restrictive cardiomyopathy
S4
dx restrictive cardiomyopathy
echo
endomyocardial biopsy - criterion standard
echo for restrictive cardiomyopathy
non-dilated ventricles
diastolic dysfunction
biatrial enlargement
if amyloidosis - bilateral ventricular wall and inter ventricular septal thickness
endomyocardial biopsy for amyloidosis/restrictive cardiomyopathy
apple-green birefringence with Congo red stain
what is HCM
autosomal dominant genetic disorder of inappropriate LV and/or RV hypertrophy –> LV outflow obstruction, diastolic dysfunction, and ischemia
PE for HCM
S4
pulsus bisferiens - double pulse
EKG for HCM
LVH
prominent Q waves
echo for HCM
asymmetric ventricular wall thickness 15 mm or greater
tx HCM
BB - first line
CCB
what is dilated cardiomyopathy
systolic dysfunction and dilation of both ventricles
PE for dilated cardiomyopathy
S3
lateral displacement of the PMI
echo for dilated cardiomyopathy
systolic dysfunction
dilated chambers and thin-walled ventricles
what meds should be avoided for dilated cardiomyopathy
NSAIDs
CCBs
what is giant cell arteritis
immune mediated large and medium vessel granulomatous vasculitis of the extra cranial branches of the carotid artery
risks for giant cell arteritis
women
> 50
caucasian
sx giant cell arteritis
HA - new onset or change in baseline
jaw claudication - relieved by stopping jaw movement
visual changes - eye pain, vision loss, diplopia, amaurosis fugax
may have decreased temporal artery pulsation
