Cardiology

Question 1

pt with chest pain, signs of decreased carrdiac output and pulsus paradoxus after a viral infection most likely has___? and why? what is pulsus paradoxus

Answer 1

pulsus paradoxus: large decrease in SBP during inhalation

pt has cardiac tamponade s/p a viral infection

cardiac tamponade produuces a decrease in the cardiac output because the pressure exerted on the heart by the pericardial fluid is greater than the venous pressure that fills the right atrium during diastole; cardiac filling can only occur during deep inhalation when the negative intrathoracic pressure allows for a pressure difference between the vena cava and the right atrium.

Question 2

pts that need prophylaxis before high risk dental procedures

Answer 2

unrepaired congenital heart disease, previous IE, prosthetic heart valves

Question 3

Normal cardiac cath values:

1. RA MAP
2. RV BP
3. PA BP
4. LA MAP/PCWP:
5. LVEDP
6. CVP

Answer 3

1. RA MAP: 1-8mmHg
2. RAVBP: (15-30)/(1-8)
3. PA BP: (15-30)/(4-12)
4. LA MAP/PCWP: 4-12
5. LVEDP: 4-12
6. CVP: 3-8

Question 4

aortic regurg murmur characteristics and its most common cause

Answer 4

diastolic decrescendo murmur heard at LSB; most common cause in a person with cardiac risk factors is aortic root dilatation (possible ascending aortic aneurysm), or bicuspid valve; rhematic fever is a worldwide cause

Question 5

heart failure with preserved ventricular EF

Answer 5

diastolic dysfunction - impaired filling of left/right ventricle because of impaired myocardial relaxation or a stiff non compliant ventricle