Cardiology Flashcards by Eric Carter

beck’s triad of cardiac tamponade

hypotension, diminished heart sounds, and JVD

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classic ECG findings of atrial flutter

sawtooth p waves

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definition of unstable angina

angina that is new, is worsening, or occurs at rest

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anti-HTN med for diabetic pt w/ proteinuria

ACE-I

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drugs that slow the heart

beta-blockers, CCBs, digoxin, and amiodarone

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hypercholesterolemia tx that leads to flushing and pruritis. pre-tx w/ this med to reduce?

niacin. ASA

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murmur - HOCM

systolic ejection murmur heard along the lateral sternal border that increases w/ decreased preload (valsalva)

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murmur - aortic insufficiency

austin flint murmur - diastolic, decrescendo, low-pitched, blowing murmur that is best heard sitting up; increases w/ increased afterload (handgrip)

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murmur - aortic stenosis

systolic crescendo/decrescendo murmur that radiates to the neck; increases w/ increased preload (squatting)

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murmur - mitral regurg

holosystolic murmur that radiates to the axilla; increases w/ increased afterload (handgrip)

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murmur - mitral stenosis

diastolic, mid-to-late, low pitched murmur preceded by an opening snap

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tx for atrial fibrillation and atrial flutter

if unstable, cardiovert. if stable or chronic, rate control w/ beta-blocker or CCBs

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tx for ventricular fibrillation

immediate cardioversion

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dressler’s syndrome

an autoimmune reaction w/ fever, pericarditis, and increased ESR occuring 2-4 wks post MI

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pulsus paradoxus

a decrease in systolic BP of > 10 mm Hg w/ inspiration that is seen in cardiac tamponade

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classic ECG findings in pericarditis

low voltage, diffuse ST-segment elevation

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eval of pulsatile abdominal mass and bruit

abdominal US and CT

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indications for surgical repair of AAA

> 5.5 cm, rapidly enlarging, symptomatic, or ruptured

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tx for ACS

morphine, O2, nitro, ASA, heparin, clopidogrel, beta-blockers

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characteristics of metabolic syndrome

abdominal obesity, high triglycerides, low HDL, HTN, insulin resistance, prothrombotic or proinflammatory states

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target LDL in pt w/ DM

less than 70

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signs of active ischemia during stress testing

angina, ST-segment changes on ECG, or decreased BP

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ECG findings suggesting MI

ST-segment elevation (depression means ischemia), flattened T waves, and Q waves

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young female pt w/ angina at rest (most commonly at night) w/ ST segment elevations and normal cardiac enzymes

prinzmetal’s angina

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common symptoms of silent MIs

CHF, shock, and AMS

diagnostic test for PE

spiral CT w/ contrast

reverses effects of heparin

protamine

coagulation parameter affected by warfarin

prothrombin time

virchow's triad of DVT/PE

stasis, hyper-coagulability, endothelial damage

most common cause of HTN in young women? men?

OCPs. excessive ETOH

figure 3 sign

aortic coarctation

water bottle shaped heart

pericardial effusion, look for pulsus paradoxus

differentiate stable angina vs unstable angina vs NSTEMI vs STEMI

1. stable angina = chest pain that resolves w/ rest 2. unstable angina = chest pain that is new, is worsening, is non-responsive to meds, or occurs at rest + no changes on EKG + no elevation of cardiac enzymes 3. NSTEMI = chest pain + no changes on EKG + elevation of cardiac enzymes 4. STEMI = chest pain + changes on EKG + elevation of cardiac enzymes

EKG changes in pericarditis

diffuse ST segment elevation and PR-segment depression

aortic aneurysm is associated w/ _________ vs aortic dissection is associated w/ __________

aortic aneurysm is associated w/ atherosclerosis vs aortic dissection is associated w/ hypertension

potentially reversible causes of PEA (5Hs and Ts)

hypovolemia, hypoxia, hydrogen ions (acidosis), hypo/hyperkalemia, hypothermia, tension pneumothorax, tamponade, toxins (narcs/bzd), thrombosis, and trauma

treat wolf-parkinson white with? avoid?

treat w/ cardioversion and anti-arrhythmics like procainamide. avoid AV nodal blockers such as BB, CCB, digoxin, or adenosine b/c they can cause increased conductance through the accessory pathway

chaga's dz is most common cause of myocarditis worldwide. other complications include?

megaesophagus and megacolon

4 drugs shown to improve mortality in CHF pts?

ACE-I/ARB, beta-blockers, and spironolactone

new onset heart failure in young pt? most common cause in US?

myocarditis. viral infection by coxsackie

inferior MI may lead to right sided heart failure. s/s of this? tx?

s/s include hypotension, JVD, and clear lung fields. since pts are preload dependent, tx w/ IV fluids and avoidance of preload reducing meds like nitrates and diuretics

DOC for dressler's syndrome? avoid?

NSAIDs are drug of choice. avoid anticoagulation to prevent development of a hemorrhagic pericardial effusion

first test in pts w/ high risk of DVT? in low risk of DVT?

high risk = USlow risk = d-dimer

ddx for peripheral edema

HF, renal dz, venous insufficiency, and dihydropyridine CCBs

how does nitro provide pain relief for angina?

by dilation of veins and decreased ventricular preload --> reduced wall stress and myocardial O2 demand

postural or orthostatic hypotension is a common cause of syncope due to...

impaired baroreceptor sensitivity (autonomic failure) or volume depletion

tx for cocaine-associated chest pain? avoid?

IV BZD, ASA, nitro, and CCBs. avoid beta-blockers b/c they can cause unopposed alpha adrenergic stimulation and worsen coronary vasoconstriction

diastolic, continuous, or loud systolic mumurs should be investigated by...

TTE

tx for hyperthyroidism-related tachysystoilc a. fib

beta-blocker

EKG findings for pericardial effusion

electrical alterans (varying amplitude of the QRS complexes) w/ sinus tach - due to the swinging motion of the heart in the pericardial cavity causing a beat-to-beat variation in QRS axis and amplitude

ASD is associated w/?

trisomy 21

MVP is associated w/?

connective tissue disorders such as marfans, ehlers-danlos, and osteogenesis imperfecta

PDA is associated w/?

congenital rubella syndrome and char syndrome

tetralogy of fallot is associated w/?

down syndrome and digeorge syndrome

VSD is associated w/?

aneuoploidy, including patau (13), edwards (18), and downs (21)

bicuspid aortic valve is associated w/?

turner syndrome

turner syndrome is associated w/ what cardiovascular abnormalities?

bicuspid aortic valve, coarctation of the aorta, and aortic root dilation

ASD is associated w/?

trisomy 21

MVP is associated w/?

connective tissue disorders such as marfans, ehlers-danlos, and osteogenesis imperfecta

PDA is associated w/?

congenital rubella syndrome and char syndrome

tetralogy of fallot is associated w/?

down syndrome and digeorge syndrome

VSD is associated w/?

aneuoploidy, including patau (13), edwards (18), and downs (21)

bicuspid aortic valve is associated w/?

turner syndrome

turner syndrome is associated w/ what cardiovascular abnormalities?

bicuspid aortic valve, coarctation of the aorta, and aortic root dilation