Cardio Flashcards
What are the different findings for Cardiogenic, Hypovolemic and Septic shock?
Cardio: high PCWP, high syst resistance, low cardiac index
Hypovolemic: low PCWP, high syst resistance
Septic: normal PCWP, low syst resistance
How do nitrates work on ischemic hearts?
Systemic vasodilation, lowers preload which lowers LVEDV, reducing O2 demand.
What causes thoracic AAs vs. AAA?
Thoracic: cystic medial necrosis or connective tissue disorders (CXR can suggest TAA w/ wide mediastinum, increased aortic knob and tracheal deviation.
AAA: atherosclerosis
What is dual antiplatelet therapy (DAPT) and when is it indicated?
Aspirin + P2y12 receptor blocker (clopidogrel, prasugrel, ticagrelor)
Rec for all pts at least 12 months after drug eluting stent is placed.
What virus can cause myocarditis?
Coxsackie B. Young, healthy pts who develop CHF.
What are the rules for percutaneous coronary intervention for a STEMI?
- 12 hrs from symp onset
- 90mins from 1st medical contact at PCI-capable facility
- 120mins from 1st medical contact at non PCI-capable facility.
RVMI
- Occlusion of RCA, seen in 30-50% of pts w/ inferior wall mI.
- HoTN, JVD, Kussmaul sign, clear lungs
- These pts are preload dependent and should get fluids
What are the diastolic murmurs?
AR, MS
What are the signs of MR? AR?
MR: holosystolic, best heard at apex
AR: diastolic decrescendo
Cardiac myxoma
- 80% in LA
- Symps: fever, weight loss, valve abnorms, HF
- Dx: echocardiogram
- Tx: Sx
What is cor pulmonale? What causes it, and how do you Dx it?
-R heart hypertrophy (COPD, obst. sleep apnea)
-DOE, fatigue, exertional syncope
-Exam: increased JVD, loud S2, tricuspid regurge, pulsatile liver
Image: R heart cath (gold standard), echo (pHTN, dilated RV), ECG (RBBB, R axis deviation, RA enlargement)
What is the biggest influence on long-term survival after an MI?
Length of time to restoration of blood flow.
