Cardiology Flashcards
Diastolic HF characteristics and treatment
LV stiffness, increased afterload, LVH
Due to systemic hypertension or Ao stenosis
Assoc with dyspnea
S4 gallop
Tx: diuretics, beta blockers, nondihydropyridine CCB (verapamil and diltiazem)
Prinzmetal’s angina presentation and treatment
variant angina, common in women, worse in AM
Tx: CCB and nitrates
EKG of variant angina vs ischemia
variant angina: ST elevation
ischemia: ST depression
Treatment of MI due to cocaine/ephedrine containing substances
***NO Beta blockers*** benzos asa nitrates CCB alpha blocker
AFib meds
Digoxin (#1 if hypotensive or have systolic HF)
beta blocker
Nondihydropyridine CCB (#1 if COPD or PAD bc BB can make worse)
Systolic HF treated with
beta blocker
loop diuretic
ACEI
Superior vena cava syndrome presentation and causes
-facial and upper arm swelling (never in lower ext), cyanosis
-obstruction in SVC flow into right atrium:
small cell ca of the lung
NON hodgkin lymphoma
indwelling catheter thrombosis
Causes of right HF
1 chronic left HF
pulm HTN
PE
pulm parenchymal dz (fibrosis or chronic bronchitis)
Causes of constrictive pericarditis
1 prior chest radiation
cardiac sx
connective tissue dz
bacterial (tb)
Preferred initial test for acute aortic dissection
*TEE
MRI
CT
Risk factors for acute aortic dissection
collagen dz (marfan or ehlors-danlos) chronic systemic HTN vasculitis (giant cell arteritis and Takayasu) cocaine bicuspid Ao valve
Acute pericarditis in any age female must consider
SLE
Pericardial tamponade characteristics and treatment
- hypotension, tachycardia, elevated JVP, paradoxical pulse
- emergent pericardiocentesis followed by pericardiectomy
Coarctation of aorta presentation
equal and bilateral upper ext HTN
low BP in legs
radial-femoral pulse lag
bicuspid Ao valve in 70%
Aortic dissection treatment
- IV vasodilator AND Beta blocker (vasodilator alone can make worse)
- emergent surgical intervention
Systolic HF presentation and manifestations
- fatigue, weakness, mental obtundation
- LV dilation, increased preload, reduced contraction, reduced EF, decreased CO
Electrolytes associated with Digoxin toxicity
hypokalemia
hypomagnesemia
Prolonged QT interval causes and manifestation
-hypomagnesemia
hypocalcemia induced meds (phenothiazines, haldol, risperidone, TCAs, terfenadine, astemizole
congenital
-Can lead to torsades de pointes
Orthostatic hypotension findings
20-mm Hg systolic and 10-mm Hg diastolic drop with standing
**increased HR indicated hypovolemia whereas no compensatory increase in HR indicates autonomic insufficiency
acute vs subacute endocarditis
acute: indwelling cath infection or IV drug user, staph aureus, tricuspid valve, acutely ill
subacute: strep viridans, more indolent
endocarditis preferred testing
cultures, ECHO, TEE
Coarctation of the aorta
40% w/biscupid valve
apical ejection click
risk of cerebral aneurysm
Chronic HTN with orthostatic HYPOtension
pheochromocytoma
Treatment of isolated systolic hypertension
long acting thiazide diuretic
long acting dihydropyridine CCB
Afib in any patient but especially over 60
rule out hyperthyroidism
Congenital long QT syndrome exam and complicatons
Exam WNL when asymptomatic
Can get torsades de pointes during sympathetic nervous system activation (exercise or emotional)
Increased risk of syncope and sudden cardiac death
HOCM exam findings
apical lift due to LVH
systolic ejection murmur near apex
*bisferiens carotid pulse
Initial monotherapy in healthy person with essential HT
Thiazide
CCB
ACEI
ARB
Cor Pulmonale cause and presentation
Secondary to lung disease/pulmonary hypertension causing right vent HF
-signs: left parasternal lift, elevated JVP, congestive hepatomegaly, ascites, peripheral edema
