Cardio Flashcards by Claire Wilsey

What is the number one cause of death world wide?

Ischemic Heart Disease

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Tx for Printzmetal Angina

MC Females

CCB - amlodipine / nifedipine

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Absolute contraindications for use of TPA in a STEMI (<70 mins)

1) Any prior ICH
2) Any known structural cerebral vascular lesion (AVM)
3) Known CA
4) Hx of ischemic stroke
5) significant closed head/ facial trauma w/in 3 months

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TPA timeframe for

1) PCI
2) Ischemic Stroke

1) < 90 min

2) <3 hrs

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STEMI the big 5

BB
ACE
Statin 
ASA
Plavix (clopidogrel) or Xa inhibitor - no if murmur/valve dz)

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ST segment

1) Elevation
2) Depression

1) Injury

2) Ischemia

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Pharmacologic stress testing vs exercise stress test

1) unable to perform exercise
2) AS
3) LBBB
4) Pacemaker
5) Recent MI
6) Severe HTN

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Listening to murmurs

Start with Diaphragm

S3 (Ventral) + S4 (atrial) are low pitched - BELL, best heard in left lateral decubitus position

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Murmur Intensity Scale

I- VI
3= mod loud, no Thrill
4= Thrill 
5= Thrill palpable
6= Thrill visible

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Symptoms of AS

“SAD” Syncope, Angina, Dyspnea (on exertion)

-Once symptomatic need surgical referral

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Corrigans
Water-Hammer
Quincke’s pulsation

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Etiology of Mitral Stenosis

Rheumatic Fever

Opening Snap

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Etiology of Mitral Reg

Acute: Dyspnea/ PND
IE
Chorda tendinae rupture
Papillary m. ischemia/infarct

Chronic: Fatigue, A-fib
RF, calcification, MVP (MC cx)

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CHF

Dialated Cardiomyopathy

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Hypertrophic CM

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HCM

Sustained/ hyperdynamic PMI
High voltage on ECG
Nml heart size
S4

Restrictive Cardiomyopathy

Hemochromatosis 
Wilson's dz
Amyloidosis 
Scleroderma
Sarcoidosis

Restrictive Cardiomyopathy

S/S’s

RHF
Kussmaul’s sign
Low voltage on EKG
Nml heart size

Stroke a/w A-Fib MC where?

SMA (Superior mesenteric artery)

Anticoagulants approved for A-Fib

1) Warfarin
Those w/out valve dz: 
2) Dabigatran- Pradaxa-DTI
3) Rivaroxaban- Xarelto-Xa
4) Apixaban- Eliquis-Xa

Drugs for cardioversion

Flecainide
Amiodarone
Quinidine

(prophylaxis 3 wks before and 4 wks after)

Etiology of Acute vs Chronic Pericardial Effusion

Acute: infectious, inflammatory, trauma, drug induced, AMI

Chronic: malignancy, uremia, radiation

CHF or Low CO

Beta sympathetic tone

1) Inc HR (+ chronotropy)
2) Inc BP ( sm m constriction)
3) Inc contraction (+ inotropy)

CHF or Low CO

Alpha sympathetic tone

1) Inc sm m. contriction

2) Increase BP (afterload)

Parasymptathetic tone

counteracts beta + alpha 1) Dec HR 2) Dec BP

DOE, echo perserved | +40%

Diastolic dysfunction | MC HTN

DOE, echo perserved | +40%

Diastolic dysfunction MC HTN Tx: BB *no role for + inotropes like digoxin

Abn EF (<40%)

Systolic dysfunction | MC MI

Precipitating Factors of CHF

1) Inc metabolic demands 2) Inc circulating volume 3) Conditions that inc afterload 4) Conditions that impair contractility

HF Classes

I- Risk, no symptoms II- Symptoms w/ activity III- Symptoms w/ ADL IV- Symptoms at rest

+ Inotrope

Digoxin | Does not prolong life, only improves QOL, can reach toxic levels

Aneurysm size and surgery

Abdominal >5.0 cm Thoracic >6.0 cm (Surgery at >5cm if Marfan's) Tx: BB

Dx of thoracic aneursyms

MC found incidentally on CXR or PE | GS- Aortography

Diagnosis for pt with Pain, LE pallor, paralysis, paresthesia, pulselessness, poikilothermia

ARTERIAL U/S

PAD vs PVD

PAD- gangrene (no O2)

Dx for PAD Tx

Ankle-brachial Index >0.9 Exercise, RF modification, ASA/ Plavix

PVD (Venous Insufficiency)

Increased sxs w/ standing Heaviness, fatigue of legs Swelling, warmth, brawny discoloration, ulceration around malleoli

PE Syncope

Always includes VS w/ orthostatics, cardiac & complete neuro exam -Vasodepressor/motor only if PE and Hx are nml