Cardiovascular (Alice) Flashcards
types of angina
stable
unstable
prinzmetal
chest pain/discomfort/pressure/squeezing increased w. exertion or emotion
stable angina
stable angina is relieved by (2)
rest
nitro
what is levine sign
clenched fist over the sternum and clenched teeth when describing cp -> stable angina
what do q waves on ekg indicate
prior MI
stress test findings of stable angina
reversible wall motion abnl
ST dpn > 1 mm
gs dx for angina
CTA
5 indications for CTA w. cp
severely symptomatic despite tx
being considered for PCI
troublesome sx difficult to dx
previous cardiac event
ischemia visualized on noninvasive tests
tx for stable angina (4)
nitro
bb
angioplasty
bypass
previously stable and predictable sx of angina that are now more frequent or present at rest
unstable angina
what will cardiac enzymes show for unstable angina
normal
tx for unstable angina
continuous cardiac monitoring
IV, O2
NTG
morphine
ASA and/or clopidogrel
LMWH
bb
stress test when stable
revascularization
ACEI/statin
angina not associated w. ischemia
prinzmetal
4 triggers for prinzmetal angina
hyperventilation
cocaine
tobacco
nitric oxide deficiency
4 substances that may trigger prinzmetal angina
Ach
ergonovine
histamine
serotonin
3 HPI clues that it’s prinzmetal angina over unstable angina
preservation of exercise capacity
smoking or cocaine hx
cyclical AM pain w. no relation to cardiac load
EKG findings of prinzmetal angina
inverted u waves
ST segment/T wave abnl’s
tx for prinzmetal angina
stress test
NTG
what 2 meds are used for long term management of prinzmetal angina
ccb
long acting nitrates
revascularization is indicated when stenosis of the left main coronary artery is > _
50%
tearing cp radiating to the back
aortic dissection
back pain, pulsatile mass, hypotn
AAA
screening recs for AAA
1 time US for males 65-75 yo w. any prev hx smoking
management of AAA based on size
< 3 cm: no further testing
3.0-4.4 cm: monitor annually
4.5-5.0 cm: monitor q 6 mo, refer to vascular
5.5-5.4 cm: monitor q 3 mo
>5.5 cm OR expands > 0.5 cm/year: surgery
pharm for AAA
bb
CXR finding of AAA
widened mediastinum
two types of AAA
typa a (ascending): emergency
type b (descending): bb
PE finding of aortic dissection
variation in pulse btw left and right arm
gold standard imaging for dissection
MRA
4 arrhythmias that cause DOE
afib
inappropriate sinus tachy
sick sinus syndrome
bradycardia
2 myocardial causes of DOE
cardiomyopathy
ischemia
PE findings of cardiomyopathy
edema
jvd
s3
displaced aplical impulse
murmur
crackles
wheezing
tachy
2 restrictive causes of DOE
pericarditis
pericardial effusion/tamponade
PE finding of pericarditis/pericardial effusion
paradoxical pulse: exaggerated variation in bp w. respiration
EKG finding of pericarditis/effusion
electrical alternans
CXR finding of pericarditis/effusion
bottle shaped heart
valvular causes of DOE
aortic stenosis
mitral stenosis
congenital defects
what causes claudication
atherosclerotic plaque -> reduced blood flow to the leg muscles -> demand exceeds supply
not a clot
presentation of claudication (3)
pain in legs w. walking
relieved w. a few minutes of rest
reproducible w. same distance each time
claudication is a sx of what condition
PAD