Cardiology Flashcards
most efficient extractor of oxygen from the blood
heart
Intracellular junctions responsible for the cardiac syncytium
Gap junctions
Substance that dilates upstream blood vessels
Endothelium derived relaxing factor aka Nitric Oxide (NO)
Most potent vasoconstrictor
ADH
An increase in venous return will increase the heart rate
Bainbridge reflex
an increase in venous return will increase the stroke volume, Basis: stretching of cardiac sarcomeres will increase contraction
Frank starling mechanism
Hypertension, irregular respiration and bradycardia due to activation of the CNS ischemic response and baroreceptor reflex in increased intracranial pressure
cushing reflex
Abdominojugular reflux
atleast 10 sec pressure over the upper abdomen (RUQ)
Positive response: sustained rise of >3cm in JVP for atleast 10-15 seconds after release of the hand
carvallo’s sign
pansystolic murmur of tricuspid regurgitation
louder during inspiration and diminishes during forced expiratoin
graham steel murmur
high pitched, diastolic decrescendo blowing murmur along the left sternal border due to dilation of the pulmonary valve ring; occurs in mitral valve disease and severe pulmonary hypertension
gallavardin effect
condition where the murmur of aortic stenosis may be transmitted downward and to the apex and may be confused with the systolic murmur of mitral regurgitation
broadbent’s sign
apical pulse is reduced and may retract in systole in constrictive pericarditis
corrigan’s pulse
a rapidly rising “water hammer” pulse that collapses suddenly as arterial pressure falls rapidly during late systole and diastole, seen in aortic regurgitation
traube’s sign
a booming pistol shot sound heard over the femoral arteries, seen in aortic regurgitation
duroziez sign
to and fro murmur audible if the femoral artery is lightly compressed with a stethoscope seen in aortic regurgitation
triad of ruptured aneurysm
left flank pain
hypotension
pulsatile mass
triad of wolff parkinson white ecg pattern
wide qrs
short pr interval
slurring of the initial part of the qrs complex
triad of chronic renal failure in ecg
peaked T waves (hyperkalemia)
long qt due to st segment lengthening (hypocalcemia)
LVH (systemic hypertension)
beck’s triad for cardiac tamponade
hypotension
muffled heart sounds
neck vein distention
plaques that have caused fatal thromboses tend to have
thin fibrous caps
large lipid cores
high content of macrophages
major determinants of myocardial oxygen demand
heart rate
myocardial contractility
myocardial wall tension
triad of buerger’s disease
claudication of the affected extremity
raynaud’s phenomenon
migratory superficial vein thrombophlebitis
virchow
stasis
hypercoagulability
vascular/endothelial damage
Dressler’s Triad (post MI pericarditis)
fever
pleuritic pain
pericardial effusion
drugs that increases contractility
digoxin
dobutamine
milrinone
drugs that reduces preload
diuretics
vasodilators (nitrates, hydralazine)
ace inhibitors
beta blockers
this drug causes Na excretion and reduction in blood volume
diuretics
CCB that exerts more effect in the vessels than the heart
Dihydropyridines (Nifedipine, Felodipine, Amlodipine)
CCB that exerts more effect on the heart than the vessels
Nondihydropyridines (verapamil, Diltiazem)
Decreases the work load of the heart
Beta blockers
Blocks the AT1 receptor of angiotensin II
ARBs
Notorious for drug induced cough by increasing bradykinin
ACE inhibitors
Blocks aldosterone action in the collecting tubules
spironolactone, eplerenone
drug for hypertension with benign prostatic hyperplasia
alpha 1 antagonist (prazosin)
maintenance medication for pre eclampsia
methyldopa
most common sustained arrhythmia
atrial fibrillation
Mobitz type 1
has a prolongation of PR interval before dropped qrs complex
Mobitz type 2
has no prolongation of PR interval before dropped QRS complex
duration that distinguishes sustained from nonsustained ventricular tachycardia
> 30 seconds
Most common arrhythmia post MI
PVC
most common lethal arrhythmia post MI
Ventricular Fibrillation
most common cause of systolic dysfunction that leads to L sided HF
Coronary Artery Disease
most common cause of diastolic dysfunction that leads to L sided HF
concentric LVH due to HPN
most common cause of R sided HF
L sided HF
earliest cardinal symptom of L sided HF
Dyspnea
earliest cardinal sign of L sided HF
L sided S3
