Cardiology Flashcards
***HIGH OUTPUT CHF is due to
Thyrotoxicosis
Anemia
Berri Berri
Pagets disease
Peaked T waves on EKG
Hyperkalemia (like eiffel tower)
Pericarditis presentation
pain relieved by sitting leaning forward, worse when supine
PND
Idiopathic but can be post viral
Cardinal symptoms of aortic stenosis
dyspnea, angina, exertional syncope
Treatment for sinus bradycardia
Atropine 1 mg
Treatment of PSVT
Vagal maneuver
Adenosine 6 mg
If unsuccessful with Adenosine, cardiovert
Wandering atrial pacemaker/ Multifocal Atrial Tachycardia EKG
3 distinct P wave morphology, common in patients with COPD
CHADS 2 in Afib (most common arrhythmia)
CHF HTN Age >75 DM Stroke/TIA (2 points) if two or more put on Warfarin INR 2-3
*** Only way to reverse a dilated cardiomyopathy
Stop alcohol consumption
Acyanotic congenital heart disease
Left to right shunt
ASD
VSD
PDA
Cyanotic Congential heart disease
Right to left shunt
Tetrology of Fallot
Transposition of great arteries
Most common congenital heart malformation
VSD
presents with holosystolic murmur
PDA presentation and treatment
PDA connects aorta and pulmonary artery
WASHING MACHINE murmur
treat with Indomethacin (prostaglandin inhibitor) to close shunt
Tetrology of Fallot
Pulmonary Stenosis
RVH
Overriding aorta
VSD
Presents with Tet spells and systolic ejection murmur
CXR with boot shaped heart
Treat with prostagladins to keep ductus open
Transposition of great arteries CXR
Egg on a String
*** Modified Jones criteria for diagnosis of Rheumatic Fever
Need 2 major OR 2 minor + 1 major
Major: arthritis, carditis/valvulitis, CNS involvement, Erythema MArginatum, Sydenham’s chorea
Minor: Fever, Arthralgia, Elevated ESR, Leukocytosis, PR elongation, previous rheumatic fever
Screening for AAA
US for all men above age 65 who have smoked or have a relative with AAA repair
surgically repair if >5 cm
6 P’s of limb ischemia
Pain Pallor Pulselessness Paresthesia Paralysis Poikilothermia
*** Virchow’s Triad
Venous statsis, injury to vessel wall, hypercoagulable state
Thromboangiitis Obliterans (Buerger’s disease) presentation
vasculitis of hands and feet with ischemia
STRONG association with smoking
men 30’s-40’s
Dressler syndrome
After MI get pericarditis 2-5 days post
Presents with pericardial friction rub, chest pain relieved by sitting slumped forward
Beck’s Triad
Cardiac Tampanode:
Hypotension
JVD
Muffled heart sounds
Infective Endocarditis in IVDU (valve and microbe)
tricuspid and staph
signs and sx of infective endocarditis
Heart murmur, fever, hematuria, splenomegaly
JANEWAY lesions: palms and soles, non painful
OSLER nodes: on fingers tips, painful
roth spots on eyes
Neural control on heart rate
SNS increases heart rate and force of contraction
PNS via VAGUS nerve decreases heart rate, inhibits SA node
Contraindications to tPA or other thrombolytics
previous intracranial bleed, CVA in last 3 months, aortic dissection, uncontrolled HTN >180/100, surgical procedure 2 weeks prior, bleeding diathesis, pregnancy
*** the only modifiable risk factor in cardiovascular disease
smoking
Printzmetal’s angina
from coronary vasospasm
presents with angina at rest that comes in cycles
Treat with CCBs!
Treatment of coronary vasospasm
Calcium channel blockers
avoid beta blockers as they leave alpha 1 receptors unopposed which lead to vasoconstriction (don’t use beta blockers in cocaine associated MI either)
