Cardiology 3 Flashcards
Systolic crescendo-decrescendo murmur at the right upper sternal border.
Echo and ECG show LVH.
Aortic stenosis
Diastolic blowing decrescendo murmur best heard at the left upper sternal border.
Aortic regurgitation
Prominent S1, opening snap, mid-diastolic murmur best heard at the apex.
MC caus is rheumatic heart disease.
Mitral stenosis.
Blowing holosystolic murmur best heard at the apex with radiation to the axilla.
Mitral regurgitation.
Mid-late systolic ejection click best heard at the apex.
MVP
Mid diastolic murmur at the left lower sternal border. Increased intensity with inspiration.
Tricuspid stenosis.
When do you screen for AAA?
65-75 years of age who ever smoked.
At what cm expansion do they operate for AAA?
≥5.5 cm or > 0.5 cm in 6 months need immediate surgically repair.
> 4.5 cm need vascular surgeon referral.
3.0 cm monitor by ultrasounds
Which type of aortic dissection is the most common and highest mortality?
Ascending (Stanford A)
Most important risk factor for Aortic dissection?
Hypertension.
Tx for Aortic dissection?
Acute proximal Stanfor A or acute distal with complications treat with surgical repair.
Descending distal Stanford B use Nonselective BB labetalol with Sodium nitroprusside if needed.
Physical findings of PAD?
Lower extremity pain with ambulation
Decreased or absent pulses.
Atrophic skin changes such as thin/shiny skin, hair loss,
Lateral malleolar ulcers.
Pale on elevation, dependent rubor (dusky red with dependency)
How do you diagnose PAD?
Ankle brachial index: Pos if ABI <0.90 normal is 1-1.2
What is the treatment for PAD?
Exercise, smoking cessation, Cilostazol.
This is an acute limb ischemia and a vasulcar emergency.
Paresthesias, pain, pallor, pulselessness.
Acute arterial occlusion.
