Cardiology Flashcards
ES HF refractory to medical tx
refer for mech support/cardiac tx
Secondary causes of HLD
hypothyroid, DM, nephrotic syndrome obstructive liver dzz
Surgery in patient with ICD and is PPM dependent
turn off shock function and put in asynchronous mode (VOO) - magnet over ICD only stops shock function, does not change ppm part to asynchronous mode - problem because electrocautery could cause inhibition of pacing if not in VOO mode
Surgery in patient with PPM that is PPM dependent
Magnet over PPM ok - put in asynchronous mode
Surgery in patient with ICD that is NOT ppm dependent
Magnet over PPM ok - just turns of shock fxn - does not need asynchronous mode (has native rhythm not PPM dependent)
SLE with chest pain
check EKG - pt with SLE great risk of early CAD - late deaths with lupus in later age related to CAD - inflammation induced CVD - next should r/o PE also
Stress Cardiomyopathy
normal coronaries, apical ballooning, +CE, anginal chest pain with ST elev on EKG - apical hypokinesis, basal hyperdynamic - tx with BB/ACEi
Hospital d/c from ADHF
f/u appt in 1 week
Myopericarditis
acute pericarditis with +CE unrelated to MI with new WMA and can lead to HF - ST seg with concave down
Cardiac tamponade
+pulsus paradoxus, JVD, effusion
Post-myocardial infarction syndrome
pericarditis preceeded by myocardial injury (MI) - does not cause HF
Syncope
pt with palpitations then syncope - inpatient cardiac monitoring (esp with PVCs on EKG) - esp patients with fhx SCD, exertional syncope, supine syncope, palpitations prior to syncope, NSVT, abn ekg
Dx PAD
ABI 1.4 is uninterpretable (has calcification but not dx of flow limiting lesion - if uninterpretable check great toe pressure or get toe-brachial index (pressure <0.7 = PAD - toe vessels rarely become non-compressible)
PAD testing
Excercise ABI - if normal resting but exc induces reduction of >20% then PAD
Ischemia with new onset HF - high pretest probability of CAD
Cath - has DM, with Q waves and twi on EKG and new onset CHF - could have silent ischemia - no need for non-invasive testing as pt already high pretest probability (only use in intermediate pretest probability to recategorize as low or high)
