Cardiology Flashcards
Dressler’s syndrom
post-MI syndrome (1-2wks)
pericarditis, fever, leukocytosis, and pericardial/pleural effusion
Cardiac markers in MI
Myoglobin: rises 1-4h peaks 6-7h normal 24h
Troponin-I: rises 3-12h peaks 24h normal 5-10d
Troponin T: rises 3-12h peaks12-48 norm5-14d
Total CK: rises 3-5h peaks 24h normal 48-72h
CK-MB: rises 3-12h peaks 24h normal 48-72h
LDH: rises 10h peaks 24-48h normal 10-14d
Drawing of cardiac markers in MI
Myoglobin 1-2h after onset
troponin - 12h after onset
Ck-MB three times; 12h apart
LDH once 24h + after onset
Congenital heart anomalies are classified as
cyanotic and non-cyanotic
Cyanotic congenital heart defects
Tetralogy of Fallot
Pulmonary atresia
Hypoplastic left heart syndrome
transposition of the great vessels
Non-cyanotic heart defects
ASD VSD AV septal defect/canal PDA Coarctation of the aorta
Tetralogy of Fallot
subaortic septal defect, RV outflow obstruction, overriding aorta, RVH
cres-decres holosytolic murmur at LSB rad to back
cyanosis, clubbing, inc RV impulse at LLSB, loud S2
polycythemia present
TET spells (cyanosis, hyperpnea, agitation)
Pulmonary Atresia
Most often with an intact ventricular septum
Pulmonary valve closed; ASD and PDA present
May have TR
cyanosis/tachypnea at birth; single s1/s2; hyperdynamic apical impulse
Hypoplastic left heart syndrome
group of defects with a small L ventricle and normally placed great vessels
presentation varies
M>F; 1/4 of cardiac deaths before age 7
Transposition of the great vessels
complete transposition of the aorta and pulmonary arteries
systolic murmur if VSD; sys ejec mur if pul stenos
cyanosis in newborn MC
may have CHF symp, poor feeding, absent LE pulses
ASD- MC type
ostium secundum is the MC
Systolic ej murmur 2nd L ICS; early-mid sys rumble
FTT; fatigue; RV heave; wide FIXED SPLIT S2
VSD types
muscular, perimembranous, or outlet openings btw the ventricles
systolic murmur at LLSV
asymptomatic to signs of CHF
AV septal defect
Due to incomplete fusion between the endocardal cushions
*common in Downs syndrome (15-20% DS pts)
First dx may occur in adulthood
constellation of defects
Coarctation fo the aorta
narrowing in the proximal thoracic aortasystolic LUSB and left intersapular murmur; may be cont
Infants present w CHF
pathognomonic differences btw arterial pulses and BP in UE vs LE
PDA
failure to close or a delay in closure of the channel bypasing lungs 12-15% cong dx; MC in premature infants CONTINUOUS MACHINERY MURMUR Wide pulse pressure hyperdynamic apical pulse
Machinery murmur
PDA
Holosystolic murmurs
MR
TR
VSD
Differences in UE and LE BP and arterial pulses is pathognomonic for
Coarctation
Widened pulse pressures
aortic regurg/insuff
midsystolic murmur heard 2nd R ICS rad to neck and LSB. Loud and hash in quality. Inc with pt siting and leaning forward
AS
Blowing, high-pitched diastolic decrescendo murmur. 2nd-4th L ICS rad to apex and RSB. Inc with pt sitting and leaning forward on full exhalation. May have soft systolic component. Pulses are large and bounding
AR
Low-pitch, mid-dyastolic murmur heard at apex. No radiation. Heard best with patient in L lateral on full exhalation. S1 accentuated with opening snap following S2
MS
Medium-high blowing holosystolic murmur heard best at apex; radiates to L axilla. S2 decreased with apical impulse prolonged
MR
Holosystolic, blowing murmur heard best at LLSB with radiation to R sternum and xiphoid area. JVP elevated
TR
