Cardiology Flashcards by kathryn thornton

Allantois –> Urachus becomes what adult structure?

Median Umbilical Ligament

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Ductus Arteriosus becomes what adult structure?

Ligamentum Arteriosum

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Ductus Venosus becomes what adult structure?

Ligamentum Venosum

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Foramen Ovale becomes what adult structure?

Fossa Ovalis

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Notochord becomes what adult structure?

Nucleus Pulposus

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Umbilical Arteries become what adult structure?

Medial umbilical Ligaments

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Umbilical Vein becomes what adult structure?

Ligamentum teres hepatis

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S3 Heart sound is associated with that?

Increased filling pressures:

Mitral Regurgitation

Dilated Ventricles

(can be normal in kids/young adults)

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S4 heart sound is associated with what?

Ventricular noncompliance

LV Hypertrophy

Always abnormal

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Inspiration has what effect on heart sounds?

(increased venous return to RA)

Increases intensity of right heart sounds

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Hand grip has what effect on heart sounds?

(increased afterload)

Increases intensity of MR, AR, VSD murmurs

Decreases hypertrophic cardiomyopathy murmurs

MVP: later onset of click/murmur

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Valsalva / Standing up has what effect on heart sounds?

(decreases preload)

Decreases intensity of most murmurs (including AS)

Increases intensity of hypertrophic cardiomyopathy murmur

MVP: earlier onset of click/murmur

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Rapid squatting has what effet on heart sounds?

(INC VR, INC Preload, INC Afterload)

Decreases intensity of hypertrophic cardiomyopathy murmur

Increases intensity of AS murmur

MVP: later onset of click/murmur

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Crescendo-decresendo systolic ejection murmur

Loudest at heart base

Radiates to carotids

Can have pulsus parvus et tardus (weak pulses)

Aortic Stenosis

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Holosystolic, high-pitched blowing murmur

Loudest at apex

Radiates to axilla

Mitral Regurgitation

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Holosystolic, high-pitched blowing murmur

Loudest near sternal border

Radiates to right sternal border

Tricuspid Regurgitation

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Late systolic crescendo murmur with midsystolic click

Best hear over apex

Loudest just before S2

Mitral Valve Prolapse

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Holosystolic, harsh-sounding murmur

Loudest at tricuspid area

Ventricular Septal Defect

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High-pitched blowing early diastolic decrescendo murmur

Hyperdynamic pulse

Wide pulse pressure

Aortic Regurgitation

(Head bobbing)

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Opening snap

Delayed rumbling late diastolic murmur

Mitral stenosis

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Continuous machine-like murmur

Loudest at S2

Left Infraclavicular area

Patent Ductus Arteriosus

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Inherited disorder of myocardial repolarization, typically due to ion channel defects

Congenital Long QT

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AD, pure cardiac phenotype congenital long QT syndrome

Romano-Ward Syndrome

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AR, congenital long QT + sensorineural deafness

Jervell and Lange-Nielsen Syndrome

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AD Asian Males ECG = pseudo RBBB and ST elevations in V1-V3

Brugada Syndrome

Most common ventricular pre-excitation syndrome Abnormally fast accessory conduction pathway from atria to ventricle (bundle of Kent) bypasses the rate-slowing AV node Delta wave + wide QRS + shortened PR

Wolff-Parkinson-White Syndrome

ECG = Chaotic and eratic baseline, no discrete P waves between irregularly spaced QRS complexes Irregularly irregular HR

Atrial Fibrillation

ECG = Rapid succession of identical, back-to-back atrial depolarization waves Sawtooth pattern

Atrial Flutter

ECG = competely erratic rhythym with no identifiable waves

Ventricular Fibrillation

ECG = PR interval is prolonged

1st Degree AV block

ECG = Progressive lengthening of PR interval until a beat is "dropped"

2nd Degree Mobitz Type 1 | (Wenckebach)

ECG = Dropped beats that are not proceeded by a change in the length of the PR interval

2nd degree AV block Mobitz Type 2

ECG = atria and ventricles beat independently of each other

3rd degree AV block (complete)

What are the 5 Right to Left Shunts?

Truncus Arteriosus (1 vessel) Transposition (2 switched vessels) Tricuspid Atresia (3 = Tri) Tetralogy of Fallot (4 = Tetra) TAPVR (5 letters)

What are the 4 issues in Tetralogy of Fallot?

PROV Pulmonary Infundibular Stenosis RV Hypertrophy Overriding Aorta VSD

What cardiac defect is associated with EtOH?

VSD, PDA, ASD, Tetralogy of Fallot

What cardiac defect is associated with Congenital Rubella?

PDA Pulmonary Artery Stenosis Septal Defects

What cardiac defect is associated with Down Syndrome?

AV Septal defect (endocardial cushion) VSD ASD

What cardiac defect is associated with a diabetic mother?

Transposition of the great vessels

What cardiac defect is associated with Marfan Syndrome?

MVP Thoracic Aortic Aneurysm/Dissection Aortic Regurgitation

What cardiac defect is associated with prenatal lithium?

Ebstein Anomaly

What cardiac defect is associated with Turner Syndrome?

Bicuspid Aortic Valve Coarctation of the Aorta

What cardiac defect is associated with Williams Syndrome?

Supravalvular Aortic Stenosis

What cardiac defect is associated with 22q11 syndromes?

Truncus Arteriosus Tetralogy of Fallot

What is the difference between hypertensive urgency and a hypertensive emergency?

Urgency = without acute end organ damage Emergency = evidence of acute end organ damage

Abdominal aortic aneurysm is associated with what pathogenesis?

Atherosclerosis

Thoracic aortic aneurysm is associated with what pathogenesis?

Cystic Medial Degeneration

ECG STEMI in leads V1-V2

Anteroseptal (LAD)

ECG STEMI in leads V3-V4

Anteroapical (distal LAD)

ECG STEMI in leads V5-V6

Anterolateral (LAD or LCX)

ECG STEMI in leads I, aVL

Lateral (LCX)

ECG STEMI in leads II, III, aVF

Inferior (RCA)

ECG STEMI in leads V7-V9 ST Depression in V1-V3 with tall R waves

Posterior (PDA)

Endomyocardial fibrosis with a prominent eosinophilic infiltrate

Loffler Syndrome

What drugs DECREASE MORTALITY in patients with HF?

ACEI/ARBs B-blockers Spironalactone

What is the difference between Acute and Subacute bacterial endocarditis?

Acute = large vegetations on previously normal valves, rapid onset; staph aureus Subacute = smaller vegetations of previously damaged valves, gradual onset; strep viridans

What type of endocarditis has vegetations on both sides of the valves? What is it associated with?

Libmann Sacks Endocarditis SLE

Rheumatic Fever is what type of hypersensitivity reaction?

Type 2

What is Beck's Triad for cardiac tamponade?

Hypotension Distended neck veins Distant heart sounds

Decrease in amplitude of systolic BP by \> 10 mmHg during inspiration

Pulsus Paradoxus

Tertiary syphilis disrupts what part of the aorta?

Vasa Vasorum of aorta --\> atrophy of vessel wall and dilatation of aorta and valve ring

INC in Jugular Venous Pressure on inspiration (normally it should drop)

Kussmaul Sign