Cardiology 1

Question 1

Dyspnea is mc symptom, harsh systolic murmur increased intensity with decreased venous return such as valsalva. or standing.
Loud S4.
Managment is beta blockers and avoiding dehydration, extreme exertion and exercise.

Answer 1

HOCM

Question 2

Diastolic dysfunction, mc cause is amyloidosis, but also sarcoidosis, hemochromatoisis. 
Increased JVP (Kussmaul's sign) 
Echo is test of choice - will see non-dialated ventricles with a normal thickness along with marked dilation of both atria. 
Endomyocardial biopsy gives definitive diagnosis. 
Tx underlying disorder.

Answer 2

Restrictive cardiomyopathy (RCMP)

Question 3

Systolic dysfunction, idopathic mc cause,
S3 gallop hallmark. Decreased EF.
Management is ACE inhibitors, BB, and symptom control with diuretics.

Answer 3

Dilated Cardiomyopathy

Question 4

What is essentially the acute phase of Dilated cardiomyopathy that is mc from viral infections such as enteroviruses and coxsackievirus B? It will start out as fever, myalgias, malaise for several days followed by symptoms of systolic dysfunction as seen in dilated cardiomyopathy.
S3 gallop, cardiomegaly.
Supportive mainstay of treatment with ACE inhibitors, BB, diuretics.

Answer 4

Myocarditis.

Question 5

What is the managment for stable vs unstable A-flutter?

Answer 5

Stable: Vagal maneuvers, BB (metoprolol, Atenolol, esmolol). CCB (Diltiazem, verapamil.
Unstable: DC synchronized cardioversion.

Definitive management is radiofrequency catheter ablation.

Question 6

What are the general rules of anticoagulation for AF and cardioversion?

Answer 6

AF greater than 48 hours needs anticoagulation for at least 3 weeks before cardioversion and must be continued for 4 weeks after.

Question 7

Tx for stable regular narrow complex PSVT?

Answer 7

Vagal maneuvers, adenosine. Second line is CCB, BB.

Question 8

Tx for stable wide complex PSVT?

Answer 8

Amiodarone. Procainamide if WPW.

Question 9

Multiple p wave morphologies at a HR < 100.

Answer 9

Wandering atrial pacemaker.

Question 10

Multiple p wave morphologies at a HR > 100. What is this classically associated with?

Answer 10

MAT. Associated with severe COPD.

Question 11

What is the TX for stable WPW?

Answer 11

Procainamide.

Question 12

Tx for unstable WPW?

Answer 12

DC synchronized cardioversion.

Question 13

TX for pulseless V-tach?

Answer 13

Defib + CPR

Question 14

MC cause of V-fib and pulseless v-tach?

Answer 14

Ischemic heart disease

Question 15

Tx for Pulseless Electrical Activity (PEA)

Answer 15

CPR, Epi, check for shockable rhythm ever 2 min.