Cardio 7 Flashcards by molla asnake

Anterior MI blocked vessel and ECG pattern?

LAD ST-elevation V1-V6

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Inferior MI?

RCA or LCX ST elevation in II, III and aVF

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Posterior MI?

LCX or RCA ST depression in V1-V3 ST-elevation I and aVL—LCA ST-depression in I and aVL—RCA

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LCA and diagonal?

ST elevation in I,aVL, V5 and V6 ST depression in II, III and aVF

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Right ventricle MI?

Occur in 1/2 of inferior MI RCA ST elevation in lead 4-6

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Type of ventricular arrhythmia?

Ventricular premature beat Ventricular tachycardia(sus..and non-sus.) Ventricular fibrillation

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The common cause of SCA in acute MI?

Ventricular fibrillation

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Common time of Ventricular FIB

In the first 1 hour (50%)

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Cause of Ventricular arrhythmia in post-MI?

In the first 10 min post-MI–Reentry(due to delay conductin in the infarcted area) the predominant mechanism

IN 10-60 MIn post-MI-Abnormal automaticity

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Rare arrhythmia in post-MI?

Supraventricular tacyaretemia other than AFIB and fluter

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All patients with persistent narow or wide complex arrhythmia with hemodynamic instability management?

Immediate synchronized direct current cardioversion

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why we do not use amiodarone in hypotensive patients?

It will exacerbate the Hypotension

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Cause of syncope in HCM?

Mainly due to outflow obstruction Rarely may be due to ischemia, arrhythmia, and inappropriate baroreceptor response that result in vasodilatin.

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Management of carotid artery stenosis depends on?

Presence of symptom (TIA and Stroke) Severity of stenosis

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Asymptomatic with low-grade stenosis(<80 % occlusion)?

Antiplatelet Statin Risk factor managment

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Symptomatic (Having TIA or Stroke in last 6 months)?

Carotid endarterectomy

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Asymptomatic with high-grade (80-99%) stenosis?

Carotid endarterectomy

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Why carotid endarterectomy is preferred over stent?

low periprocedural mortality and stroke risk

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Treatment of mild HTN?

Lifestyle modification

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component of Lifestyle modification

Weight loss DASH diet Exercise Reduce dietary salt Limit alcohol intak

Wight loss mechanism and effect on SBP?

Reduction of BMI<25 5-20 per 10 KG loss

DASH diet mechanism and effect on SBP?

High fruit and vegetable and low saturated and total FAT 8-14

Exercise mechanism and effect on SBP?

30 min/day for 5-6 day/week 4-9

Low sodium diet mechanism and effect on SBP?

<3gm/day 2-8

Low alcohol intake mechanism and effect on SBP?

\<2/day for men and \<1/day for women 2-4

Smoking session in HTN.

Decrease CV complication

Clu of renovascular disease?

Sever HTN(\>180/120 after age 55 Malignant HTN(end-organ damage) Resistant HTN(Not respond to 3 drugs) Defuse atherosclerosis Recurrent flash pulmonary edema

Physical examination?

Asymmetric renal size \>1.5 Abdominal bruit (systolic-diastolic)-Highley specific

Laboratory?

an unexplained rise in creatinine(\>30%) after ACE inhibitor/ARB

Imaging

Unexplained atrophic kidney

Diagnosis confirmation?

Renal Dopler sonography CT/MRI angiography

When we suspect UE atherosclerosis

Mild B/P discrepancy

symptom of aortoenteric fistula?

Abdominal pain GI bleeding Hypotension

Torsades de Pointes?

Polymorphic ventricular tachycardia

treatment?

IV magnesium sulfate: hemodynamically stable Defibrillation;: hemodynamically Unstable

Cause of TdS other than drugs?

Decrease serum Mg, K, and Ca Starvation and Hypothermia Hypothyroidism Sinus node dysfunction and AV block MI Intracranial disease HIV

B blocker effect in DM patients?

Block B-1 receptor --decrease lipolysis(B1) mediated--insulin resistance and weight gain -decrease B/F to Skeletal M--reduce glucose uptake increase unopposed alpha effect--decrease B/F to muscle--decrease glucose uptake decrease insulin secretion

Pulmonary endolism symptom?

Pluritic chest pain Dyspnes Tachypnea Tachycardia

CXR?

low sensitivity(usually normal) Atelectasis Infiltration and pleural effusion Pheripherial hypo lucency due to oligimia (westmark sign) Wage shaped lung opacity(Hampton's hump) Enlarged pulmonary artery(filcher sign)

Acute managment of aortic dissection?

Pain control(morphine) Reduction of systolic blood pressure to 100---120 (sodium nitroprusside if B/P more than 120 despite beta-blocker Decrease left ventricular contractility by beta-blocker --reduce stress on aorta (labetalol, esmolol, and propranolol are the preferred ones. If ascending--emergency surgery b/c 1-2 % mortality per hour

Treatment of any arrhythmia with hemodynamic instability?

Direct cardioversion

Typical ECG future of cardiac tamponade?

Pulses alterans with sinus tachycardia If have large effusion --Low QRS voltage

Cardiovascular risk managment in DM patients?

General measure Blood pressure and cholesterol

G.mesure?

Healthy wight Exercise smoking cessation

Blood pressure?

Medication and lifestyle modification Target \<140/90 Continiu measure ,120/80

colestrol?

High intensity statin--establish CVD or 10 year risk of CVD .=20 Moderate intesisty statine--all other patient age \> 40

What are Premature ventricular contractions (PVCs)?

are extra heartbeats that begin in one of your heart's two lower pumping chambers (ventricles). These extra beats disrupt your regular heart rhythm, sometimes causing you to feel a fluttering or a skipped beat in your chest

Ventricular tachycardia (VT)?

is a fast, abnormal heart rate. It starts in your heart's lower chambers, called the ventricles. VT is defined as 3 or more heartbeats in a row, at a rate of more than 100 beats a minute. If VT lasts for more than a few seconds at a time, it can become life-threatening.