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Cardiovasc Flashcards

1
Q

Atrial flutter

A
  • Saw tooth pattern

- Regular rate, 250-350 BPM

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2
Q

A. fib

A
  • Irregularly irregular

- wavy baseline

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3
Q

V. tach

A
  • > 100 BPMs

- Rapid and regular, > 3 PVCs

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4
Q

Pre-ventricular contractions

A
  • Wide, bizarre QRS
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5
Q

Torsade de pointes

A

Characteristic pattern, tachy twisting around baseline

- HypoMg, HypoK

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6
Q

V. fib

A
  • Bizzare, wide QRS, fast rate

- lack identifiable waves

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7
Q

Bradyarrythmias

A

Rate

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8
Q

Right BBB

A
  • Wide QRS > 120
  • rSR in V1, V2
  • Wide s in 1, V6
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9
Q

Left BBB

A
  • bunny ears in V6

- broad, slurred monophasic R

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10
Q

Paroxysmal SVT

A
  • Sudden onset and termination

- Enormous, consecutive PVCs, originates above ventrile

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11
Q

EKG- Ischemia

A

T wave inversion

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12
Q

EKG- Acute Injury

A
  • ST elevation with significant Q waves
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13
Q

EKG- Infarction/ necrosis

A
  • Significant Q waves
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14
Q

Indication for defibrillation

A
  • Pulseless V. tach
  • V fib
  • Asystole d/t VF
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15
Q

Indication for electrical cardioversion

A
  • V tach with pulse
  • A. fib, flutter
  • SVT
  • Dysrhythmias
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16
Q

EKG Digitalis toxicity

A
  • Sagging ST depression

- “Dali” mustache

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17
Q

EKG- Hypercalcemia

A
  • Shortened QT interval
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18
Q

EKG- Hypocalcaemia

A
  • Prolonged QT, PR intervals
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19
Q

EKG- Hypokalemia

A
  • T wave flattening, prominent U wave
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20
Q

EKG- Hyperkalemia

A
  • Tall, peaked T waves, Wide QRS
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21
Q

EKG- WPW

A
  • Delta wave (slurred QRS upstroke, wide QRS)
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22
Q

EKG- Pericarditis

A
  • Concave ST elevation

- PR depression

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23
Q

Cardiac tamponade- Eti

A
  • Accumulation of fluid in pericardial space -> compression of heart -> reduced diastolic filling -> CO -> shock and death
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24
Q

Cardiac tamponade- Sx

A
  • Muffled heart sounds
  • Elevated JVP
  • Tachy with hypotension
  • Pulsus paradoxus
  • Kussmaul sign- increase in JVP
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25
Cardiac tamponade- Dx/ Tx
- Echo | - O2, pericardiocentesis
26
Acute pericarditis- Eti
Viral- entero coxsackie | - Dressler syndrome s/p MI
27
Acute pericarditis- Sx
Sharp chest pain, worse with inspiration - Relieved with sitting forward - Friction rub
28
Acute pericarditis- Dx
- Diffuse ST elevation with PR depression | - Normal echo
29
Acute pericarditis- Tx
- ASA or NSAIDs
30
COnstrictive pericarditis- Eti
- Fibrosis, calcified pericardium, viral or chronic inflammation
31
COnstrictive pericarditis- Sx
- Dyspnea - R- sided heart failure - 3rd heart sounds
32
COnstrictive pericarditis- Dx
Echo- pericardial thickening
33
COnstrictive pericarditis- Tx
Pericariectomy
34
Myocarditis- Eti
Viral or post-viral - Kids - SLE/ autoimmune - Rheumatic fever
35
Myocarditis- Sx
- Viral prodrome | - Heart failure- dyspnea at rest, impaired systolic fxn
36
Myocarditis- Dx
Myocardial bx- gold standard | - CXR: dilated cardiomyopathy
37
Myocarditis- Tx
- Diuretics, ACEIs
38
Endocarditis- Eti
- 2/2 transient bacteremia - Mitral MC (IVDU= tricusp) - Strep viridans MC - S. aureus in IVDU
39
Endocarditis- Sx
- Fever, anorexia, wt loss | - Janeway, roth, osler, splinter
40
Endocarditis- Dx
- 3+ blood cultures > 1 hr apart - + echo - New valvular regurgitation (AR, MR)
41
Endocarditis- Tx
- Nafcillin, gentamicin x 4-6 wks | - Vanc
42
VTE- Eti
- Venous stasis + endothelial damage + hypercoaguability | - Originate in calf
43
VTE- Sx
- Unilateral swelling of lower extremity - TTP - Phlebitis
44
VTE- Dx
- Venous US (wells > 2) - D-dimer to RO - Venography = gold standard
45
VTE- Tx
- Anticoag: Heparin, LMWH, warfarin x 3-6 mo
46
VTE- wells criteria
- CA - Immobilization of LE - Bedridden - Local tenderness of deep vein - Entire leg swollen - Unilateral calf swelling > 3 - Unilat. edema - collateral superficial veins - Alt dx as or more likely = -2
47
Heart failure- Eti
- CAD MC cause - L- sided = CAD + HTN - R- sided = L sided - Systolic > diastolic
48
Left Heart failure- Sx
- Dyspnea- exertional to orthopnea - Pulm congestion, rales, pink frothy sputum - Dusky, pale skin, diaphoresis
49
Right Heart failure- Sx
- Fluid retention- peripheral edema, JVD,
50
Heart failure- Dx
Echo- EF decreased - CXR: butterfly pattern, kerly B lines, edema, effusion, megaly - Increased BNP
51
Heart failure- Tx
- ACEI 1st line- decreased after/ pre-load - Diuretics- sx control - Dig for short term acute CHF
52
Dilated cardiomyopathy- Eti
- MC myopathy - Idiopathic MC (viral?) - Systolic dysfxn, dilated heart - Viral, ETOH, cocaine
53
Dilated cardiomyopathy- Sx
- L&R systolic HF- S3 | - Edema, pulm congestion, JVP
54
Dilated cardiomyopathy- Dx
- Echo: L. vent dilation, decreased EF | - CXR: cardiomegaly
55
Dilated cardiomyopathy- Tx
- ACEI + diuretics
56
Restrictive cardiomyopathy- Eti
- Amyloidosis, sarcoid | - Impaired diastolic fxn, preserved contractility
57
Restrictive cardiomyopathy- Sx
- R sided HF - Increased JVP with inspiration - Stiff RV
58
Restrictive cardiomyopathy- Dx
- Echo- atrial dilation, non-dilated ventricles
59
Restrictive cardiomyopathy- Tx
Symptoms
60
Hypertrophic cardiomyopahy- Eti
- Inherited, narrowed LV +/- RV hypertrophy | - Increased contractility, Decreased LV volume
61
Hypertrophic cardiomyopahy- Sx
- Asymp to sudden death - Dyspnea, fatigue - Angina pectoris - Syncope + arrythmias - Harsh crescendo-decresendo murmur
62
Hypertrophic cardiomyopahy- Dx
Echo- asymmetric wall thickness
63
Hypertrophic cardiomyopahy- Tx
- Beta blockers first line | - Septal ablation, myometomy
64
Hypertensive emergency- Eti
- Increased BP > 220/120 + acute target organ damage
65
Hypertensive emergency- Sx
- Neuro: encephalopathy, stroke - Cardiac: HF, dissection - Renal: AKI, proteinuria, hematuria - Retinal: Papilledema
66
Hypertensive emergency- Dx
- Neuro exam, CXR, EKG, CK/ trop. UA, chemistries, blurred vision
67
Hypertensive emergency- Tx
IV agents- Decrease BP 10% 1st hour
68
Pulmonic stenosis- Eti
Congenital
69
Pulmonic stenosis- Sx
LUSB, radiates to neck - Sx of R HF - Increases with respiration
70
Pulmonic stenosis- Tx
Balloon valvoplasty
71
Pulmonic regurg- Eti
- Pulm HTN | - Endocarditis
72
Pulmonic regurg- Sx
- Diastolic | - Increases with venous return
73
Pulmonic regurg- Tx
Nothing
74
Tricuspid stenosis- Eti
- R. sided HF | - Carcinoid heart disease MC
75
Tricuspid stenosis- Sx
- Mid-diastolic rumble at LLSB | - Opening snap
76
Tricuspid stenosis- Tx
- Decrease volume- diuretics
77
Tricuspid regurg- Eti
- 2/2 R. vent dilation
78
Tricuspid regurg- Sx
Holosystolic murmur, high pitched
79
Tricuspid regurg- Tx
- Diuretics
80
Aortic stenosis- Eti
- LV outflow obstruction | - Degeneration or congenital
81
Aortic stenosis- Sx
- Angina, syncope and CHF - RUSB, ejection crescendo decrescendo - Radiates to carotid
82
Aortic stenosis- Tx
- Valve replacement | - Avoid Beta Blockers & CCB
83
Mitral stenosis- Eti
- Rheumatic heart dz
84
Mitral stenosis- Sx
- R sided HF - A fib - mitral facies (flushed cheeks) - Diastolic rumble
85
Mitral stenosis- Tx
Valvotomy
86
Aortic regurg- Eti
- Backflow, LV volume overload
87
Aortic regurg- Sx
L sided HF - Wide pulse pressure - Water hammer pulse
88
Aortic regurg- Tx
Vasodilators | - Surg if EF
89
Mitral regurg- Eti
- Mitral valve prolapse | - Ischemia
90
Mitral regurg- Sx
- Blowing holosystolic murmur, radiates to axilla | - Dyspnea
91
Mitral regurg- Tx
- Vasodilators | - Surgery
92
Mitral prolapse- Eti
Young women, CT dz
93
Mitral prolapse- Sx
- Asymptomatic, progression to MR
94
Mitral prolapse- Tx
Reassurance

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