Cardiology Flashcards
What is the common Tetralogy of Fallot post-op sequela?
Pulmonary Regurgitation
If a patient has HFrEF, what is the best medication to give?
Entresto
Bad ABIs 0.62 and 0.44, what is the next best step, for the patient?
Invasive Angiography
ABIs that are symptomatic, above 0.68 and 0.98, what are the next best treatment steps?
Supervised Exercise Training Program
If a patient has a NSTEMI, EKG looks ok, what is the next best treatment option?
Plavix and Aspirin
Left Atrial Myxoma, what is the next best step? Particularly if the patient has a TIA and SOB
Surgically Remove Left Atrial Myxoma
A TAVR valve candidate requires what life parameters?
80 years old, and less than 10 years of life left, or patient is a poor surgical candidate to live at any point
S/p myocardial infarction, what is the most common cause of M.I. in woman?
Spontaneous Coronary Artery Dissection
After a STEMI, is there benefit to having another culprit lesion fixed 4-6 weeks after the fact?
Yes
AAA screening shows a 6.1cm Aneurysm, what is the next best step?
CT angiography
Patient has a bicuspid aortic valve, what is the next test that should be done?
CT aortaography
Symptomatic PVCs, Echo is wnl, no CAD, what is the next best step?
Propranolol
A patient with end stage restrictive heart disease, RVSP 64, what should be considered next?
Cardiac transplant
Patient has a high bleeding risk, had a stent placed 4 months ago. What should be done for the patient’s aspirin and plavix?
Hold the Plavix, high risk bleeding, 3 months at a minimum, but 6 months is ideal with the plavix and high GI bleeding risk
Patient has a recurrent peridcarditis, what should be done?
Give Colchicine and Ibuprofen, Steroids are only given if NSAIDS are contraindicated
What two statins have a low risk of muscle inflammation and low CK values?
Fluvastatin and pravastatin
Osborne Wave is seen in an EKG for what?
Hypothermia
Voyager and Compass trail have said that a decreased dose of what can treat PAD (peripheral artery disease)?
DOAC, low dose
A patient has an elevated RCRI score, what tests should be done pre-surgery to determine if ok to go?
EKG, XR chest, and Echo
What questionarie for functional capacity during preoperative evaluation should be done?
Duke Activity Status Index Questionnaire
Patient undergoing surgery, what needs to be evaluated if patient needs an EKG?
Type of surgery needed
Aortic Dissection, what is the medication of choice?
Esmolol #1
Nitroprusside with beta blocker #2
Cardiac Tamponade has what key JVP waveform?
Constrictive Pericarditis has what key JVP waveform?
Cardiac Tamponade: loss of the Y descent, filling ability is impeded
Constrictive Pericarditis: rapid x and y descent, myocardial relaxation is unimpaired
What is the following triad:
Hypotension
Elevated JVD
Muffeled heart sounds
Beck’s Triad -> Cardiac Tamponade
What is Pulsus paradoxus?
Inspiration drops SBP > 10
Can be seen in restrictive pericarditis/cardiac tamponade
What is Kussmaul’s Sign?
A paradoxical rise in JVP > 10, usually during cardiac restrictive pericarditis/cardiac tamponade
Typically, JVP decreases during inspiration -> this sign is indicative of Right Heart Failure of difficulty filling
If an athlete has pericarditis, how long should they wait to return to competitive sports?
3 months
With regards to tracking pericarditis inflammation, what lab value should be followed?
CRP level
Pericarditis round #1? What treatment is recommended?
Round #1) ASA or Ibuprofen
Round #2) Colchicine
Pericarditis that is refractory to glucocorticoid treatment, what is the next best step?
IL-1 inhibition -> rilonacept
The following indications, patients can have what?
1) EF less than 35% or less (NYHA functional class II or III) with GDMT
2) same as above, LBBB and QRS > 150 ms or longer
CRT-D device
When can a CRT-D device be considered in patients with the following conditions:
1) Myocardial infarction
2) All other conditions
1) Myocardial infarction is 40 days
2) All other conditions -> 3 months
What is number is needed for surgical AAA repair? This is usually found via Abdominal Ultrasound
5.5 cm -> Vascular Surgery follow up
Looking at a JVP, what is an “a-wave”?
Right Atrium contracts
Looking at a JVP, what is an “c-wave”?
Tricuspid Valve Contracts
Looking at a JVP, what is an “v-wave”?
filing or right atrium against a closed tricuspid valve
Looking at a JVP, what is an “x-descent”?
Relaxation of the right atrium, causes the pressure to drop
What does the triad mean?
Claudication
Decreased Femoral Pulses
Erectile Dysfunction
Leriche’s Syndrome
severe aortoiliac occlussive disease (PAD, peripheral artery disease)
