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PANCE/EOC > Cardiology #1 > Flashcards

Cardiology #1 Flashcards

1
Q

Dilated cardiomyopathy is MCC by what things?

A

Idiopathic, Coxsackievirus, Alcohol, Cocaine, B1 deficiency

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2
Q

Symptoms of Dilated cardiomyopathy

A

S3 gallop, heart failure symptoms

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3
Q

Diagnostics for dilated cardiomyopathy

A

-Echo (LV dilation), CXR (cardiomegaly)

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4
Q

Treatment for dilated cardiomyopathy

A

ACE, ARB, BB, Spironolactone, Diuretics, AICD if EF < 35%

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5
Q

Stress cardiomyopathy is the result of what

A

Catecholamine surge during stress (such as postmenopausal, death of family member)

-Transient regional systolic dysfunction of the left ventricle in absence of significant obstructive coronary artery disease or evidence of plaque rupture.

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6
Q

Treatment for stress cardiomyopathy

A

Aspirin + BB + Nitro + Heparin (mimics MI)

Supportive care is mainstay of treatment (BB or ACE for 3-6 months with serial imaging to assess for improvement)

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7
Q

What is on history of a patient with restrictive cardiomyopathy?

A

Infiltrative disease (amyloidosis, sarcoidosis, scleroderma)

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8
Q

Diagnostics for restrictive cardiomyopathy

A
  • Echo (initially) - diastolic dysfunction and marked dilation of both atria
  • Endomyocardial biopsy (definitive)
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9
Q

Hypertrophic cardiomyopathy pathophysiology

A

Diastolic dysfunction due to inappropriate LV and RV hypertrophy

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10
Q

What does an Echo for hypertrophic cardiomyopathy show?

A
  • Asymmetric ventricular wall thickness (especially septal), 15 mm or greater
  • Small LV chamber size
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11
Q

Treatment for hypertrophic cardiomyopathy

A

BB

If no response, myomectomy performed or alcohol septal ablation.

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12
Q

What does the murmur for hypertrophic cardiomyopathy sound like?

A

Harsh systolic murmur at LSB, Loud S4

  • Increased intensity with standing, Valsalva
  • Decreased intensity with squatting, supine
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13
Q

Myocarditis is MCC by

A

-Enterovirus (Coxsackievirus), Clozapine

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14
Q

Symptoms of Myocarditis

A
  • Viral prodrome followed by systolic dysfunction
  • S3 gallop
  • Pericarditis
  • Megacolon
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15
Q

Diagnostics for myocarditis

A
  • CXR: cardiomegaly
  • Echo: Ventricular systolic dysfunction
  • Endomyocardial biopsy: gold
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16
Q

Treatment for myocarditis

A
  • Supportive (systolic heart failure treatment)

- ACE/Diuretics/BB

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17
Q

Treatment for sinus tachycardia

A
  • BB if they have ACS

- Otherwise, treat the underlying cause (first line)

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18
Q

Treatment for sinus bradycardia

A
  • Atropine is symptomatic

- If asymptomatic, no treatment needed

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19
Q

What is sick sinus syndrome

A

Sinus arrest alternating paroxysms of tachycardia and bradycardia

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20
Q

Treatment for sick sinus syndrome

A
  • Stable: may not need treatment, often transient
  • Atropine if needed
  • Long term: pacemaker + ICD if alternating between tachycardia and bradycardia
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21
Q

What defines a first-degree AV block

A
  • Prolonged PR interval, but all followed by QRS complex

- PR Interval is > 0.20 seconds

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22
Q

Treatment for first-degree AV block

A

Atropine is first-line if symptomatic
-If asymptomatic, no treatment, observation.

-Pacemaker is definitive, if persistent or PRI > 0.30 seconds

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23
Q

What defines a second-degree AV block (Type I)

A

progressive lengthening of PR interval, dropped QRS complex

-This is known as a Wenkebach

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24
Q

Treatment for second-degree AV block

A

-Atropine, Pacemaker definitive

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25
Q

Causes for second-degree AV block Type I

A

Inferior Wall MI, AV nodal blocking agents (BB, CCB, Lyme Disease)

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26
Q

What defines a second-degree AV block (Type II)

A

Constant PR interval before and after dropped QRS complex

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27
Q

Treatment for Mobitz Type II

A

Transcutaneous pacing or Atropine

-Permanent Pacemaker for long-term

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28
Q

What defines a third degree AV block

A

Regular P-P intervals and R-R intervals but they are not related to each other

(AV Dissociation)

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29
Q

Treatment for 3rd degree AV block

A

Transcutaneous pacing followed by permanent pacemaker

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30
Q

Treatment for Atrial Flutter

A

Vagal maneuvers, BB, CCB

  • Unstable: Direct current synchronized cardioversion
  • Radiofrequency catheter ablation (definitive)
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31
Q

Symptoms of atrial fibrillation

A

Hypotension, AMS, refractory chest pain

32
Q

What does an ECG show for atrial fibrillation?

What is Ashman’s Phenomenon on ECG?

A

Irregularly irregular rhythm with fibrillary waves (no discrete P waves)

-Occasional aberrantly conducted beats (wide QRS) after short R-R cycles

33
Q

Treatment for stable atrial fibrillation

A

BB, CCB (Diltiazem, Verapamil)

-Digoxin only used when BB and CCB are contraindicated (CHF or severe hypotension)

34
Q

Treatment for unstable A-fib

A

direct current synchronized cardioversion

-Echo needed prior to tell if there are atrial clots

35
Q

Treatment for A-Fib determined by time present. Explain

A
  • AF > 48 hours: anticoagulation for 3 weeks

- AF < 48 hours: elective cardioversion, anticoagulation for 4 weeks

36
Q

What is the definitive treatment for A-Fib

A

Radiofrequency catheter ablation

37
Q

Regarding the CHA2DS2-VASc score, a score of 2 or greater needs chronic anticoagulation. Explain this score.

A 
Congestive heart failure (1)
Hypertension (1)
Age > 75 (2)
Diabetes (1)
Stroke (2)
Vascular event such as MI, PAD (1)
Age 65-74 (1)
Sex Female (1)
38
Q

What does an ECG for Paroxysmal Supraventricular Tachycardia show?

A

regular, narrow QRS tachycardia with no discernible P waves

39
Q

Treatment or SVT

A

Vagal maneuvers, Adenosine

  • Unstable: Direct current synchronized cardioversion
  • Definitive: Radiofrequency catheter ablation
40
Q

Three components of Wolff-Parkinson White Syndrome

Pathophysiology of WPW

A

Delta wave, shortened PR, wide QRS

-Accessory pathway (Bundle of Kent) preexcites the ventricles and leads to a delta wave

41
Q

Treatment for WPW

A
  • Stable (Procainamide)
  • Unstable (Cardioversion)
  • Definitive: Catheter Ablation
42
Q

Treatment for Torsades de Pointes

A

IV Magnesium Sulfate

43
Q

Treatment for V-fib

A

Unsynchronized cardioversion (Defibrillate) + CPR

44
Q

Treatment for V-tach

A
  • Stable: Amiodarone

- Unstable: Direct current synchronized cardioversion

45
Q

Define a LBBB

A

R and R1 (upward bunny ears) in V4-V6

STEMI Equivalent

46
Q

Define a RBBB

A

-R1 and R1 in V1-V3 Upward bunny ears

47
Q

Best test for Patent Foramen Ovale

A

Echo

48
Q

What is a patent foramen ovale?

A

Unsealed opening between RA and LA

49
Q

MC type of ASD

A

Ostium Secundum

50
Q

Murmur of ASD

A

-Systolic ejection crescendo-decrescendo flow murmur at LUSB with wide, fixed split S2 that does not vary with respiration

51
Q

Diagnostics for ASD

A
  • Echo

- Catheter (Definitive)

52
Q

Treatment for ASD

A
  • < 5 mm may be observed

- > 1 cm surgical correction

53
Q

What is a patent ductus arteriosus

A

-Persistent communication between descending thoracic aorta and main pulmonary artery

54
Q

Murmur of PDA

A

-Continuous machine like murmur loudest at pulmonic area

55
Q

Diagnostics for PDA

A
  • Echo

- Catheter (Definitive)

56
Q

Treatment for PDA

A
  • NSAIDs

- Indomethacin

57
Q

Symptoms of Coarctation of Aorta

A

-Bilateral claudication, syncope, DOE, failure to thrive, poor feeding, upper extremity hypertension with lower extremity hypotension

58
Q

Murmur of Coarctation of Aorta

A

-Systolic murmur radiating to back, scapula, or chest

59
Q

Diagnostics for Coarctation of Aorta

A
  • CXR: rib notching, figure 3 sign
  • Echo
  • Angiography (gold)
60
Q

Treatment for Coarctation of Aorta

A
  • Prostaglandin E1 preoperatively

- Corrective surgery

61
Q

Four factors of Tetralogy of Fallot

A
  • Pulmonary stenosis
  • RVH
  • Overriding Aorta
  • VSD
62
Q

Symptoms of ToF

A
  • Tet spells (relieved with squatting)

- Cyanosis

63
Q

Murmur of ToF

A

-harsh systolic murmur at Upper sternal border (VSD) and right ventricular heave

64
Q

Diagnostics for ToF

A
  • Echo (diagnostic of choice)

- CXR (boot shaped heart)

65
Q

Treatment for ToF

A
  • Prostaglandin E1 preoperatively

- Surgical repair

66
Q

Pathophysiology of Transposition of Great arteries

-What is the MC type of ToGA?

A
  • Aorta arises from RV and pulmonary trunk from LV
  • Dextro-TGA: prior to surgical correction, survival dependent on presence of shunts between right and left circulations (PDA, ASD, VSD)
67
Q

Diagnostics for Transposition

A
  • Echo
  • CXR (egg on string)
  • Catheter (gold)
68
Q

MC congenital heart disease in children

A

VSD

69
Q

Murmur of VSD

A

-High pitched harsh holosystolic murmur at LLSB

70
Q

Order of ECG strip

A

I avR V1 V4
II avL V2 V5
III avF V3 V6

71
Q

Anterior Wall and Septal MI corresponds to which artery

A

LAD

72
Q

Inferior Wall MI corresponds to what artery

A

RCA

73
Q

Lateral Wall MI corresponds to which artery

A

LCA

74
Q

What is stress cardiomyopathy in regards to ventricles?

A

-Transient regional systolic dysfunction of the left ventricle that can imitate MI but in absence of significant obstructive CAD or plaques

75
Q

Risk Factors for Stress Cardiomyopathy

A
  • Postmenopausal women
  • Exposure to emotional or physical stress
  • Death of relative, etc.

PANCE/EOC (63 decks)

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