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Clinical Medicine III > Cardiology Diseases > Flashcards

Cardiology Diseases Flashcards

1
Q
  • retrosternal pressure, burning, heaviness, squeezing, indigestion that may radiate
  • precipitated by exercise, cold, stress and relieved by rest or nitro
  • <2-10 min
A

angina

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2
Q
  • retrosternal pressure, burning, heaviness, squeezing, indigestion that may radiate
  • precipitated by exercise, cold, stress and relieved by rest or nitro
  • usually <20 min
A

unstable angina

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3
Q
  • substernal heaviness, burning, pressure, constriction
  • unrelieved by rest or nitro
  • > 30 min
A

MI

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4
Q
  • sharp, stabbing, knifelike pain over sternum and may radiate
  • aggravated by deep breathing, supine position
  • relieved by sitting up and leaning forward
  • lasts hours to days w/ waxing and waning
  • pericardial friction rub heard
A

Pericarditis

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5
Q
  • sudden, unrelenting, excruciating, tearing, , knifelike pain in anterior chest and may radiate to back
  • murmur or aortic insufficiency, pulse or BP asymmetry, neurologic deficit
A

Aortic Dissection

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6
Q
  • sudden or within 1 hr onset of substernal or chest pleuritic pain
  • may be aggravated by breathing
  • dyspnea, tachypnia, tachycardia, hypotension, rales, friction rub, hemoptysis
A

Pulmonary Embolism

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7
Q

drugs for pharmacologic stress test

A
  • adenosine
  • persantine (dipyridamole)
  • tetrofosmin
  • dobutamine (commonly used w/ echo)
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8
Q

indications for TEE

A
  • endocarditis
  • aortic dissection
  • evaluation for surgical intervention
  • evaluation of A-fib
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9
Q

test for detection of left-to-right shunts

A

contrast echocardiography (bubble study)

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10
Q

test for cardiomyopathy, CHF, coarctation of aorta

A

CXR

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11
Q

GOLD standard for Dx of coronary artery Dz (and EF measurement)

A

coronary angiography aka cardiac catheterization (w/ ventriculography)

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12
Q

contraindications for cardiac cath

A
  • severe uncontrolled HTN
  • ventricular arrhythmia
  • recent acute stroke
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13
Q

test to Dx pulmonary arterial HTN

A

right side heart cath

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14
Q

test for burden of atherosclerotic plaque

A

cardiac CT/calcium score

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15
Q

test for analyze arrhythmias and evaluate therapy

A

electrophysiologic study (EPS) w/ catheter ablation

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16
Q

test for causes of syncope, orthostatic hypotension

A

tilt table test

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17
Q

qualifications for ICD

A
  • non-ischemic cardiomyopathy w/ EF <35
  • Class II or III heart failure
  • CAD w/ EF <35
  • VT
  • MI w/ EF <30
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18
Q

GOLD standard for Dx of peripheral artery Dz

A

angiogram

19
Q

device to monitor heart at home for 24h

A

Holter monitor

20
Q

device to monitor heart at home 1-2 weeks (not for syncope)

A

event recorder

21
Q

device to monitor heart at home 2w-1m

A

external loop recorder

22
Q

device to monitor heart at home up to 3y

A

implantable loop recorder

23
Q
  • transsternal or retrosternal pressure or a choking sensation or pain that may radiate to the left arm, jaw, neck, or back that is brought on in a predictable manner by exertion or by emotional upset and alleviated by sublingual nitroglycerin or cessation of exertion
  • peaks in a period of just a few minutes
A

chronic stable angina

24
Q

resting EKG findings in stable angina/stable CAD

A

ST segment depression or T wave inversion

25
Q

Tx of stable angina

A
  • nitrates (for relief)
  • Beta-blockers to lower HR (“-lols”) 1st choice if MI
  • non-dihydropyridine CCBs for vasodilation, vasospasm (Verapamil, Diltiazem) if B-blockers not tolerated
  • dihydropyridine CCBs (Amlodipine) have greater effect on vascular smooth muscle
  • Ranolazine (Ranexa) reduces O2 demand
26
Q

Other stable angina meds

A
  • statins for hyperlipidemia
  • ACEI’s reduce CV events (“-prils”)
  • aspirin or Clopidogrel (Plavix) if ASA not tolerated
27
Q

Big 4 that damage blood vessels

A
  • cholesterol
  • glucose
  • HTN
  • tobacco
28
Q

secondary causes of HTN

A
  • hyperaldosterone (high K+)
  • hyperparathyroid (high Ca+)
  • kidney disease (high creatinine)
  • estrogen
29
Q

criteria for HTN tx after lifestyle failure

A

Defined: daytime OOO > 130/80

  • OOO daytime BP > 135/85
  • OOO mean BP > 130/80
  • office BP > 140/90
  • office BP > 130/80 + comorbidity
30
Q

HTN med classes

A
  • thiazide-type diuretics (Bendroflumethiazide, Chlorthalidone, Hydrochlorothiazide, Indapamide)
  • long-acting CCBs (Amlodipine, Diltiazem, Nitrendipine)
  • ACE inhibitors (“-prils”)
  • ARBs (“-sartans”)
    ACE/ARBs: check K+, Cr, not in pregnancy
31
Q

Best HTN meds on whites vs. blacks

A

W: Clonidine, Atenolol
B: Diltaizem, HCTZ

32
Q

Best HTN combination therapies

A
  • ACE + long-acting dihydropyridine CCB
  • ACE + diuretic
  • ARB + long-acting dihydropyridine CCB
  • ARB + diuretic
33
Q

BP targets

A
  • daytime OOO average < 130/80

- office < 135/85

34
Q
  • xanthalasmas
  • xanthomas (tendinous, tuberoeruptive)
  • very high LDL (190-500)
  • normal triglycerides
A

Familial Hypercholesterolemia

confirmed by genetic test

35
Q
  • high LDL
  • high triglycerides
  • both high
  • xanthelasmas but no xanthomas
  • many relatives w/ hyperlipidemia
A

Familial Combined Hyperlipidemia

36
Q
  • polygenic inheritance
  • high LDL (130-250)
  • triglycerides normal
  • no xanthomas
A

Polygenic Hypercholesterolemia

37
Q
  • elevation of triglycerides only (200-500 fasting, 1000+ w/ high fat meal)
  • xanthelasmas but rarely eruptive xanthomas (“the butt”)
  • lipemia retinalis (“white retinal arteries”)
A

Familial Hypertriglyceridemia

38
Q

cholesterol targets

A 
total: <200
LDL: w/ heart dz <70
         w/ risk <100
         ideal 100-129
HDL: >40 men, >50 women, >60 ideal
39
Q

cholesterol lowering add-on med

A

Ezetimibe (cholesterol absorption inhibitor)

40
Q
  • new, worsening angina or at rest

- NO elevated troponin or CK-MB

A

acute coronary syndrome: unstable angina

41
Q
  • angina
  • elevated troponin (myonecrosis)
  • NO ST segment elevation
A

acute coronary syndrome: NSTEMI

42
Q
  • angina
  • elevated troponin (myonecrosis)
  • persistant (>20min) ST segment elevation
A

acute coronary syndrome: STEMI

43
Q

4 criteria for Dx of MI

A

any two:

  • history of angina or equivalent
  • EKG evidence of ischemia or infarction
  • elevated serum biomarkers
  • imaging evidence of new myocardium loss or wall motion abnormalities
44
Q

evidence of prior MI

A

any one:
- new pathological Q waves
(>.04sec or >25% of R height -or- >2mm deep)
- loss of viable myocardium contraction in absence of non-ischemic cause
- pathological findings of healed or healing MI

Clinical Medicine III (3 decks)

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