Cardio Flashcards

1
Q

Sinus tachycardia def and causes

A

Fast heart rate over 100bpm with normal rhythm that can be caused by anemia, CHF, pain, anxiety, exercise, and hyperthyroidism

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2
Q

Sinus tachycardia Sx

A

rate over 100, chest pain, palpitations, dyspnea

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3
Q

Sinus tachycardia sequelae

A

CHF, clots

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4
Q

Sinus tachycardia workup

A

ECG, halter monitor

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5
Q

Sinus tachycardia tx

A

beta blockers, CCB, carotid massage, adenosine for emergency rate control

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6
Q

aortic regurg def and causes

A

valvular incompetence causing backflow into the ventricle, most commonly due to rheumatic fever but can also be from infective endocarditis and congenital bicuspid valve

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7
Q

aortic regurg sx

A

HTN, dyspnea, paroxysmal nocturnal dypnea, palpitations, arrhythmias, syncope, angina, pallor, diastolic decrescendo murmur, wide pulse pressure (>40), LVH, JVD

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8
Q

aortic regurg sequelae

A

CHF

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9
Q

aortic regurg workup

A

chest xray for cardimegaly, echocardiogram

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10
Q

aortic regurg tx

A

vasodilators to decrease preload (nitro, ACE, CCB), diuresis to decrease blood volume, blood pressure, and after-load (thiazides, loops, aldosterone antagonists, ACE inhibitors)

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11
Q

Vascular causes of claudication

A

atherosclerotic disease, vasculitis (Buerger’s, Takayasu), diabetic nephropathy, venous disease (DVT, varicose veins)

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12
Q

neurologic causes of claudication

A

neurospinal disease (spinal stenosis), reflex sympathetic dystrophy

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13
Q

musculoskeletal causes of claudication

A

OA, RA, connective tissue diseases

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14
Q

ischemic heart disease def and causes

A

results from atherosclerosis of the coronary arteries causing insufficient cardiac perfusion and is usually associated with smoking, diabetes, HTN, and hyperlipidemia

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15
Q

ischemic heart disease sx

A

substernal chest pain, dyspnea on exertion, paroxysmal nocturnal dysnea, tachycardia, diaphoresis

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16
Q

ischemic heart disease sequelae

A

CHF, MI, angina, stroke

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17
Q

ischemic heart disease workup

A

cardiac catherization is gold standard, lipid panel (risk factors), ECG, echo

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18
Q

ischemic heart disease tx

A

anticoagulants to prevent thrombo (ASA, pentoxifyline), rate control to decrease cardiac demand (BB, CCB), lipid management (statins), supplemental antioxidants to reduce atherosclerosis

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19
Q

cardiac tamponade def

A

complication of pericardial effusion in which accumulation of fluid in the pericardial space restricts the heart’s ability to pump, decreasing cardiac output

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20
Q

cardiac tamponade sx

A

beck’s triad (hypotension, distended neck veins, muffled heart sounds), chest pain, tachycardia, dyspnea, tachypnea, pulsus paradoxus (inspiratory fall in systolic BP by >10mmHg), Kussmaul’s sign (increased JVP on inspiration)

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21
Q

cardiac tamponade sequelae

A

hypotension, cardiogenic shock, cardiac failure, cardiac arrest, death

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22
Q

cardiac tamponade workup

A

ECG, echo, x ray

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23
Q

cardiac tamponade tx

A

Iv fluids, pericardiocentesis, avoid vasodilators and diuretics (will further decrease venous return and thus cardiac output)

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24
Q

cardiac causes of chest pain

A

acute coronary syndrome, acute MI, angina, pericarditis, cardiac tamponade, aortic dissection, aortic stenosis

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25
Q

respiratory causes of chest pain

A

pulmonary HTN, pulmonary embolism, pneumothorax, pneumonia

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26
Q

gastric causes of chest pain

A

GERD, PUD, esophageal rupture, pancreatitis, pneumomediastinum

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27
Q

musculoskeletal causes of chest pain

A

costochondritis

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28
Q

Raynaud’s def

A

bilateral vasospastic disorder leading to intermittend attacks of pallor and cyanosis of the digits due to cold exposure. Raynaud’s phenomenon is a secondary disorder of the small blood vessels causing similar symptoms.

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29
Q

Raynaud’s sx

A

sudden onset pallor and cyanosis of the digits, discoloration of the digits, arthralgia, sclerodactyly, telangectasia, photosensitivity

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30
Q

Raynaud’s sequelae

A

ulceration, gangrene, cellulitis, osteomyelitis

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31
Q

Raynaud’s workup

A

inflammatory markers (ESR, c-reactive protein)

32
Q

Raynaud’s tx

A

vasodilators to increase blood flow to the digits (CCB, diltiazem = CCB)

33
Q

mitral stenosis def and causes

A

reduced function of the mitral valve almost always due to rheumatic heart disease

34
Q

mitral stenosis sx

A

dypnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, hemoptysis, pulmonary edem, ascites, atrial fib, diastolic murmur (opening snap followed by murmur), JVD

35
Q

mitral stenosis sequelae

A

stroke, a-fib, thromboembolism, PE, pulmonary edema, bacterial endocarditis

36
Q

mitral stenosis workup

A

imaging (echo, x ray)

37
Q

mitral stenosis tx

A

rate control to increase diastolic filling time (BB, CCB)

38
Q

aortic stenosis def

A

constiction of the aortic valve with reduced function commonly found in the elderly and in those with congenital bicuspid valves

39
Q

aortic stenosis sx

A

classic triad (syncope, angina, dyspnea on exertion), chest pain, systolic ejection murmur

40
Q

aortic stenosis sequelae

A

CHF, LVH, angina, death

41
Q

aortic stenosis workup

A

imaging (echo, x ray showing hypertrophy

42
Q

aortic stenosis tx

A

aortic valve replacement, AVOID vasodilators

43
Q

tricuspid stenosis def and causes

A

reduced function of the right atrioventricular valve and can be congenital or causes by disease (rheumatic heart disease)

44
Q

tricuspid stenosis sx

A

fatigue, pulmonary congestion, dyspnea, ascites, edema, diastolic murmur (click), elevated jugular venous pressure

45
Q

tricuspid stenosis sequelae

A

endocarditis, CHF, valve replacement

46
Q

tricuspid stenosis workup

A

echo, ECG

47
Q

tricuspid stenosis tx

A

diuresis to decrease blood volume, blood pressure, and after-load (thiazides, loops, aldosterone antagonists, ACE inhibitors)

48
Q

thromboangitis obliterans (Buerger’s) def

A

recurring progressive inflammation and thrombosis of small and medium arteries and veins of the hands and feet, strongly associated with smoking

49
Q

thromboangitis obliterans (Buerger’s) sx

A

gradual onset cyanosis, persistent pain, parasthesias, diminished pulses, diminished sensation

50
Q

thromboangitis obliterans (Buerger’s) sequelae

A

ulcerations, gangrene

51
Q

thromboangitis obliterans (Buerger’s) workup

A

CBC with diff, disease markers (ANA, RF, antiphospholipid, Ab), inflammatory markers (eosinophils, sedimentation rate, C-reactive protein), LFTs, renal function tests, urinalysis

52
Q

thromboangitis obliterans (Buerger’s) tx

A

lifestyle modification: avoidance of cold environments and drugs that lead to vasoconstriction

53
Q

premature ventricular contractions def

A

occur when the heartbeat is initiated by ectopic foci in the ventricles (Purkinje fibers) rather than by the SA node. These contractions occur periodically and are the most common type of arrhythmia.

54
Q

premature ventricular contractions sx

A

palpitations, often asymptomatic

55
Q

premature ventricular contractions sequelae

A

ventricular tachycardia

56
Q

premature ventricular contractions workup

A

ECG (wide QRS without preceding P wave, T wave inversion)

57
Q

premature ventricular contractions tx

A

rate control to decrease cardiac demand (BB, CCB, digoxin)

58
Q

pericarditis def and causes

A

inflammation of the pericardial tissue, commonly caused by viral infection (coxsackie), autoimmune disease, storage diseases (SLE, scleroderma) or infarct

59
Q

pericarditis sx

A

flu-like symptoms (fever, myalgia), acute chest pain better sitting up and leaning forward, dyspnea, pericardial friction rub

60
Q

pericarditis sequelae

A

cardiac tamponade

61
Q

pericarditis workup

A

ECG, chest x ray

62
Q

pericarditis tx

A

anti-inflammatories (NSADs, steroids), pericardiocentesis to treat pericardial effusion or tamponade

63
Q

intermittent claudication def and causes

A

muscle pain (usually in the calf) caused by peripheral arterial disease with significant atherosclerotic blockages, leading to arterial insufficiency

64
Q

intermittent claudication sx

A

predictable and reproducible pain on exertion

65
Q

intermittent claudication sequelae

A

arterial insufficiency

66
Q

intermittent claudication workup

A

doppler ultrasound

67
Q

intermittent claudication tx

A

vasodilators to increase peripheral blood supply (CCB, diltiazem)

68
Q

premature atrial contractions def and causes

A

periodic contractions of the atria from ectopic foci and can be brought on by stress, caffeine, and alcohol

69
Q

premature atrial contractions sx

A

occasional irregular heart beats

70
Q

premature atrial contractions sequelae

A

a-fib

71
Q

premature atrial contractions workup

A

ECG (occasional irregular P-R interval, QRS is normal), halter monitor

72
Q

premature atrial contractions tx

A

rate control to decrease cardiac demand (BB)

73
Q

heart block def and causes

A

delayed conduction between the SA node and ventricular depolarization. First and second degree (type I) heart block are commonly associated with increased vagal tone or drug effects (digoxin, BB, CCB) and are usually asymptomatic. Second degree (type II) and third degree heart block usually result from fibrotic or ischemic septal damage and often present with syncope.

74
Q

heart block sx

A

syncope, chest pain, palpitations, dyspnea, heart rate less than 40

75
Q

heart block sequelae

A

arrhythmias, asystole

76
Q

heart block workup

A

ECG (no relationship between P wave and QRS complex)

77
Q

heart block tx

A

pacemaker (second degree type II and third degree heart block)