CARDIOLOGY Flashcards
description of HOCM murmur
how do you Decrease this murmur?- 2
Harsh mid systolic crescendo-descrescendo murmur
(…Hulk HOCM, but HOCM put them down making Squats a Trend!)
- Squatting
- Trendelenburg
description of HOCM murmur
how do you increase this murmur?- 2
Harsh mid systolic crescendo-descrescendo murmur
(Val Stood up to Hulk HOCM)
- Valsalva
- Standing Up
how long can Troponin be detected after acute MI?
LOE 7 days
what are the contraindications to using Nitrates in acute HF? - 4
- Aortic Stenosis
- R Vt Infarction (tx = FLUIDS)
- HOCM
- Volume Down/depletion
In these states, the pt’s heart DEPENDS on the preload from capacitance vessels
tx for Dressler’s Syndrome- 3
- Colchicine
- Steroids
- NSAIDs if necessary
Which coronary arteries correlate to the Lateral heart?- 2
- L circumflex
- LAD Diagonal aspect
Which EKG leads correlate to the Lateral heart?- 4
I, avL, V5, V6
in STEMI mgmt, PCI > [tPA Thrombolytics]
but what is the criteria for PCI?- 3
which drug beneficially adjuncts in pts undergoing PCI?
- in PCI center: has to be LOE 90 mins from contact to device
- in NON-PCI: has to be LOE 120 mins from contact to device
- in NON-PCI: if greater than 120 min from contact to device –> MUST USE [tPA THROMBOLYTICS]
If giving PCI, also give Glycoprotein 2b/3a inhibitors
whats the difference between Restrictive cardiomyopathy and Constrictive cardiomyopathy
Restrictive = Rigid and stiff myocardium from fibrosis –> Restricted Vt filling = Diastolic HF
Constrictive= Collagen-like elasticity of periCardial sac decreases from sCarring
causes of Restrictive cardiomyopathy- 5
- amyloidosis
- sarcoidosis
- Hemochromatosis
- Tropical endomyocardial fibrosis (most cmmn worldwide)
- idiopathic
EKG findings for Posterior MI- 4
- ST Depression V1-3 thats horizontal
- Tall R V1-3
- Upright T V1-3
- STEMI V7-9
(doesn’t have to be all V1 thru 3)
what r the high risk sx that likely indicate Cardiac as the cause of chest pain?- 6
- RADIATION TO (ESPECIALLY R) ARM/SHOULDER <–BIGGEST PREDICTOR
- “Pressure” characterization
- Diaphoresis
- Vomiting
- pain similar to previous cardiac pain
- worst w exertion
most common cause of acute MI
dysrhythmia
what’s the strongest indicator that HF is a dx for a pt?
S3
ABSOLUTE contraindications to [tPA thrombolytic]- 7
- ANY HEAD HEMORRHAGE OR HEMORRHAGE SURPLUS (Intracranially, Active, bleeding disorder hx)
- Malformation in head hx
- Neoplasm in head hx
- Aortic dissection suspected
- LOE 6 MO= Head truma, Brain surgery
- LOE 6 wks= internal bleeding, gen trauma, gen surgery
- LOE 3 wks= traumatic CPR hx
EKG signs of R Vt Infarction- 3
- Inferior MI with a V1 STEMMI
- Early TWI avL
- V4R STEMMI
Aortic Regurgitation characteristics- 4
- Diastolic blowing murmur @ 2/3 LICS
- [de-Musset’s Head bobbing w systole]
- [Quincke’s nail pulsations]
- [Duroziez’s femoral artery thrill/murmur]
HOCM is also at the 2/3 LICS
pt comes in w seizure v syncope
describe how you decide if they’re concerning enough for admit?
Use the SAN FRANCISCO Syncope rule!
Aortic Valve Stenosis sx- 3
that AS is SAD
- Syncope
- Angina
- DyspneaOnExertion
usally caused by age-calcification or early calcification in bicuspid
most common complication of Mitral Valve stenosis
aFib
Diastolic opening snap followed by Diastolic low pitched rumbling apical murmur
DUKE’S CRITERIA IS FOR ______ and requires __ MAJOR, Mix consistenting of ____ or ___ minor for the dx
what are the MAJOR criteria- 3
- 2 separate positive bcx with “Infective Endocarditis” organisms
- Positive echo (vegetations, prosthetic dehiscence)
- REGURGITANT murmur THATS NEW
DUKE’S CRITERIA IS FOR ______ and requires __ MAJOR, Mix consistenting of ____ or ___ minor for the dx
what are the minor criteria- 5
- fever
- Immunologic ROJ sx (fROm Jane)
- Vascular sx (from jane)
- only 1 positive bcx with infective endocarditis organisms
- predisposiing risk factor (IVDU, heart condition)
3 major differences between Biologic and Mechanical heart valves
EKG manifestation for Acute Fibrinous Pericarditis-2
DIFFUSE ST elevations + sometimes PR depressions
Pericarditis gave HIM A UTI
