Cardiovascular Flashcards
Best initial test for valvular disease
Echo
Most acurate test for valvular disease
Catheterization
Murmurs that do not inclease with expiration
murmurs thar increase with a decrease in preload(standing and valsalva)
HOCM
MVP
Drugs that decrease mortality in dilated cardiomyopathy
ACEi
ARBs
B-blokers(metoprolol,bisoprolol,carvidelol)
spironolactone(only in III-IV class)
drugs that decrease mortality in HTN
Diuretics
CCB
ACEIs
B-blockers
drugs that decrease mortality in ANGINA
ASA and B blokers
decrese preaload
standing
valsalva
increase afterload
hand grip
squad
cannon A waves
III degree block
right ventricle infarction
LBBB
QRS>200msec
deep S in V1 ,Tall R in I, V5,V6
NEW LBBB COULD BE ISCHEMIA
RBBB
QRS>200
RSR´ with wide R in V1
wide S in I,V5,V6
P Pulmonale
right atrial
P-amplitude >2.5mm in lead II
P mitrale
left atrial
wide P>120 msec in lead II
notched P waves in lead II
LVH EKG findings
S in V1 + R in V5 or V6>35mm
RVH EKG findings
right axis deviation
R wave in V1>7mm
holosistolyc murmur that increase with inspiration
tricuspid regurgitation
holosistolyc murmur ,radiates to axilaincreases with hand grip
mitral regurgitation
midsystolic murmur
Mitral valve prolapse
it increases with decrease in preload
CHADS
anticoagulation criterai for patients with AF
WARFARIN IF CHADS>2 CHF(1 point) HTN(1 point) Age >75(2 points) DM(1 point) Stroke or ITA history(2 points) Vascular disease(1 point) Age 65-74(1 point) Sex (female)(1 point)
Aacute AF causes:
PIRATES
PIRATES
- pulmonary disease
- Ischemia
- Rheumatic heart disease
- Anemia/Atrial mixoma
- Thyrotoxicosis
- Ethanol
- Sepsis
most common cardiomyopathy
dilated cardiomyopathy
systolic ejection crescendo decresendo murmur that increases with standing or valsalva
HOCM
HCM
PCI critaria in unstable angina (TIMI)
TIMI>3
- Age>65
- Three or more CAD risk
- known CAD(>50%)
- ASA use in past 7 days
- severe angina(2 or more episodes in 24 hours)
- ST elevatio>0.5mm
- positive cardiac markers
inferior MI
obtain a right-sided ECG
AVOID NITRATES
posterior MI
obtain posterior ECG leads(V7-V8)
indications for CABG
unable to perform PCI
left main CAD
triple-vessel diase}
depressed ventricualr function
2 hypertension mnemonic
CHAPS
cushing syndrome Hyperaldosteronism aortic coarctation pheochromocytoma Stenosis of renal arteris OCP
Hypertensive emergency tx
(>180/120 with end-organ damage)
IV labetalol, nitroprusside ,nicardipine)
Hypertensive urgency
PO medication
B-blockers
clonidine
ACEIs
AAA Tx
> 5.5cm Cx
Aortic disection Tx
A= Cx
B=B-blokers
PAD Dx
chronic= ABI(ankle-brachial index)
CAD risk factors
- DM(WORTS)
- Tabacco
- HTN(MOST COMMON)
- Hyperlipidemia
- Famili history(only parents and brothers)male45, women>55)
tako-tsubo cardiomyopathy
MI after overwhelming emotionally stressful event.
angiography is normal
echo=apical left ventricular balloning
drgs that decrease mortality in chronic angina
- ASA
- B blockers(metoprolol,bisoprolol or cavedilol[non especific])
- nitroglycerin
most common cause of dead in CHF
arrhythmia/sudden death ( prevented with b-blockers)
worst CAD risk factor
DM
most common coronary disease risk factor
Hypertention
most dangerous hyperlipidemia
increse LDL
elevation of troponing following a overwhelming emotional stress
tako-tsubo diseae
p2Y12 inhibitor for angiplasty
ticagrelor or prasugrel
most common cause of death in ACS
ventricular arrhythmia(tachychardia or fibrillation)
inferor wall MI with sudden drop in BP after nitrates
IT IS A RIGTH VENTRICULAR INFARCTION
-give high volume fluid and avoid nitroglycerin.
most accurate test for CHF
multiple-gated acquisition scan (MUGA) or nuclear venticulography
implantable defibrilaltor indication inCHF
ischemic cardiomyopathy and ejection fraction below 35%
biventricular pacemarker indication in CHF
EF under 35% dilated cardiomyopathy and QRS above 120 milliseconds
most common cause of death in CHF
arrhythmias(sudden death)
dyastolic disfunction treatment
BB and diuretics
best inital test in pulmonary edema
EKG -AF -atrial flutter -Ventricular tachycardia DO SYNCHRONIZED CARDIOVERSION
valvualr disease best inital step and most accurate
best inital: echocardiogram
most accurate:catheterization
valvualr desease ¨general medical treatment
- All get better with diuretics
- REGURGITATION respong better to ACEIs or ARBS
surgical replasmetn indication for Mitral regurgitation
BIGGER HEART
LVESD above 40mm or EF below 60%
surgical replasment indication for Aortic regurgitation
EF less thatn 55% or LVESD greater than 55mm
increase mortality in CAD
CCB only used in special situations: -bblockers contraindicated(severe asthma) -princemetal angina -cocaine induced chest pain
auscultation association with ACS
S4 gallop
ischemia leading to nocompliance of the left ventricle
ST depressions in leads V1 and V2
suggestive of a posterior wall myocardial infarction
ABSOLUTE contraindications for thrombolytics
- mayor bleedin into the bowel or brain
- recen surgery(within the last 2 weeks
- severe hypertension(above 180/110)
- Nonhemorrhagic stroke within the last 6 months
medication contraindicated in HOCM
Diuretics
will increase the obstruction
endocartis profilaxis with amoxicilin indication
- previous endocarditis
- uncorrected cyanotid congenital heart disease
- prostethis valves
- repaired congenital heart disease with residual defect
- valvulopathy in a transplanted heart
MVP DOES NOT NEED
posterior stroke
- ipsilateral sensory loss of the face, ninth and 10th creneal nerve(VII,XI,X)
- contralateral sensory loss of the limbs
- limb ataxia
patient already on ASA during stroke
- add dipyridamole or switch to clopidogrel
magraine medicaitions contraindicated to convine
DO NOT CONVINE triptans with ergotamine
most single effective treatment for cluster headache
100% oxigen
SAH treatmetn
EMBOLIZATION its not present amoung teh answers chose clipping
most accurate test for guillian barre
nerve conduction studies/electromyography
msota ccurate test for miastenia gravis
alectromyography
best initial test for myastenia gravis
acetylcholine receptor Ab
