Cardiology Flashcards
MC type of ASD
Ostium secundum
Ostium secundum defect plus defect in gene TBX5
Holt Oram Syndrome
Most common congenital heart disease in ADULTS
ASD
Snowman sign on xray
TAPVR
AKA: cardiac-limb syndrome/ ventriculo radial syndrome
Holt oram syndrome
Four pulmonary veins drain to RA instead of LA
TAPVR
MC ASD associated with Down Syndrome
Ostium primum
Anomalous vein draining to IVC, seen as crescentic shadow on the R border of cardiac silhouette
Scimitar syndrome
MC congenital heart disease in children
VSD
CHD associated with maternal rubella infection
PDA
Large communication between 2 circulations with result in reversal of left to right shunt into a right to left shunt
Eisenmenger syndrome
Functioning connection between pulmonary artery and descending aorta
PDA
Tx for closure of PDA
Indomethacin
MC cyanotic congenital HD
TOF
Machinery like murmur
PDA
Components of TOF
Pulmonary infundibular stenosis
RVH
Overriding of aorta
VSD
Trilogy of fallot
Pulmonary stenosis
RVH
VSD
In what condition do you see tet spells
TOF
Pentalogy of fallot
Pulmonary stenosis RVH Overriding of aorta VSD ASD
Boot shaped heart
TOF
Aortic narrowing at the area of ductus venosus(ligamentum arteriosum)
Coarctation of aorta
Surgical tx for TOF
Blalock Taussig Shunt
BP higher in upper ext than in lower ext
Coarctation of aorta
Coarctation of aorta w/c is proximal to a PDA
Infantile
Most common site of aortic dissection
Ascending aorta,w/in 10cm from aortic valve
Rib notching
Coarctation of aorta
Coarcation of aorta located distal of aortic arch
Adult
Tricuspid valve is displaced,atrialized RV, ASD
Ebstein anomaly
Inversion of aorta and pulmonary artery with respect to ventricles (ventriculo-arterial discordance)
TGA
Box shaped heart
Ebstein anomaly
Egg on its side
TGA
Aka systolic click murmur syndrome
MVP
Symptoms of aortic stenosis
Syncope
Angina
Dyspnea
Floppy valve syndrome
MVP
2 disorders associated with MVP
Marfan syndrome
Ehler Danlos syndrome
Ballooning of Mitral valve
MVP
MC benign cardiac tumor in adults
Myxoma
Myxomatous degeneration of the valve
MVP
MC location of myxoma
Left atrium
MC cardiac tumor in children
Rhabdomyoma
Midsystolic click murmur
MVP
MC location of cardiac rhabdomyoma
Ventricles
Morphologic feature of rhabdomyoma
Spider cells
MC type of cardiomyopathy
Dilated CM
Cardiac rhabdomyoma is associated with what condition
Tuberous sclerosis
Cardiac enlargement with dilation all 4 chambers
Dilated CM
MCC of dilated cardiomyopathy
Idiopathic
Progressive cardiac dilation with systolic dysfunction
Dilated CM
Second MCC of dilated CM
Alcohol
Chemo drug associated with dilated CM
Doxurubicin
Aka idiopathic hypertrophic subaortic stenosis
Hypertrophic CM
New onset atrial fibrillation,w/o a structural abnormality, after a binge drinking spree
Holiday heart syndrome
Aka congestive cardiomyopathy
Dilated CM
Aka asymmetric septal hypertrophy
Hypertrophic CM
Most common rhythm associated with holiday heart syndrome
Atrial fibrillation
Hallmark of restrictive CM
Abnormal diastolic function
Ventricular walls are rigid often secondary to myocardial fibrosis
Restrictive CM
Associated with sudden cardiac death in young athlete
Hypertrophic CM
Broken heart syndrome
Takotsubo stress CM
MCC of restrictive CM
Amyloidosis
Normal amount of pericardial fluid
30-50 ml
MC type of pericardial effusion
Serous type
Pericardial friction rub
Pericarditis
MC type of pericarditis
Fibrinous/serofibrinous
Post MI pericarditis
Dressler syndrome
MCC of pericarditis
Viral
Most important lesion if infective endocarditis
Vegetations
Non bacterial endocarditis associated with small cell/oat cell lung cancer
Marantic endocarditis
“Malinis”
“Maliit”
“Malignancy”
Prototype lesion in IE
Vegetation
Most consistent sign of IE
Fever
Lesions at palm of hands seen in IE
Janeway lesion
“Hold jane at her palms to show her the way”
Retinal hemorrhage seen in IE
Roth spots
Lesions at pulp of fingers seen in IE
Osler nodes
Causative agent of IE in IV drug users
S.aureus
Causative agent in subacute bacterial endocarditis
S.viridans
Causative agent in prosthetic valve endocarditis
S.epidermidis
Cardiac arrhythmia associated with sudden cardiac death
V. Fibrillation
MC aquired heart disease in children
Rheumatic fever
Pathognomonic of Rheumatic fever
Aschoff bodies
Large histiocytes with central oval nuclei in w/c chromatin has condensed toward the center to form an irregular linear shape
Anitschkow cells
Fish mouth orifice/button hole deformity of MV
Mitral stenosis
Most common cause of mitral stenosis
RHD
Tachycardia out of proportion to the fever and persists during sleep
Myocarditis
MC symptoms in RF
Fever and polyarthritis
Opening snap and diastolic rumble
Mitral stenosis
DOC for RF
Penicillin
Hallmark of RF
MV damage
MCC of death in RHD
CHF
Mutation in SCN5 gene encoding for sodium channel
Brugada syndrome
Auscultation site for mitral valve
Left 5th ICS MCL
MCC of natural death in men <50yo
Brugada syndrome
Fastest rate of automaticity of the heart
SA node
Sawtooth on ECG
Atrial flutter
MC ECG finding associated with graves disease/hyperthyroidism
Atrial fibrillation
DOC for SVT
Adenosine
Single most common cause of heart failure
CAD
MCC for pump failure
Myocardial hypertrophy secondary to hypertension
MCC of right sided HF
Left sided HF
Right sided heart failure caused by pulmonary hypertension from an intrinsic lung disease
Cor pulmonale
Hepatomegaly with centrilobular congestion and atrophy of central hepatocytes (chronic passive congestion of liver)
Nutmeg liver
Tx for stable angina
BANSA +lifestyle
Tx for UA/NSTEMI
BANSA +heparin
+/- PCI or CABG
Lifestyle
Tx for STEMI
BANSA + PCI/CABG
Heparin
Lifestyle
Indications for CABG
left main coronary artery occlusion + DM
Contraindication for morphine in AMI
Posteroinferior MI
Initial ecg changes in stemi
ST elevation
Tachycardia and hypertension in MI stimulated by sympathetic reflex
James reflex
Killips class with cardiogenic shock
Killips class 4
Bradycardia and hypotension seen in posterior / inferior wall MI
Bezold Jarisch reflex
Killips class with rales and s3 gallop
Killips class 3
Microscopic change in MI at 4-24 hrs
Coagulative necrosis
Killips class with pulmonary edema
Class 3
Microscopic change in MI at 1-4 days
Neutrophilic infiltrates
Cardiac biomarker which is elevated by 3-6 hrs and return to normal at 7-10 days
Troponin I
Gross changes in MI at 1-7 days
Yellow pallor
Microscopic change in MI at 4-7 days
Macrophages
Cardiac biomarker which is elevated by 4-8 hrs and returns to normal at 2-3 days
CK-MB
Gross changes in MI at 0-18 hrs
No gross change
Location of SA node
In the wall of Right atrium lateral to sinus venarum where SVC enters the RA
Cardiac muscle fiber RMP
-90 mV
Closure of AV valves
1st heart sound
Closure of semilunar valves (aortic and pulmonic valves)
2nd heart sound
Permanently wide split s2 is seen in
RBBB
Capacitance is greatest in:
Veins
Site of highest resistance
Arterioles
Largest cross sectional and surface area
Capillaries
Reservoir of blood
Veins
Most important determinant of pulse pressure
Stroke volume
Conditions with different bp in the extremities
Coarctation of aorta
Thoracic aortic dissection
Neurodegenerative disease that presents with parkinsonism and autonomic dysfunction and loss of balance
Multiple systems atrophy
Previously known as Shy dragger syndrome
Normal effect of respiration on BP
Systolic bp decreases on inspiration
Exaggerated fall of 10mmhg or more in SBP during normal inspiration
Pulsus paradoxus
Fixed splitting of heart sound is seen in
ASD
2 conditions presenting with pulsus paradoxus
Cardiac tamponade
Status asthmaticus
Corrigan pulse
Aortic regurgitation
Co-RA
Pulsus parvus et tardus
Aortic stenosis
PPTas
Bisferiens pulse (twice beating pulse)
HCOM
AR
“BIHORA”
WPW triad
Short P-R interval
Prolonged QRS
Delta wave
DOC for prizmetal angina
CCB
Causative agent of an indolent culture negative afebrile endocarditis
Tropheryma whipplei
Diagnostic method of choice in visualization of vegetation
TEE
Most common peripheral manifestion in IE
Petechiae
Most common lab finding in IE
Anemia
Jones major criteria for RF
Joints- polyarthritis Oh my heart-carditis Nodules-sq nodules Erythema marginatum Sydenham chorea
Tx for doxurubicin induced cardiomyopathy
Dexazoxane (iron chelator)
Most common brand/trade name of doxurubicin
Adriamycin
