Cards Flashcards
What syndrome consists of triad of - LE claudication, decr femoral pulse, erectile dysfunction
Leriche syndrome
Most common cause of quick death after steering wheel accident
Aortic rupture
Pts on amiodarone should have what labs checked
Tsh q6m bc risk if hypothy 85%, vs thyrotoxicosis 15%
Hypothyroidism happens bc high iodine deposit
Wolff-parkinson-white syndrome and treatment
Ekg shows short PR, delta wave, wide qrs. may get tachyarrhythmias like afib which can cause vfib and then death
Caused by extra conduction between A and V whcihs excites ventricle faster
Precipitant like alcohol
Tx with catheter directed ablation
Nitroprusside often used for hypertensive urgency bc potent vaso/venodilator but main risks are what?
Cyanide tox esp with renal failure. Esp if prolonged use or fast infusion. Can cause SEIZURE/AMS.
Tx is stopping and giving SODIUM THIOSULFATE
Multifocal atrial tachycardia caused BY
Hypoxia, hypoMg or hypoK, heart disease, COPD
Verapamil is preferred treatment if cant treat underlying cause
Treatment of AS (severe, ava
avr no matter age will decr mortality
Ballon vulvolotomy is assoc with HIGH morbidity and only transient efficacy
40s to 50s yo woman p/w sob, fatigue, afib, hoarseness, diastolic rumbling murmur, loud S1 due to what heart prob?
Mitral stenosis likely from rheum hd.
Vs noonan syndrome has short stature, facial deform and heart defect
30 yo m active jogger wo symp found to have incidental harsh 4/6 holosystolic murmur at 4th left intercostal space with thrill has…
vsd - most likely Small one
40-60% close during childhood
How do u monitor for risk of AR dissection in marfans pt?
Tte at dx and q6 months. If aortic diameter>50 mm than replace the aortic root
Narrow complex qrs tachycardia with no identifiable q waves
psvt
Where can you best hear the heart sounds?
rusb, lusb, apex (midclavicular line between 5th and 6th ribs)
L lower sternal border
Lusb - pulm valve
llSb - tricuspid
How to treat TG>500? What if TG
Gemfibrozil. If
How to tx cocaine induced mi?
First nitrates, asa, benzo
If no imp then cath them!
Dvlp chf after cabg due to
Constrictive pericarditis!
Tx w supportive measures like nsaids and pericardiectomy for refractory cases
Note that amyloidosis would cause incr wall thickness of ventricle
Asymp lv dysfunction w ef 35%. What is most imp drug to start
Ace inh.
not spirono which is not rec if asymp!!!
Person w stemi gets hypotensive, nausea/weak. Next step is
1) incr preload?
2) incr afterload?
3) ionotrope?
Incr preload ie ivf
Intraop hypotension in pheo managed w
Ns ivf bolus
Not pentolamine w is a alpha blocker and worsen hypotension
Prior to procedure need preop alpha block, fluid repletion
Pt on sotalol!! And placed on azithro for pna now w ekg showing torsades. What is most likely to cause another ep?
Sinus brady
Fever
Htn
What is tx?
Sinus brady or pauses
Best tx for htn in gout pt
Arb like losartan (even if cr 1.2)
Acute gout flare tx is indomethacin or colchicine
Avoid asa which decr renal urate excetion
Ivdu w loud holosystolic murmur, petechaie, w headache lethargy neck stiffness has
Mycotic aneurysm- inf of any artery (even cerebral) causing anuerysm and neuro deficit
Tx w abx and surgey
Vsd has what heart sound
Asd?
Vsd has holosystolic murmur at left sternal border
Asd has fixed split s2
Bicuspid aortic valve found. Next step is
Screen first deg relatives w tte!!
Fu tte in 1-2 yrs
Pt w horners syndrome and new onset unilateral headache has
Next step
Carotid artery dissection
Get cta of head and neck
Tx is antiplatete or ac
When can u have sex after mi w stent placement?
1-4 wks
A woman w mvr and lifelong warfarin now wants baby. What to do w warfarin?
Replace warfarin w lmw heparin during first trimester and before delivery (bc reversible) but can continue due breastfeeding and 2nd-3rd trimester
Cocaine induced vasospasm cp and now w persistent htn and already gave benzo. What to give?
Pentolamine a alpha antagonist
Nitropruss is also reasonable
When do u need immediate perc intervention for catdiac tamponade?
Pericardiocentesis!
When rv collapse during diastole, ivc full, pulsus paradosus >10 mmhg
Sudden cardiac death in teen w cp, palpitations, syncope but normal ekg and echo due to
Anomalous coronary artery!!!
Va brugada see rbbb and ste
Man w scoliosis velvety hyperextensibke easily bruised skin w atrophic scars has pulm edema and MR regurg on exam. Dx
Chordae tendonae rupture and has ehlers danlos
SE of pioglitazone
Pulm edrma and sodium retention esp in HF pts
