Cardio Flashcards
pulsus paradoxus
decrease SBP w/ inspiration pericardial tamponade COPD tension pneumo foreign body
pulsus alternans
weak-then strong - poor prognosis
cardiac tamponade
pulsus parvus et tardus
weak + delayed
aortic stenosis
kussmal sign
increased JVP w/ inspiration
cardiac tamponade
tricuspid regurg
constricitive pericarditis
tx brady or symptomatic mobtiz 1
atropine
causes of mobitz 1
Digoxine
BB, CCB
increased vagal tone
right ischemia/infarct
CHADS2 score
anticoagulate if 2+ CHF HTN 75y/o = 2 Diabetes Stroke/tia = 2 vasc dz female 65-74
multifocal atrial tachy
COPD/hypoxemia
verapamil/Bb for rate ctrl
rate ctrl options Afib
BB
CCB
digoxin
tx v tach
amiodarone
lidocaine
procainamide
MCC:
systolic HF?
diastolic HF?
systolic = CAD diastolic = HTN
tx CHF
BB/ACEI/ARB - prevent remodeling + decrease mortality
spironolactone for types 3-4 decrease mortality
BB for CHF
bisoprolol
carvedilol
metoprolol
what tx is not usefule in diastolic HF
digoxin #1 - diuretics
PE in HOCM
sustained apical impulse
S4
tx: BB
restrictive cardiomyopathy
decreased elasticity
bx = fibrosis/infiltrates
typically see LBBB, low voltage w/ amyloidosis
what meds show mortality benefit for tx angina
BB
ASA
tx unstable angina
same as stable angina
add clopidogrel, heparin, or enoxaparin
when to give heparin + do PCI
TIMI score > 3 out of 7
CP refractory to meds
trop elevated
ST changes > 1mm
best predictor survival STEMI
LVEF
leads I, AVL, V5-6
LCA
leads V1-4
LAD
leads II, III, AVF
RCA
tx if can’t do PCI w/in 90 min
thrombolysis w/ tPA - reteplase or streptokinase
indications to do CABG are “UnLimiTeD”
U - unable to do PCI
L - left main disease
T - triple vessle
D - depressed vent func
tx LDL > 130
ezetimibe
tx TG > 150
fibrates
tx HDL < 40
niacin
when to start fasting lipid profile
at 35
at 20 w/ CAD risk factors
repeat Q5y
hypercholesterolemia vs dyslipidemia
TC > 200 (x2) = hypercholesterolemia
LDL > 130 or HDL < 40 = dyslipidemia (regardless TC)
strongest statins
atorvastatin (lipitor)
rosuvastatin (crestor)
most effective life style modification for HTN
weight loss
cause of 2ndary HTN
CHAPS Cushings Hyperaldosteronism (Conn's) Aortic coarcation Pheo Stenosis renal arteries
HoTN + hypoK + met alkalosis = ?
Conn’s syndrome (hyperaldosteronism)
tx malignant HTN
IV labetalol, nitropursside, nicardipine
PR segment depression + diffuse ST elevation
followed by T wave inversions
pericarditis
tx: ASA if post-MI, ASA/NSAID viral
ekg shows electrical alternans
large pedicardial effusion
CXR = water bottle shaped heart
tx: IV fluid, pericardiocentesis
if decompensated do pericardial window
blowing diastolic murmur LSB, mid-diastolic rumble (Austin Flint)
de Musset’s
Corrigan’s
Duroziez
Aortic regurg
Tx: vasodilators (CCB, ACEI)
opening snap, mid diastolic murmur at apex
pulm edema
Bblockers
digoxin
usually 2nd to rheumatic fever or chordae tendineae rupture
holosystolic murmur radiates to axilla
nitrates/diuretics to reduce preload
antiarrhythmics (AF + LAE common)
pulsatile abdominal mass/bruits
aortic aneurysm (assoc w/ atherosclerosis)
MC above aortic valve
HTN
asymmetric pulses and BP
aortic dissection (assoc w/ HTN)
CT angiography
Stanford system - proximal to left subclavian = type A
Tx: BP meds
tx DVT
1) IV unfractionated heparin or SQ LMWH
2) follow w/ PO warfarin x 3-6mon
ABI results for PAD
ABI < 0.4 w/ rest pain
buttock claudication
decreased femoral pulse
male impotence
Aortoilliac PAD
calf claudication
decreased pulses below femoral artery
femoropopliteal disease
