Cardio Flashcards
What is the classic ECG finding in atrial flutter?
“Sawtooth” P waves.
What is the definition of unstable angina?
Angina that is new or worsening with no increase in troponin level.
What is the antihypertensive for a diabetic patient with proteinuria?
Angiotensin-coverting enzyme inhibitor.
What is “Beck Triad” for cardiac tamponade?
Hypotension, distant heart sounds, and jugular venous distention (JVD).
What drugs can be used to slow heart rate?
B-blockers, calcium channel blockers (CCB), digoxin, amiodarone.
What is hypercholesterolemia treatment that leads to flushing and pruritus?
Niacin
Murmur - hypertrophic obstructive cardiomyopathy
A systolic ejection murmur heard along the lateral sternal border that increases with decreased preload (Valsalva maneuver)
Murmur - aortic insufficiency
Austin Flint murmur, a diastolic, decrescendo, low-pitched, blowing murmur that is best heard sitting up; increased with increased after load (handgrip maneuver)
Murmur - mitral regurgitation
A holosystolic murmur that radiates to the axilla; increase with increased afterload (handgrip maneuver)
Murmur - aortic stenosis
A systolic crescendo/ decrescendo murmur that radiates to the neck; increased with increased preload (squatting maneuver)
Murmur - mitral stenosis
A diastolic, mid to late, low-pitched murmur preceded by an opening snap
What is the treatment for atrial fibrillation and atrial flutter?
If unstable, cardiovert.
If stable or chronic, rate control with CCBs or B-blockers.
What is the treatment for ventricular fibrillation?
Immediate cardioversion.
What is Dressler syndrome?
An autoimmune reaction with fever, pericarditis, and increased ESR occurring 2-4 weeks post-MI.
A patient with a hx of IV drug use, with JVD and a holosystolic murmur at the left sternal border. What is the treatment?
Treat existing heart failure, replace tricuspid valve.
What is the diagnostic test for hypertrophic cardiomyopathy?
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
What is pulses paradoxus?
A decrease in systolic BP of > 10mm Hg with inspiration; seen in cardiac tamponade.
What is the classic ECG finding in pericarditis?
Low-voltage, defuse ST-segment elevation.
What are eight surgically correctable causes of HTN?
1) Renal artery stenosis
2) Coarctation of the aorta
3) Pheochromocytoma
4) Conn syndrome
5) Cushing syndrome
6) Unilateral renal parenchymal disease
7) Hyperthyroidism
8) Hyperparathyroidism
How do you evaluate a pulsatile abdominal mass and bruit?
Abdominal ultrasound and CT
What are the indications for surgical repair of AAA?
> 5.5cm, rapidly enlarging, symptomatic, or ruptured
What is the treatment for acute coronary syndrome?
ASA, heparin, clopidogrel, O2, IV b-blockers (maybe morphine, nitro)
What is metabolic syndrome?
Abdominal obesity, high triglycerides, low HDL, HTN, insulin resistance, prothrombotic or pro inflammatory states
What is the appropriate diagnostic test for a 50 year old man with stable angina who can exercise to 85% of maximum predicted HR?
Exercise stress treadmill with ECG
What is the appropriate diagnostic text for a 65 year old woman with a left bundle branch block and severe osteoarthritis who has unstable angina?
Pharmacologic stress test (i.e. dobutamine ECHO)
What are signs of active schema during stress testing?
Angina, ST-segment changes on ECG, or decreased BP
What ECH findings suggest MI?
ST-segment elevation (depression means ischemia), flattened T waves, and Q waves
What are the coronary territories in MI?
Anterior wall (LAD/diagonal)
Inferior (PDA - posterior descending artery off RCA)
Posterior (left circumflex/ oblique, RAC/ marginal)
Septum (LAD/diagonal)
What is the diagnosis for a young patient with angina at rest and ST-segment elevation with normal cardiac enzymes.
Prinzmetal angina
What are common symptoms associated with silent MIs?
CHF, shock, and altered mental status
What is the diagnostic test for PE?
Spiral CT with contrast
What is protamine used for?
Reverses effets of heparin
What drug affects prothrombin time?
Warfarin
What is the diagnosis for a young patient with a family history for sudden death who collapses and dies while exercising?
Hypertrophic cardiomyopathy
What is the endocarditis regimen?
Oral surgery - amoxicillin
GI/GU procedure - not recommended
What is “Virchow Triad”?
Stasis, hyper coagulability, endothelial damage
What is the most common cause of hypertension in young women?
OCPs
What is the most common cause of hypertension in young men?
Excessive EtOH
What condition is associated with a “Figure 3 sign”?
Aortic coarctation
What condition is associated with a “water bottle-shaped heart”?
Pericardial effusion (look for pulses paradoxus)
