Cardiology Flashcards
Physical exam finding of pericardial effusion
Distant heart sounds and difficult to palpate apical pulsation
In what cardiac conditions would one see kussmal’s sign (rise in JVP inspiration)
Constrictive pericarditis Restrictive cardiomyopathy Right sided ventricular infarct Massive PE Rare with tamponade
Diagnosis: bronze diabetes, heart failure and elevated LFTs
Hemochromatosis
What is the only condition that causes a restrictive cardiomyopathy that can be reversed with phlebotomy
Hemochromatosis
What is the most common cause of heart failure in very young patients
Myocarditis due to viral infection, usually ECHO and coxsackie
When will a sub clinical mitral stenosis from rheumatic fever become clinically apparent
Any fluid overloaded state, usually pregnancy
What is Beck’s triad of tamponade?
Hypotension
JVD
Distant heart sounds
What work-up should be done in a patient with a diastolic murmur in a healthy asymptomatic patient
Diastolic murmurs are commonly pathological, so whether or not the patient is symptomatic an ECHO should be done
What work-up should be done if a systolic murmur is heard in a healthy asymptomatic patient
Systolic murmurs are usually benign; in a low grade systolic murmur no work up is needed, if it is high grade then an ECHO should be done
Identify: late diastolic murmur with opening snap
Mitral stenosis
Identify: diastolic murmur best heart in the left lower sternal boarder that increases with inspiration
Tricuspid stenosis
Identify: systolic murmur best heart at the right 2nd intercostal space
Aortic stenosis
Identify: systolic murmur best heard in the 2nd left intercostal space
Pulmonic stenosis
Treatment for acute exacerbation of CHF
LMNOP
Loop diuretics, morphine, nitrate, oxygen, position and pressors (dobutamine)
Outpatient treatment for CHF
ABCDD
ACEI/ARBS, beta blockers, spironolactone, digoxin, diuretics (loops)
Identify: holo systolic murmur best heard at the apex and radiates to the axialla
Mitral regurgitation
Identify: holosystolic murmur best heard at the left lower sternal boarder that increases with inspiration
Tricuspid regurgitation
Identify: diastolic murmur with a wide pulse pressure
Aortic regurgitation
Identify: late systolic murmur best heard at the apex that decreases with squatting
Mitral valve prolapse
In what condition is pulsus paradoxus (>10mmHg in BP with inspiration) seen and what is the pathophysiology behind it?
Tamponade, due to decreased capacity of left ventricle
Classic cheat xray findings with pericardial effusion
Similar to that of dilated cardiomyopathy, balloon like or globular shaped heart
