Cardiology_RR Flashcards
“Sawtooth” P waves
Classic EKG finding in Atrial Flutter
Chest pain that is new, is worsening, or occurs at rest
Unstable angina
Antihypertensive for a diabetic patient with proteinuria
ACE Inhibitor
Hypotension, distant heart sounds, jugular venous distention
Beck’s Triad for Cardiac Tamponade
Drugs that slow heart rate
Beta-blockers, Calcium Channel blockers, Digoxin, Amiodarone
Hypercholesterolemia treatment that leads to flushing and pruritus
Niacin
A systolic ejection murmur heard along the lateral sternal border;
Increases with Valsalva maneuver
Hypertrophic Obstructive Cardiomyopathy
Effect of Valsalva maneuver on cardiac function
Decreases preload
A diastolic decrescendo, low-pitched, blowing murmur that is best heard sitting up;
Increases with handgrip maneuver;
Associated with an Austin Flint murmur
Aortic Insufficiency
Effect of handgrip on cardiac function
Increases afterload
A systolic crescendo/decrescendo murmur that radiates to the neck;
Increases with squatting maneuver
Aortic Stenosis
Effect of squatting on cardiac function
Increases preload
A holosystolic murmur best heard at the apex that radiates to the axilla;
Increases with handgrip maneuver
Mitral regurgitation
A diastolic, mid- to late, low-pitched murmur preceded by an opening snap
Mitral Stenosis
Treatment for atrial fibrillation and atrial flutter
If unstable, cardiovert.
If stable or chronic, rate control with calcium channel blockers or beta-blockers.
Treatment for ventricular fibrillation
Immediate cardioversion
An autoimmune reaction with fever, pericarditis, and increased ESR occurring 2-4 weeks post-MI
Dressler’s Syndrome
How do you treat an IV drug user with JVD and a holosystolic murmur at the left sternal border?
Treat the existing heart failure, and replace the tricuspid valve
Diagnostic test for hypertrophic cardiomyopathy
Echocardiogram showing a thickened left ventricular wall and outflow obstruction
Describe pulsus paradoxus
A decrease in systolic blood pressure of > 10 mm Hg with inspiration that is seen commonly in cardiac tamponade
Low-voltage, diffuse ST_segment elevation
Classic EKG findings in pericarditis
Definition of hypertension
BP > 140/90 mm Hg on 3 separate occasions 2 weeks apart
What are eight surgically correctable causes of hypertension?
Renal artery stenosis Coarctation of the aorta Pheochromocytoma Conn's Syndrome Cushing's Syndrome Unilateral renal parenchymal disease Hyperthyroidism Hyperparathyroidism
Evaluation of a pulsatile abdominal mass and bruit
Abdominal ultrasound and CT
What are the indications for surgical repair of an abdominal aortic aneurysm?
> 5.5 cm,
Rapidly enlarging,
Symptomatic, or
Ruptured
What are some medications used in treating acute coronary syndrome?
Aspirin Heparin Clopidogrel Morphine Oxygen (O2) Nitroglycerin, sublingual IV Beta-blockers
What are the characteristics of metabolic syndrome?
Abdominal obesity High triglycerides Low HDL Hypertension Insulin resistance Prothrombotic or proinflammatory states
A 50-year-old man with stable angina can exercise to 89% of his maximal predicted heart rate. What is the most appropriate diagnostic test?
Exercise stress treadmill with EKG
A 65-year-old woman with left bundle branch block and severe osteoarthritis has unstable angina. What is the most appropriate diagnostic test?
Pharmatologic stress test (i.e. dobutamine echo)
Target LDL in a patient with diabetes
< 70 mg/dL
Signs of active ischemia during stress testing
Angina,
ST-segment changes on EKG, or
Decreasing blood pressure
EKG findings suggesting MI
ST-segment elevation (depression means ischemia),
Flattened T waves, and
Q waves
Coronary territories in MI
Anterior Wall – LAD / Diagonal
Inferior Wall – PDA
Posterior Wall – Left circumflex/Oblique, RCA/marginal
Septum – LAD/Diagonal
A young patient presents with angina at rest and ST-segment elevation with normal cardiac enzymes. What is the most likely diagnosis?
Prinzmetal’’s angina
Common symptoms associated with silent MIs
CHF, shock, altered mental status
Diagnostic test for pulmonary embolism
Spiral CT with contrast
When is protamine used?
To reverse the effects of heparin
Which coagulation parameter is affected by warfarin?
Prothrombin time
A young patient with a family history of sudden death collapses and dies while exercising. What is the most likely diagnosis?
Hypertrophic cardiomyopathy
Endocarditis prophylaxis regimens
Oral surgery–amoxicillin for certain situations
GI or GU procedures–not recommended
What comprise Virchow’s Triad?
Stasis, hypercoagulability, endothelial damage
The most common cause of hypertension in young women?
Oral Contraceptives
The most common cause of hypertension in young men?
Excessive EtOH
Which cardiac condition reveals the “Figure 3 Sign”?
Aortic coarctation
What cardiac condition is commonly associated with the “water-bottle-shaped heart”?
Pericardial effusion. (Be sure to look for pulsus paradoxus to confirm the diagnosis.)
