Cardio Flashcards
Continuous machinery murmur at the left upper sternal border
PDA: small PDA would be asymptomatic, whereas a large PDA would present in infancy with signs of heart failure, including failure to thrive, poor feeding, and respiratory distress.
Harsh holosystolic murmur at the left lower sternal border, with diastolic murmur at apex
ventricular septal defect (VSD). Neonates with isolated small VSDs are usually asymptomatic, whereas those with large VSDs present with signs of heart failure by 3–4 weeks of age
Widely split, fixed S2 and systolic ejection murmur at the left upper sternal border
atrial septal defect (ASD). Small ASDs do not cause symptoms in infancy and childhood. Those with large ASDs may develop heart failure, or present later in life with dyspnea, fatigue, and atrial arrhythmias.
Loud S2 (pulm HTN), systolic ejection murmur, holosystolic murmur at left upper sternal border; dx, a/w?
Complete arterioventricular septal defect, most common cardio defect in Downs (2nd VSD, 3rd ASD); may lead to pulm HTN
Cardiac sign in infant with the high-arched palate, webbed neck, widely spaced nipples, and edematous hands and feet
Turner’s syndrome: Bicuspid aortic valve and coarctation of the aorta: delayed femoral pulses suggest coarctation, a/w a systolic murmur loudest below the left scapula.
5 days post MI, sudden loss of HR, BP, and consciousness, while the ECG show a sinus rhythm.
Free wall rupture (5-10days post MI), may prevent w β- blockers, ACEis, avoid anti-inflammatory agents such as ibuprofen and indomethacin.
Patient rx for HTN now displays symptoms of angina, tachycardia, rash, and joint pains
Hydralazine: Lupus like sx
SE ACEi’s
dry cough (10–20% of people), hyperkalemia (blocks aldosterone secretion), angioedema, renal failure
SE β-Blockers
depression and erectile dysfunction, hypoglycemia via adrenergic blockade, hyperkalemia, pulmonary reactivity, bradycardia
SE: Calcium channel blockers such as verapamil
act as reverse chronotropes: bradycardia and even atrioventricular block; gingival hyperplasia and constipation
pt p/w acute chest pain(MI), time to therapy <12 H and STE > 2–3 mm in the chest leads and 1 mm in the limb leads.
Classic acute MI, and he has fulfilled all indications for fibrinolytic therapy: give TPA
advance cardiac life support bradycardia algorithm mnemonic: symptomatic brady (HR<60)
“All Trained Dogs Eat Iams”: Atropine (.5mg up to 3mg), Transcutaneous pacing, Dopamine, Epinephrine, and Isoproterenol, given in that order.
pt p/w vague abdominal sx, neurologic (headache, delirium), visual (altered color perception, scotomata), and cardiac arrhythmias (hyperkalemia, especially w K sparing diuretics)
Digoxin Toxicity; give Antidigoxigenin antibody Fab fragments; also renally secreted
Diastolic heart failure (dyspnea and increased venous pressure) in the setting of a normal ejection fraction and normal valvular function.
Diastolic failure is due to the inability of the ventricle to relax and properly fill during diastole. This results in a normal or decreased end-diastolic volume.
Pt p/w heart failure, arrhythmias, or even sudden death, Ejection Fr
Left ventricular dilation and systolic dysfunction: Dilated (LV) results in decreased contraction -> decreased LV ejection fraction
physical examination findings suggestive of aortic insufficiency
Diastolic murmur, Corrigan’s pulse (water-hammer pulse), de Musset’s sign (head bobbing), Traube’s sign (pistol-shot sound over the femoral artery), Duroziez’s sign (to-and-fro murmur over the femoral artery), Quincke’s pulse (capillary pulsation in the nail beds), or Hill’s sign (popliteal artery pressure greatly increased over brachial pressure).
Vegetative growth on a native mitral valve
Mitral valve prolapse, particularly as a complication of rheumatic heart disease, is a risk factor for native valve infective endocarditis.
Pt w/ holosystolic murmur at apex radiates to axilla; dx/sx features?
Mitral regurge; dry cough and exertional dyspnea (LV dysfnc, pulmonary edema HTN), aFib (LA dilatation)
Pt p/w fever, fatigue, malaise, Janeway lesions, and immunologic phenomena such as Osler nodes.
Infective endocarditis: IVDA -> Staphylococcus aureus acute endocarditis; prosthetic valve-> coagulase-negative staph; subacute-> Streptococcus viridans
Neonate p/w cyanosis and tachypnea. harsh holosystolic murmur at L lower sternal border; CXR: egg-shaped silhouette due to the absent main pulmonary artery stem and small heart base.
Dextraposed transposition of the great arteries (D-TGA); Prostaglandin E1 keep the PDA open. Balloon atrial septostomy. Arterial switch surg
Neonate p/w systolic ejection murmur at L upper sternal border, radiating to interscapular region. PE: weak, delayed femoral pulses relative v. UE, HTN in UE. CXR “reverse 3” sign, notched ribs
Coarctation of the aorta: acyanotic heart disease
Neurologic adverse effects of lidocaine
slurred speech and confusion. Other common adverse effects include tremor, personality and mood changes, and hallucinations
Lidocaine use in arrhythmias?
Used for treatment of ventricular arrhythmias (Vtach), should not use prophylactically b/c risk of asystole
Chest pain, fatigue, and dyspnea, +Beck’s triad: hypotension, distant heart sounds, distended neck veins
Cardiac Tamponade
