Cardiology Flashcards
beck’s triad of cardiac tamponade
hypotension, diminished heart sounds, and JVD
classic ECG findings of atrial flutter
sawtooth p waves
definition of unstable angina
angina that is new, is worsening, or occurs at rest
anti-HTN med for diabetic pt w/ proteinuria
ACE-I
drugs that slow the heart
beta-blockers, CCBs, digoxin, and amiodarone
hypercholesterolemia tx that leads to flushing and pruritis. pre-tx w/ this med to reduce?
niacin. ASA
murmur - HOCM
systolic ejection murmur heard along the lateral sternal border that increases w/ decreased preload (valsalva)
murmur - aortic insufficiency
austin flint murmur - diastolic, decrescendo, low-pitched, blowing murmur that is best heard sitting up; increases w/ increased afterload (handgrip)
murmur - aortic stenosis
systolic crescendo/decrescendo murmur that radiates to the neck; increases w/ increased preload (squatting)
murmur - mitral regurg
holosystolic murmur that radiates to the axilla; increases w/ increased afterload (handgrip)
murmur - mitral stenosis
diastolic, mid-to-late, low pitched murmur preceded by an opening snap
tx for atrial fibrillation and atrial flutter
if unstable, cardiovert. if stable or chronic, rate control w/ beta-blocker or CCBs
tx for ventricular fibrillation
immediate cardioversion
dressler’s syndrome
an autoimmune reaction w/ fever, pericarditis, and increased ESR occuring 2-4 wks post MI
pulsus paradoxus
a decrease in systolic BP of > 10 mm Hg w/ inspiration that is seen in cardiac tamponade
classic ECG findings in pericarditis
low voltage, diffuse ST-segment elevation
eval of pulsatile abdominal mass and bruit
abdominal US and CT
indications for surgical repair of AAA
> 5.5 cm, rapidly enlarging, symptomatic, or ruptured
tx for ACS
morphine, O2, nitro, ASA, heparin, clopidogrel, beta-blockers
characteristics of metabolic syndrome
abdominal obesity, high triglycerides, low HDL, HTN, insulin resistance, prothrombotic or proinflammatory states
target LDL in pt w/ DM
less than 70
signs of active ischemia during stress testing
angina, ST-segment changes on ECG, or decreased BP
ECG findings suggesting MI
ST-segment elevation (depression means ischemia), flattened T waves, and Q waves
young female pt w/ angina at rest (most commonly at night) w/ ST segment elevations and normal cardiac enzymes
prinzmetal’s angina
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
- stable angina = chest pain that resolves w/ rest
- 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
- NSTEMI = chest pain + no changes on EKG + elevation of cardiac enzymes
- 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
