Cardio Flashcards
MC type of cardiomyopathy
Dilated Cardiomyopathy
3 types of cardiomyopathies
- Dilated
- Restrictive
- Hypertrophic
Dilated cardiomyopathy is associated with _____ dysfunction
Systolic
MC etiology of dilated cardiomyopathy
Idiopathic
MC infectious cause of dilated cardiomyopathy
Viral (enterovirus, coxsackievirus B)
Clinical manifestations of dilated cardiomyopathy
Systolic heart failure
- dyspnea
- fatigue
- peripheral edema
Physical examination of dilated cardiomyopathy
- S3 gallop
- laterally displaced PMI
Diagnostic test of choice for dilated cardiomyopathy
Echocardiogram
- left ventricular dilation
- thin ventricular walls
- DECREASED ejection fraction (<30%)
Txm for dilated cardiomyopathy
- Treat underlying cause
- Mortality reduction w/ ACEI and B-blockers
Restrictive cardiomyopathy
- Diastolic dysfunction in a non-dilated ventricle
- impedes ventricular filling
MC etiology of restrictive cardiomyopathy
Infiltrative disease
- Amyloidosis (MC)
- Sarcoidosis
- Hemochromatosis
- Scleroderma
Clinical manifestations of restrictive cardiomyopathy
Right sided HF
- peripheral edema
- JVD
- ascites
- hepatomegaly
- Dyspnea
- Kussmaul’s sign: increase in JV pressure w/ inspiration
Diagnostic test of choice for restrictive cardiomyopathy
Echocardiogram
- Non-dilated ventricle w/ normal thickness
- diastolic dysfunction
- Marked dilation of both atria
- NORMAL EF
Restrictive cardiomyopathy definitive diagnosis
Endomyocardial biopsy
Txm for restrictive cardiomyopathy
Treat underlying cause
Myocardial hypertrophy, often asymmetrical, that occurs in the absence of inciting hypertrophy stimulus
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy clinical features
-Dyspnea, atypical chest pain, syncope, fatigue, Sudden cardiac death
- Systolic murmur at lower left eternal border
- increases w/ decreased filling
- Decreases w/ increased filling
- Milk Jug analogy
MCC of sudden death in young otherwise healthy patients
Hypertrophic Cardiomyopathy
Test of choice to diagnose Hypertrophic Cardiomyopathy
Doppler Echocardiography
Shows septal hypertrophy, normal systolic fxn, poor diastolic fxn, degree of mitral regurgitation
W/ hypertrophic cardiomyopathy, avoid ___, ___, and ___
Digoxin, vasodilation, and exertion
To avoid increased outflow obstruction
Txm for hypertrophic cardiomyopathy
-improve diastolic fxn: BBs, CCBs
1st degree AV block
- 1 P wave/QRS
- Prolonged, constant PR interval
- No txm
2nd Degree AV block Type I is also known as what?
Wenckebach
PR progressively increases until a QRS is “dropped”
2nd degree AV block Wenckebach
Prolonged PR intervals constant until QRS drop
2nd degree AV block Mobitz II
Txm for 2nd degree AV block
Type I: atropine, pacer IF symptomatic
Type II: Pacer
P wave regular, QRS regular, but all unrelated
3rd degree AV block
Txm for 3rd degree AV block
Pacing
Types of regular tachydysrhythmias w/ NARROW QRS
- Sinus tachycardia
- Supraventricular tachycardia (SVT)
- Atrial flutter (A-flutter)
Types of irregular tachydysrhythmias w/ NARROW QRS
- Atrial fibrillation (A-fib)
- Atrial flutter w/ variable conduction
- Multifocal atrial tachycardia (MFAT)
Types of regular tachydysrhythmias w/ WIDE QRS
- Sinus tachycardia w/ aberrant conduction
- Ventricular tachycardia (V-tach)
- Polymorphic V-Tach
Types of irregular tachydysrhythmias w/ WIDE QRS
- Atrial fibrillation w/ BBB
- Atrial fibrillation w/ WPW
Continuous machine-like murmur that is loudest at the left upper sternal border on physical exam
Patent Ductus Arteriosus
Pathophysiology responsible for PDA
Continued prostaglandin E1 production & low arterial oxygen content promotes patency
Eisenmenger Syndrome
Pulmonary HTN & cyanosis heart disease occurring when left-to-right shunt SWITCHES to right-to-left shunt (cyanosis)
Persistent communication between the descending thoracic aorta & main pulmonary artery after birth
Patent ductus arteriosus
PDA is usually associated w/ a ______ shunt
Left-to-right shunt
Best initial test to diagnose PDA
Echocardiogram
Txm for UNstable bradydysrhythmias
+/- atropine → pacer → pressors (epi/dopamine)
Txm for ventricular escape rhythm
Pacer
Txm for Multifocal Atrial Tachycardia (MAT)
Treat the underlying cause
Txm for sinus tachycardia
Treat the underlying cause
Txm for supraventricular tachycardia
-Vagal manuvers
-Adenosine
-AV Nodal blockers
-Amiodarone
Synchronized cardioversion
Txm for A-Fib/flutter
- AVN blockers, Amiodarone
- Anticoagulation
V-tach txm
- Lidocaine
- Amiodarone
- Procainamide
- Cardioversion
Txm for A-Fib w/ WPW
Procainamide or shock
Txm for polymorphic VT & Torsades
- Cardiovert/defibrillate if unstable
- QT normal → ventricular antidysrhymic to prevent recurrence (lidocaine)
- QT >500 → Magnesium Sulfate
