CARDIO Flashcards
If a patient has lower extremity pain that is worse with prolonged standing or sitting & better with leg elevation and walking what dx? Tx?
Venous insufficiency
Tx with compression, leg elevation, and exercise
If a patient has lower extremity pain that is wore with walking and relieved with rest what dx? Tx?
Peripheral artery disease
Tx with colpidogrel and Aspirin
Who should be treated with a high dose statin?
Atherosclerotic disease, LDL >190 + family Hx, Diabetic + LDL>190
Side effect of statin therapy?
Rhabdo!!
How do you treat rheumatic fever?
PCN (or cephalosporin)
What are the sxs of pericarditis? Tx?
P’s! Persistent, pleuritic, postural, and pericardial friction rub
Tx with NSAID & ASA
How do we distinguish pericarditis from tamponade and MI’s?
Echo! If you see wall motion tenderness think Tamponade
How do you tx tamponade?
Pericardiocentesis
What cardiomyopathy involves systolic dysfunction? Tx?
Dilated
Tx with ACE & Diuretics
What cardiomyopathy is associated with sudden cardiac death?
Hypertrophic
What cardiomyopathy is associated with diastolic dysfunction?
Hypertrophic (Septum is enlarged)
When would you see pulsus alternans?
dilated cardiomyopathy
When would you see bisferens carotid pulse?
Hypertrophic cardiomyopathy
If a patient has continuous PVC’s for longer than 30 seconds at a rate greater than 100 and they are stable – what Dx? Tx?
Ventricular tachycardia
Tx with Amiodarone
What if your patient is in vtach and they are unstable but have a pulse?
Synchronized cardiovert
What if your patient is in vtach and they are unstable without a pulse?
Defibrillate/CPR (like Vfib)
How can you treat torsades?
IV Magnesium
If a patient is stable and has a sudden onset of a racing heart and EKG shows HR >100 that’s regular and narrow – what dx? Tx?
PSVT
Tx with Valsalva or carotid massage or ADENOSINE
What if your patient in PSVT is unstable? What must you ALWAYS rule out with PSVT?
Unstable = cardiovert
MUST rule out WPW
How do you tx WPW?
Amiodarone
How do you treat Aflutter?
CCB – ablation is definitive
If the PR interval is progressively lengthening until the heart fails to produce a p wave or QRS complex – what Dx?
Mobitz 1
Continuously dropped beats without PR interval lengthening – what dx?
Mobitz 2
What is Rate control for Afib?
CCB (Diltiazem or Verapamil)
What is rhythm for Afib?
DC cardiovert – but NOT IF IT HAS BEEN LONGER THAN 48 HOURS
What medication reduces afterload in HF?
ACE inhibitors
What medication reduceds preload in HF?
Diuretics
Side effect of Lisinopril? Alternative medication?
Cough! Can try an ARB
Side effect of diuretics? Alternative med?
Drop in K levels
Can switch to spironolactone or eplernone
A diabetic with HTN should be placed on what kind of med?
ACE/ARB
A patient with heart failure, ischemia, or CAD + HTN should be placed on what kind of medications?
Beta blocker or ACE
A patient with Angina or hyperthyroidism + HTN should be placed on?
Beta blockers
A patient with raynauds with HTN should use what kind of med?
CCB
At what levels do patients become stage 2 HTN? What does that mean?
160+/100+
They will most likely need 2 meds to treat their HTN. ONE WILL BE A DIURETIC
What is the drug of choice for HTN?
Hydrochlorothiazide
Can you use a dihydropyridine (verapamil and diltiazem) with a statin?
NO
What’s the DOC for HTN in pregnancy?
Methyldopa
When would we not use a thiazide?
someone with an MI, pregnant women, CKD
When would we use a BB for HTN treatment?
MI, CAD, and diabetes
