Cardiology Flashcards
Treatments for unstable bradycardia
Atropine: decrease vagal tone, improve a/v conduction
Epinephrine or Dopamine infusion: Beta agonists
Transcutaneous Pacing
Treatment for tachycardia
Unstable?
Wide QRS?
Narrow complex QRS?
Unstable: synchronized cardioversion (Adenosine if narrow)
Wide: Amiodarone, Lidocaine/Procainamide
Narrow: Vagal maneuvers, Adenosine, BB/CCB
Artery that supplies inferior portion of heart
EKG leads?
Right coronary artery
II, III, avF
Dresslers Syndrome
Post-MI pericarditis, fever, pulmonary infiltrates
Treat with ASA, cholchicine
Systolic HF vs Diastolic HF
Systolic: LVEF decreased, s3 gallop, more common
Diastolic: Normal EF/ s4 gallop
Medications that decrease mortality in HF
ACEI/ARBs, BB’s, nitrates + hydralazine, spironolactone
Pericarditis signs and symptoms
persistent, pleuritic, postural pain and pericardial friction rub, +/- fever
EKG finding with Pericardial effusion
low voltage QRS comples or electrical alternans
Pericardial tamponade manifestations
Becks Triad: distant heart sounds, inc. JVP, hypotension
Pulsus paradoxus
Dyspnea, fatigue, edema
Dyspnea, right sided HF, JVD during inspiration (Kussmauls), pericardial knock
Constrictive pericarditis
Most common cause of pericarditis and myocarditis
Enteroviruses (coxsackie, echo)
Cardiomyopathy with systolic dysfunction
Dilated Cardiomyopathy
Most common cause of restrictive cardiomyopathy
Amyloidosis
Echocardiogram findings of Restrictive cardiomyopathy, hypertrophic cardiomyopathy
Restrictive: Ventricles nondilated, normal wall thickness, dilation of both atria
Hypertrophic: Asymmetric wall thickness (septal)
Most common complication of Rheumatic fever
Mitral valve disease (Mitral Stenosis)
Jones Criteria
Rheumatic fever diagnosis
2 major or 1 major + 2 minor criteria
Major: Polyarthritis, carditis, sydenhams chorea, erythema marginatum, subQ nodules
Minor: fever, arthralgias, elevated ESR/CRP, prolong PR interval
Ejection click
Mitral valve prolapse
Opening snap
Mitral Stenosis
Tetralogy of Fallot
- RV outflow obstruction
- RV hypertrophy
- VSD
- Overriding Aorta
Right to left shunt (cyanosis)
Bootshaped heart on CXR
“egg on a string” CXR finding
Transposition of Great Vessels
1st line treatment HTN in african americans
Diuretics or CCB
Dihydrpyridines
amlodopine, nifedipine: vasodilators with no effect on contractility or conduction
Hypertensive Emergency and management
> 220/120 + target organ damage
Decrease BP by 10% first hour, 15% next 2-3 hours (IV meds!)
Hypertensive Urgency and management
Elevated BP, no target organ damage
Decrease BP by 25% in 1-2 days (PO meds!)
Most effective agent for increasing HDL
Niacin
Endocarditis: Most common valve involved in IVDA
Tricuspid valve (Mitral valve in other types)
Most common cause of acute bacterial endocarditis?
Subacute? Treatment?
Acute: S. Aureus, Nafcillin + Gentamicin 4-6 weeks
Subacute: S. Viridians, PCN/Amp + Gentamicin
Painless erythemateous macules on palms/soles
Janeway lesions
Tender nodules on pads of digits
Oslers Nodes
Diagnosis for Endocarditis
Modified Duke Criteria:
2 major or 1 major + 3 minor
Major: 2 + cultures with common organism, + echocardiogram or new AR, MR
Minor: Predisposing condition, fever, vascular phenomena, immunologic phenomena, + culture with uncommon organsim, + echocardiogram not meeting criteria
Endocarditis prosthetic valve: organism and treatment
S. epidermis
Vanco + Gentamicin + Rifamipin
Most common vessel involed in peripheral arterial disease
Femoral and popliteal (80-90%)
Which vessel is involved if patient has buttock/thigh pain, impotence and decreased femoral pulses
Aortic bifurcation/common iliac
Ankle brachial index score with PAD
<0.9
Most common area for aortic dissection
Asecending (highest mortality)
Anterior chest pain, new onset AR
Which disease is present in 50% of Giant cell arteritis cases
Polymyalgia rheumatica
20-45 y/o male smoker with tender nodules along venous distruction, digit/toe ischemia, raynauds
Thromboangiitis obliterans (buerger disease)
Most common location for VENOUS ulcers
Medial malleolus
Widely split fixed splitting s2
ASD
Causes of Obstructive shock
PE, pericardial tamponade, tension PTX, aortic dissection (proximal)
Septic Shock definition
Sepsis (SIRS + infection focus) + refractory hypotension
SIRS= Elevated Temp, pulse, RR, WBC (2 of 4)
Hallmark of Distributive Shock
Decrease CO, SVR, PCWP (early septic shock is elevated CO)
Kussmauls sign
Increase in JVP with inspiration. Seen in Cardiac tamponade
Greater/less saphenous vein is apart of which venous system
Superficial
