Cardio Conditions Flashcards
- MASSIVE heart with R/L S3 & S4 sounds
- Alcohllism/thiamine deficiency, myocarditis, chemo
- Arrhythmias
What do you suspect? Next step & treatment?
Dilated Cardiomyopathy
Echocardiogram*, BNP, ECG
Treatment:
- Same as CHF = ACEi, ARB, Beta blocker, aldosterone antagonist, cardiac glycosides, vasodilators, antiarrthmics
What does BNP measure?
Which suspected conditions would you order them for?
B-type natriuretic peptide, is a hormone secreted by cardiomyocytes in the heart ventricles in response to stretching caused by increased ventricular blood volume.
Cardiomyopathy, CHF
- Autosomal dominance inheritance (chromosome 14)
- Hypertrophy of the ventricular septum than the left ventricular wall
- Palpitations, angina with exertion, split S2/S4, palpble double apical impise
What do you suspect? Next step and tx?
- Etiology: amyloidosis/sarcoidosis, myocardial fibrosis after open surgery, or radiation.
Feature:
- Elevated JVP with gradually worsening SOB, progressive exercise intolerance, fatigue.
- Loud early diastolic filling sound (S3)
- Mitral & tricuspid valve regurgitation
Wchocardiogram
Chest x ray
vesntricular biopsy
Diurretics**
Which valve is most commonly affected in Endocarditis
Staph aureus and viridans
prostethis heart valve
opportunity bacterium
Clinical features:
petechiae on lefs, janeway legs, splinter hemorrange on nail
Enedocarditis
Janeway’s Lesion
Roth’s spot
Endocarditis
Osler’s node
A potential complication of endocarditis?
Echocardiogram blood culture
Endocarditiss teratment
IV antibiotics 4-6 weeks
Myocardits is usually ___ origin, __ valve is the most common valve involved (heart murmur). The gold standard to dx this treatment is ___.
Fever, chest pain, pericardial friction rub. elevated JVP
Myocarditis Tx
- Diffuse ST elevation and PR depression accompanied with chest pain and friction rub.
- Better leaning forward, worse leaning back
Acute pericarditis
ESR, CRP, Triponins I and T, serum creatinine kinase MB
ER!!!
Jones criteria
joint, carditis, subcutaneous nodules, erythema marinatum, subcutaneous nodules
Pediatric rheumatic heart disease
elevated level of anti sreptococcal antibodies
Penicillin and aspirin prednisone
CHF Tx
EMERFENT referral
use cardio meds
Ischemic heart disease
Angina
Stable angina worse with exertion
*BETA BLOKER
Prinzmetal angina/variant angianna- same sxs as stable but occurs at rest (between midnight and 8 AM)
NO AND CCB
Unstable angina
- at rest (>20 min)
NO and heparin
Chronic ischemic heart dz.
stress test and echo
My chest feels like there’s an elephant sitting on my chest! The pain radiates upwards and lasts 20 minutes to several hours. Doesn’t get better with rest or nitroglycerin.
MONA BASH: Oxygen, aspirin
A fibTx
can cause stroke
Atrial premature beats
common in healthy heartd
Arrhythmia gold standard investigation
ECG
Ventricular Premature Beats
When do you give pacemaker?
For second and third degree heart block
Dizziness, lightheadedness, hypotension, chest pain
Heart beats 100-300 bpm
Ankle Brachial Index
value
Chronic arterial insufficiency/occlusion (<0.4 = ischemia)
Peripheral vascular disease (<0.9 = PVD)
Tx for chronic rterial insufficiency
Aspirin, clopidogrel, pentoxifylline
Chronic venous insufficiency
women > 50 yo
leathery , flakym itchy skin
feels full
painless ulcer formation abode medial mallepuos
Ulcer →
Painful, cold extermities, finger and toes. NUmbe dry akin wu uclerations.
WOmen smoking with fingers tyrning pale, blue, then red. Has cold, burning pain and numbness, Tx>
Stasis Dermatitis
A 55 y/o F of Northern European ascent PTC with abrupt monocular loss of vision, jaw claudication, and scalp tenderness. Also has a severe throbbing headache.
PMHx: polymyalgia rheumatica
Dx? Next step? Tx?
Temporal Arteritis/Giant cell arteritis
Biopsy of the temporal artery**
High dose prednisone for pain
A 65 y/o M PTC with pain in the thorax.
Aortic Anyurism
Abdominal Ultrasound**
Monitor
Varicose Vein
Brodie-Trendelenburg Test
Varicose Vein
Atherosclerosis Tx
- Life style: Diet, No smoke, exercise
- Antiplatelet: Aspirin
- ACE inhibitors, ARB
- Stains
A 45 yo M with numbness in the extremities. He noticed cyanosis and thinning of his skin. He has increased sensitivity o cold
50 yo M with leg pain that is relieved by rest. Noticed blue legs, ankles, and feet. His lower extremities feels colder and noticed some ulcer formation.
What do you suspect?
Peripheral vascular disease
Tx: avoid vasocontricrivve drugs, cold temp, risk factors
antiplatelet durgs
Amputation
D-dimer lab test
DVT, DIC, PE
What imaging do you use for Thrombophlebitis?
Doppler US to differentiate from DVT?
