Cardiovascular Flashcards
Classic EKG finding in atrial flutter
“Sawtooth” P waves
Definition of unstable angina
Angina that is new or worsening with no increase in troponin level
Antihypertensive for a diabetic patient with proteinuria
ACE inhibitor
Beck triad for cardiac tamponade
Hypotension, distant heart sounds, jugular venous distension (JVD)
Drugs that slow heart rate (4)
Beta blockers, calcium channel blockers, digoxin, amiodarone
Hypercholesterolemia treatment that leads to flushing and pruritis
Niacin
Murmur of hypertrophic obstructive cardiomyopathy
Systolic ejection murmur heard best along the lateral sternal border that increases with decreased preload (e.g. Valsalva maneuver)
Murmur of aortic insufficiency
Austin flint murmur: diastolic, decrescendo, low-pitched, blowing murmur that is best heard sitting up and increases with increase afterload (e.g. handgrip maneuver)
Murmur of aortic stenosis
Systolic crescendo/decrescendo murmur that radiates to the neck. Increases with increase preload (e.g. squatting maneuver)
Murmur of mitral regurgitation
Holosystolic murmur that radiates to the axilla and increases with increased afterload (e.g. handgrip maneuver)
Murmur of mitral stenosis
Diastolic, mid-to-late, low-pitched murmur preceded by an opening snap
Treatment for atrial fibrillation and atrial flutter
If unstable: cardiovert
If stable or chronic: rate control with CCBs or beta-blockers
Treatment for ventricular fibrillation
Immediate defibrillation
Dressler syndrome
Autoimmune reaction with fever, pericarditis, and increased ESR occurring 2-4 weeks post-MI
IV drug use with JVD and a holosystolic murmur at the left sternal border. Treatment?
Treat existing heard failure and replace the tricuspid valve.
Diagnostic test for hypertrophic cardiomyopathy
Echocardiogram (showing a thickened LV wall and outflow obstruction)
Pulsus paradoxus
Decrease in systolic pressure of >10 mm Hg with inspiration; seen in cardiac tamponade
Classic EKG findings in pericarditis
Low-voltage, diffuse ST-segment elevation
Eight surgically correctable causes of hypertension
- Renal artery stenosis
- Aortic coarctation
- Pheochromocytoma
- Conn syndrome (primary aldosteronism)
- Cushing syndrome
- Unilateral renal parenchymal disease
- Hyperthyroidism
- Hyperparathyroidism
Evaluation of a pulsatile abdominal mass and bruit
Abdominal ultrasound and CT
Indications for surgical repair of abdominal aortic aneurysm
> 5.5 cm, rapidly enlarging, symptomatic, or ruptured
Treatment for acute coronary syndrome
ASA, clopidogrel, heparin, sublingual nitroglycerin, IV beta blockers, oxygen, morphine
Metabolic syndrome
Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory state
Appropriate diagnostic test for:
A. 50 year old man with stable angina who can exercise to 85% of maximum predicted heart rate
B. 65 year old woman with left bundle branch block and severe osteoarthritis has unstable angina
A: Exercise stress treadmill with EKG
B: Pharmacologic stress test (e.g. dobutamine echo)
Signs of active ischemia during stress testing
Angina, ST segment changes, decreased BP
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: PDA
Posterior: Left circumflex/oblique, RCA/marginal
Septum: LAD/diagonal
A young patient with angina at rest and ST-segment elevation with normal cardiac enzymes
Prinzmetal angina
Common symptoms associated with silent MIs
CHF, shock, AMS
Diagnostic test for PE
CT with contrast
Protamine
Reverses the effect of heparin
Prothrombin time
The coagulation parameter affected by warfarin
A young patient with a family history 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 triad
Stasis, hypercoagulability, endothelial damage
The most common cause of hypertension in young women? Young men?
Women: OCPs
Men: Excessive alcohol
Figure 3 sign
Aortic coarctation
Water bottle-shaped heart
Pericardial effusion. Look for pulsus paradoxus
