Cardiology Flashcards
unilateral headache and/or neck pain along wit hipsilateral Horner’s signs
Carotid artery dissection
diagnosis is made with an MRI of hte head and neck
Hypotension, tachycardia, and a new-onset holosystolic murmur after an MI
Ventricular septal rupture is a complication of myocardial infarction that commonly presents with hypotension, tachycardia, and a new-onset holosystolic murmur.
Symptoms usually begin 3-5 days after the MI
A complication of myocardial infarction that most commonly develops 2-7 days post MI.
Presents with chest pain, hypotension, and loss of pulse.
Free wall rupture.
What is the initial step in managing an unstable patient with a paroxysmal supraventricular tachyarrhythmia?
Synchronized cardioversion
in stable patients you can use adenosine.
PSVT commonly presents with palpitations, dizziness, dyspnea, and chest pain
ECG findings include regular tachycardia, narrow QRS complex, and absent P waves
What is the next best step in a hemodynamically stable patient with a widened mediastinum on X-ray
In the hemodynamically stable patient, a spiral CT is the next best step in management. The spiral CT will give you the extend of the aortic injury.
JVD, hypotension, decreased breath sounds on one side.
Tracheal deviation to the contralateral side, hyperlucency of the ipsilateral lung field, and depressed hemidiaphragm on the ipsilateral side
Tension pneumothorax
What is the medical treatment for an aortic dissection?
therapy should begin wiht intravenous beta-blockers (labetalol, esmolol) and opioids
What are the indications for a coronary artery bypass graft?
coronary artery bypass graft surgery is the recommended means of revascularization in patients with at least three- vessel coronary artery disease (or two vessel disease + proximal LAD stenosis) and impaired left ventricular function (EF <50%) or in those with diabetes who have left main coronary artery disease or multi-vessel disease
What are the indications for percutaneous coronary arter intervention with tent placement?
Percutaneous coronary artery intervention with stent placement is indicated if the patient has disease of one or two vessels.
What are the indication for aortic valve replacement?
Aortic valve replacement is indicated in symptomatic aortic stenosis in patients with an ejection fraction of <50%
Young woman with hypertension and an abdominal bruit
most likely diagnosis?
the most likely diagnosis in a young woman with hypertension and an abdominal bruit is renal artery stenosis due to fibromuscular dysplasia
Patient may also present with headaches, and pulsatile tinnitus.
diagnosis is confirmed with imaging (CT angiography, MR aniography, or duplex US)
what is the first step in working up a patient with suspected bacterial endocarditis?
the first step in working up a patient with suspected bacterial endocarditis is to draw blood and establish bacteremia with the offending pathogen.
look for a pt with a history of IV drug use with fever, malaise, and a new-onset heart murmur
What are the contraindications to anticoagulant therapy?
intracranial bleeding
stroke or a neurologic procedure w/in 2 months
recent surgery or major trauma w/in 2 weeks
active internal bleeding
intracranial mass lesion
recent eye surgery
malignant hypertension
history of heparin-induced thrombocytopenia
What is the appropriate follow-up regimine for an AAA that is asymptomatic and <3.9 cm?
repeat US every 2-3 years.
surgical intervention is only needed once it reaches 5.5 cm.
calcified lesion in the LUQ
splenic artery aneurysm
SAA are a result of fibromuscular dysplasia (younger patients) or portal hypertention (elderly females). If the anyurism is chronic, concentric calcification may occur.
Treatment includes endovascular stent repair, laprascopic ligation, or open surgical bypass and ligation
