Cardio Rapid Fire Facts Flashcards
What disease is associated with a Chromosome 22q11 deletion?
DiGeorge syndrome:
Tetralogy of Fallot
Truncus arteriosus
What heart defect is associated with Down’s syndrome?
Endocardial cushion defect which can cause: ASD, VSD, AV septal defect.
What cardiac defects are associated with congenital rubella?
PDA
Pulmonary artery stenosis
Septal defect
What cardiac abnormalities are associated with Turner’s Syndrome?
Coarctation of the aorta
Aortic root dilation
Bicuspid aortic valve
*coarctation of aorta may also have notching of the ribs on CXR
What cardiac abnormalities are associated with Marfan’s syndrome?
Aortic insufficiency due to abnormal aortic valve stretch —>(mitral regurgitation)
Aortic root dilatation
Aortic dissection (deadly)
An 80 YO patient presents with a systolic crescendo-decrescendo murmur, what is the most likely cause?
Aortic Stenosis
What are the normal blood pressures of the right and left ventricles of the heart?
Right ventricle- 25/5
Left ventricle- 130/10
What heart sounds are considered benign (4), if there is no evidence of disease?
Split S1
Split S2 on inspiration
S3 heart sound in patient <40 years old
Early quiet systolic murmur
What is the most common congenital cardiac anomaly?
VSD - ventricular septal defect
What is the defect in transposition of the great vessels??
Pulmonary trunk attaches to the left ventricle, and the aorta attaches to the right ventricle
Describe the problem in a PDA (Patent Ductus Arteriosus):
Left to right shunt
Aorta —> pulmonary artery
What are the three L to R shunts that can cause an S3 heart sound?
VSD, ASD, and a PDA
What pathologies are associated with an S4 heart sound?? Why is it heard?
Hypertrophic cardiomyopathy
Aortic stenosis
Chronic hypertension with LVH
Post-MI
It’s heard because the LA has to push against a stiff Left ventricle wall. (Stiff wall and atrial kick)
What gives rise to the Jugular Venous a, c, and v wave?
a wave - atrial contraction
c wave - ventricular contraction
v wave - atria filling against closed tricuspid valve
Where does the QRS complex fall in relation to valvular dynamics?
Atrioventricular valve closure
—> because it’s electrical signal of the QRS complex that’s causing the ventricles to contract and that increases the pressure in the ventricles, which causes the valves to close.
What Cardiac pathologies (6) are associated with an S3 heart sound?
Dilated cardiomyopathy Congestive heart failure Mitral regurgitation Left to right shunting - ASD, VSD, AND PDA Children (can be normal) Pregnant women
When does isovolumeteic contraction take place?
It’s taking place during the QRS after mitral valve closure, but before the aortic valve opens.
What are the diastolic murmurs??
Mitral Stenosis
Tricuspid Stenosis
Aortic Regurgitation
Pulmonic Regurgitation
A 60yo patient presents with the following PE findings:
Bounding pulses, head bobbing, wide pulse pressure, and a diastolic murmur. What is the most likely pathology at hand?
Aortic regurgitation
Wide pulse pressure can be something like 120/40.
What are the systolic heart murmurs (6)?
Aortic Stenosis Mitral Regurgitation Mitral Valve Prolapse Tricuspid Valve Prolapse VSD Pulmonic Stenosis
An elderly patient walks in to the office but presents with a history of syncope, angina, and dyspnea. What should you rule out first?
The possibility of having Aortic Stenosis. If the patient presents with ANY of these symptoms, you should think about the possibility of having the heart valve replaced.
What are the 5 MCCs of Acute Chest Pain?
Aortic dissection (or dissecting aortic aneurysm) Unstable Angina MI Tension Pneumothorax Pulmonary Embolism
Where are the MC locations for formation of atherosclerotic plaques (rank in order)?
Abdominal Aorta: AAA
Coronary Arteries: MI, angina
Popliteal arteries: Claudication/Peripheral Vascular Disease
Carotid Arteries: TIA, Strokes, multi-vascular dementia
What is the definition of arteriolosclerosis? What is the difference with atherosclerosis?
Hyaline thickening of arterioles… 2 types: hyaline (seen with diabetes or HTN) and hyper plastic (onion skin appearance seen with severe HTN)
may not have hyperlipidemia
Atherosclerosis- fibrous plaques and atheromas of intima of arteries
What would be the cause of the following complications post MI:
Cardiac tamponade
Rupture of the ventricular wall
What would be the cause of the following complications post MI:
Severe mitral regurgitation
Rupture of papillary muscle
What would be the cause of the following complications post MI:
New VSD
Rupture of intraventricular septum
What would be the cause of the following complications post MI:
Stroke
Mural thrombus —> embolus
What are the Non-Suppurative Complications of Group A Strep infection?
Scarlet Fever - Toxin mediated
Post Streptococcal glomerulonephritis - type III hypersensitivity
Acute Rheumatic Fever - type II Hypers.
Strep Toxic Shock Sd - skin or vaginal infection
What are the Jones Criteria for group A infection?
2 major and 1 minor: Major: joints, heart (pancarditis), Nodules (subcutaneous) Erythema marginatum (multiple small ring like lesions) Sydenham chorea (face, tongue, upper-limb)
Minor:
Arthralgia, Fever, elevated ESR or CRP, prolonged QT
Affects medium sized arteries. Calcification of internal elastic lamina and media of arteries —> vascular stiffening without obstruction. “Pipestem” appearance on X-ray. Does not obstruct blood flow; íntima not involved.
Monckeberg Sclerosis (medial calcific sclerosis)
What is the triad for Grabulomatosis with Polyangiitis (Wegener)?
- Focal necrotizing vasculitis
- Necrotizing granulomas in the lung and upper airway
- Necrotizing glomerulonephritis
What is the MOA of BNP? Where is it produced?
Produced in cardiac ventricles in response to stretch.
MOA: causes vasodilation and increased excretion of Na+ and water in urine
