Cardiovascular Flashcards
Definition of unstable angina
Angina is new, is worsening, or occurs at rest
Anti-HTNsive for a diabetic pt with proteinuria
ACEI
Beck’s triad for cardiac tamponade
Hypotension, distant heart sounds, and JVD
Drugs that slow AVN transmission
ß-blockers, digoxin, CCBs
Hypercholesterolemia tx that leads to flushing and pruritus
Niacin
Murmur: hypertrophic obstructive cardiomyopathy (HCM)
- SEM heard along the lateral sternal border
- INCREASES with Valsalva maneuver and standing
Murmur: aortic insufficiency (AI)
- Diastolic, decrescendo, high-pitched, blowing murmur
- Best heard sitting up
- INCREASES with decreased preload (handgrip maneuver)
Murmur: aortic stenosis (AS)
- Systolic crescendo/decrescendo murmur
- Radiates to the neck
- INCREASES with increased preload (Valsalva maneuver)
Murmur: mitral regurgitation (MR)
- HSM
- Radiates to the axillae or carotids
Murmur: mitral stenosis (MS)
Mid to late diastolic, low-pitched murmur
Tx for AFib and AFlutter
- If unstable: cardiovert
- If stable or chronic: rate control with CCBs or ß-blockers
Tx for VFib
Immediate cardioversion
AutoI complication occurring 2-4 weeks post-MI
Dressler’s syndrome: fever, pericarditis, increased ESR
IVDU with JVD and HSM at the left sternal border. Tx?
Tx existing heart failure and replace the tricuspid valve
Dxic test for HCM
Echo (showing thickened left ventricular wall and outflow obstruction)
A fall in SBP of >10 mmHg with inspiration
Pulsus paradoxus (seen in cardiac tamponade)
Classic ECG findings in pericarditis
Low-voltage, diffuse ST elevation
Definition of HTN
BP >140/90 on 3 separation occasions 2 weeks apart
8 surgically correctable causes of HTN
1) Renal a. stenosis. 2) Coarct. 3) Pheo. 4) Conn’s syndrome. 5) Cushing’s syndrome. 6) U/l renal parenchymal dz. 7) Hyperthyroidism. 8) Hyperparathyroidism.
Eval of a pulsatile abdominal mass and bruit
Abdominal U/S and CT
Indications for surgical repair of abdominal ao aneurysm (AAA)
> 5.5 cm, rapidly enlarging, sxic, or ruptured
Tx for acute coronary syndrome (ACS)
MONA-BH: Morphine, O2, SL nitroglycerin, ASA, IV ß-blockers, heparin
What is metabolic syndrome?
Abdominal obesity, high TGs, low HDL, HTN, insulin resistance, prothrombotic or proinflammatory states
Appropriate dxic test:
- 50 yo M with angina can exercise to 85% of max predicted HR
- 65 yo F with LBBB and severe OA has unstable angina
- Exercise stress treadmill with ECG
2. Pharmacologic stress test (ex: dobutamine echo)
Signs of active ischemia during stress testing
Angina, ST-segment ∆s on ECG, or decreased BP
ECG findings suggesting MI
ST elevation (depression means ischemia), flattened T waves, and Q waves
Coronary territories in MI
- Anterior wall: LAD/diagonal
- Inferior: PDA
- Posterior: LCX/oblique, RCA/marginal
- Septum: LAD/diagonal
Young pt has angina at rest with ST elevation. Cardiac enzymes are nl.
Prinzmetal angina
Common sxs a/w silent MIs
CHF, shock, and AMS
Dxic test for pulmonary embolism (PE)
V/Q scan
Agent that reverses the effects of heparin
Protamine
Coagulation parameter affected by warfarin
PT
Young pt with FHx of sudden death collapses and dies while exercising
HCM
Endocarditis prophylaxis regimen and indications
Surgery/dental: amox 2g 30-60 mins before
-prosthetic valves, h/o IE, some congenital heart dz, heart transplant pts with valvulopathy
*changed from FA (not for GI/GU procedures, not for RHD)
6 P’s of ischemia d/t peripheral vascular dz (PVD)
Pain, pallor, pulselessness, paralysis, paresthesia, poikilothermia
Virchow’s triad
Stasis, hypercoagulability, endothelial damage
MCC of HTN in young F
OCPs
MCC of HTN in young M
Excessive EtOH
Classic ECG finding in atrial flutter
“Sawtooth” P waves
