Cardiology Flashcards
What is the clinical triad that you see that would make you suspect right ventricular infarct in an inferior MI patient?
- hypotension
- clear lung fields
- elevated JVP
What should you think about in this clinical scenario? A young man with intermittent claudication of the calf or foot arch with walking - not running.
popliteal artery entrapment
What is the clinical history of a patient with Buerger disease?
Thromboangiitis obliterans occurs in men
What should you suspect in a patient with unilateral headache associated with either TIAs or a dilated pupil?
spontaneous dissection of the internal carotid artery
What is the classic triad that the CXR shows in mitral stenosis?
- prominent pulmonary artery revascularization
- an enlarged left atrium
- normal sized LV
What kind of effect can carcinoid cause on the heart valves? If you see carcinoid affecting the valves what does this imply?
Can affect either right sided heart valve
It implies a hepatic tumor
If you have mitral regurgitation, is it better to repair or replace the valve?
repair
Valsalva ___ (increase/decrease) the murmur of aortic stenosis, ____ the murmur of hypertrophic cardiomyopathy, _____ the murmur of mitral valve prolapse
Decrease, increase, increase
In what scenarios do you not shock a patient with an abnormal tachycardia atrial rhythm?
digitalis intoxication and hypokalemia
which anti arrhythmic do I definitely not want to prescribe in CHF?
dronaderone
What meds do you never give to a WPW patient who also has a-fib?
digoxin, verapamil, beta blockers
Never use _______ with any wide complex tachycardia in the emergency setting.
Verapamil - 30% of the time the v tach will rapidly deteriorate
If a patient has pericarditis and it doesn’t go away after 2 weeks, what should you suspect?
TB
What do valsalva and sustained handgrip do to the murmur of HOCM?
Valsalva increases it; handgrip decreases it
What’s the difference in BNP levels between restrictive cardiomyopathy and constrictive pericarditis?
Restrictive - BNP is elevated
Constrictive - BNP is normal - no actual CHF
What does the cardiac cath show in both tamponade and constrictive pericarditis?
the same pressure during diastole in all 4 chambers
What congenital syndrome is associated with coarctation of the aorta and a bicuspid aortic valve?
Turner syndrome
What do you need to rule out in the pregnant patient presenting with new onset a-fib and pulmonary edema?
mitral stenosis and secundum ASD
How do you differentiate acute tamponade from constrictive pericarditis based off of the x and y descents?
tamponade - rapid x but normal y
constrictive pericarditis - rapid x and y descent
“Wide fixed split” is a buzzphrase for what cardiac defect?
ASD
When do you see canon A waves?
In cases of AV dissociation
Large JV pulsations are seen when?
- right heart failure
- Tricuspid valve dz
- pericardial compressive physiology
- SVC syndrome
What does accelerated junctional rhythm (>60) signify?
digitalis toxicity
What does the JVP pulse tracing show for constrictive pericarditis? What is the other hallmark of constrictive pericarditis?
Rapid x and y descent
Other hallmark: Kussmaul’s sign (paradoxical rise in jugular venous pressure (JVP) on inspiration)
What is Kussmaul’s sign?
paradoxical rise in jugular venous pressure (JVP) on inspiration
Pulsus bisferiens
aortic regurgitation or HCM
Pulsus alternans
severely depressed systolic function
