Cardiovascular Flashcards
Classic ECG finding in AFlutter
“Sawtooth” P Waves
Define Unstable Angina
Angina that is new, is worsening, or occurs at rest
Antihypertensive for diabetic patient with proteinuria
ACEI
Beck’s triad for cardiac tamponade
Hypotension, distant heart sounds, and JVD
Drugs that slow heart rate
B-Blockers, Calcium channel blockers, digoxin, amiodarone
HLD tx that leads to flushing and pruritus
Niacin
Murmur- Hypertrophic Obstructive Cardiomyopathy
A systolic ejection murmur heard along the lateral sternal border that increased with decreased preload (Valsalva maneuver)
Murmur - Aortic Insufficiency
Austin Flint murmur, a diastolic, decrescendo, low-pitched, blowing murmur that is best heard sitting up; increases with increased afterload (handgrip maneuver)
Murmur - Aortic Stenosis
A systolic crescendo/decrescendo murmur that radiates to the neck; increased with increased preload (squatting maneuver)
Murmur - Mitral Regurgitation
A holosystolic murmur that radiates to the axilla; increased with increased afterload (handgrip maneuever)
Murmur - Mitral Stenosis
A diastolic, mid to late, low-pitched murmur preceded by an opening snap
Tx for Afib and Aflutter
If unstable, cardiovert. If stable or chronic, rate control with CCbs or B-Blockers
Tx for Vfib
Immediate cardioversion
Dressler’s Syndrome
An autoimmune rxn with fever, pericarditis, and increased ESR occurring 2-4 weeks post-MI
IV drug use with JVD and holosystolic murmur at the left sternal border. Tx?
Tx existing heart failure and replace the tricuspid valve
Dx test for hypertrophic cardiomyopathy
Echocardiogram (showing a thickened left ventricular wall and outflow obstruction)
Pulsus paradoxus
A decreased in systolic BP of >10 mmHg with inspiration; seen in cardiac tamponade.
Classic ECG findings in pericarditis
Low-voltage, diffuse ST-segment elevation
Define HTN
BP > 140/90 on 3 separate occasions 2 weeks apart
8 surgically correctable causes of HTN
Renal artery stenosis, coarctation of the aorta, pheochromocytoma, Conn’s syndrome, Cushing’s syndrome, unilateral renal parenchymal dz, hyperthyroidism, hyperparathyroidism
Evaluation of pulsatile abdominal mass and bruit
Abdominal U/S and CT
Indications for surgical repair of AAA
> 5.5 cm, rapidly enlarging, symptomatic, or ruptured
Tx for ACS
ASA, heparin, clopidogrel, morphine, O2, sublingual nitro, IV B-Blockers
Metabolic syndrome
Abd obesity, high triglycerides, low HDL. HTN, insulin resistance, prothrombotic or proinflammatory states
Appropriate dx test: 50-y/o man w/ stable angina can exercise to 85% of max predicted heart rate
Exercise stress treadmill with ECG
Appropriate dx test: 65 y/o woman with LBBB, and severe OA has unstable angina
Pharmacologic stress test (eg. dobutamine echo)
Target LDL in pt w/ diabetes
Signs active ischemia during stress testing
Angina, ST-segment changes on ECG, or decreased BP
ECG findings suggesting MI
ST-segment elevation (depression means ischemia), flattened T waves, and Q waves
Coronary territories inMI
Anterior wall (LAD/diagonal), Inferior (PDA), posterior (left circumflex/oblique, RCA/marginal), septum (LAD/diagonal)
A young pt w/ angina at rest and ST-segment elevation with normal cardiac enzymes
Prinzmetal’s angina
Common sx a/w silent MIs
CHF, shock, AMS
Dx test for PE
Spiral CT w/ contrast
Protamine
Reverse the effects of heparin
Prothrombin time
Coagulation parameter affected by warfarin
A young pt w/ a family hx of sudden death collapses and dies while exercising
Hypertrophic cardiomyopathy
Endocarditis prophylaxis regimens
Oral surgery - amoxicillin for certain situations; GI or GU procedures - not recommended
Virchow’s triad
Stasis, hypercoagulability, endothelial damage
MCC of HTN in young women
OCPs
MCC of HTN in young men
Excessive EtOH
Figure 3 sign
Aortic coarctation
Water-bottle-shaped heart
Pericardial effusion. Look for pulsus paradoxus
