Cardio 7 Flashcards
Anterior MI blocked vessel and ECG pattern?
LAD ST-elevation V1-V6
Inferior MI?
RCA or LCX ST elevation in II, III and aVF
Posterior MI?
LCX or RCA ST depression in V1-V3 ST-elevation I and aVL—LCA ST-depression in I and aVL—RCA
LCA and diagonal?
ST elevation in I,aVL, V5 and V6 ST depression in II, III and aVF
Right ventricle MI?
Occur in 1/2 of inferior MI RCA ST elevation in lead 4-6
Type of ventricular arrhythmia?
Ventricular premature beat Ventricular tachycardia(sus..and non-sus.) Ventricular fibrillation
The common cause of SCA in acute MI?
Ventricular fibrillation
Common time of Ventricular FIB
In the first 1 hour (50%)
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
Rare arrhythmia in post-MI?
Supraventricular tacyaretemia other than AFIB and fluter
All patients with persistent narow or wide complex arrhythmia with hemodynamic instability management?
Immediate synchronized direct current cardioversion
why we do not use amiodarone in hypotensive patients?
It will exacerbate the Hypotension
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.
Management of carotid artery stenosis depends on?
Presence of symptom (TIA and Stroke) Severity of stenosis
Asymptomatic with low-grade stenosis(<80 % occlusion)?
Antiplatelet Statin Risk factor managment
Symptomatic (Having TIA or Stroke in last 6 months)?
Carotid endarterectomy
Asymptomatic with high-grade (80-99%) stenosis?
Carotid endarterectomy
Why carotid endarterectomy is preferred over stent?
low periprocedural mortality and stroke risk
Treatment of mild HTN?
Lifestyle modification
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.
