Cardiovascular 9% Flashcards
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64 y/o man w/ chronic AFib and HTN presents w/ sudden-onset severe left lower-extremity pain for 30 minutes with cool pale toes, cap refill > 7 seconds, decreased sensation over plantar & dorsal aspects of foot. What is best next step?
revascularization
Most common revascularizations procedures are thrombectomy and catheter-directed thrombolysis.
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when is surgical repair of an AAA indicated?
if the pt is symptomatic
if AAA is >5.5 cm
if AAA is expanding rapidly
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RF for AAA
smoking
family history
male sex, older pts, HTN
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how is diagnosis of AAA made?
with U/S
“excellent screening tool”
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what size AAA gets monitored annually?
4.0 - 4.9 cm, via U/S
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what size AAA gets monitored every 6 months?
5.0 - 5.4 cm
via ultrasound (but can also use CT or MRI - - MRI is preferred over time d/t less radiation)
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what is ischemic colitis?
most commonly it is INADEQUATE BLOOD FLOW through mesenteric vessels
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what does ischemic colitis look like on CT imaging?
bowel wall edema
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what are the watershed areas of the colon?
splenic flexure (sup & inf mesenteric artery watershed)
rectosigmoid junction (inf mesenteric & hypogastric artery watershed)
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diagnostic imaging for hemodynamically unstable aortic dissection
transesophageal echo (TEE)
otherwise, transthoracic echocardiography (TTE)
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hemodynamically stable aortic dissection diagnostic imaging
CT angiography or
MR angiography
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what is usually causing sudden ripping or tearing chest pain that radiates to the back?
an aortic dissection
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what does aortic dissection usually look like on CXR?
widened mediastinum
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what is used for further evaluation of Peripheral Artery Disease when an ABI is greater than 1.40?
toe-brachial index for further eval
> 0.7 = normal
0.4 - 0.7 is abnormal
<0.4 is severe
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PE exam findings for peripheral artery disease
decreased/absent pulses smooth/shiny skin lower extremity hair loss pallor with leg elevation dependent rubor bruits over narrowed artery decreased skin temp m. atrophy nonhealing lower extremity ulcers (usually foot)
