Cardio Exam 3 part 2 Flashcards
Which patients need an Electrophysiology study?
- Cardiac arrythmias
- Unxeplained syncope
- Pacemaker evaluation
- Prior to radiofrequency ablation
What is catheter ablation good for?
Superventricular tachycardia and ventricular tachycardia
What are the contraindications of an EP study?
Poor ejection fraction <35%
Clear diagnosis
Whats the most effective method of preventing sudden cardiac death?
An ICD
What are some causes of secondary hypertension?
- Oral contraceptives
- Primary aldosteronism
- Liddle’s syndrome
What are the hemodynamic patterns to Hypertension?
Early: CO is high, SVR is normal
Late: CO is normal/low, SVR is high
Pressure diuresis and natriuresis are inhibited in essential hypertension
Name some microscopic changes seen in Left sided HHD?
- Mycocyte Hypertrophy
- Interstitial fibrosis
- Boxcar nuclei
What is the drug of choice for pregnant women with hypertension?
Methyldopa
Which antihypertensive drug can cause Steven Johnson Syndrome or TEN?
Aliskiren; Renin Inhibitor
What are the JNC8 hypertension treatment goals?
Age < 60 = <140/90
Age > 60 = <150/90
Discuss the recommended treatment for hypertension
- Thiazide diuretics initially
- Thiazides and CCBs for African-Americans
- Beta blockers not recommended for initial therapy
What is the clinical triad for pheochromocytoma
Headache, perspiration and palpitations
What are the symptoms of Aldosteronism?
Hypertension, Hypokalemia, Alkalosis, Hypernatremia
Discuss the pathogenesis of Atherosclerosis
Plaques occur at branches and non-turbulant flow protect against atherosclerosis
How do lipids worsen atherosclerosis?
Cholesterol impairs endothelial function by increasing free radicals
Discuss the inflammatory process of atherosclerosis
- Endothelial cells express VCAM-1 (adhesion molecule)
- Macrophages engulf LDL
- Leukocytes and endothelium release growth facors (PDGF, TGF alpha) to increase smooth muscle and ECM
What is a fatty streak?
Lipid filled foamy macrophages
What part of the aorta is most susceptible to atherosclerotic plaques?
Abdomial aorta
What is the criteria for metabolic syndrome?
- Abdominal Obesity; Men>40; Women >35
- Triglycerides >150
- HDL; Men <40; Women <50
- BP >130 systolic and >85 diastolic.
- Fasting Glucose >110
What is the relationship between adiponectin and obesity?
Inverse relationship
How is endothelial dysfunction triggered?
Dyslipidemia, High BP, diabetes and smoking all lead to oxidative stress.
