Cards Flashcards
Young adult with mild DOE
Exam - ejection click followed by crescendo-decrescendo systolic murmur over LUSB and widened splitting of S2
S2 split increases with inspiration
Pulmonic valve stenosis
Congenital heart defect
Mid systolic ejection murur, S2 is widely split w/o variation during respiration
ASD
LVH d/t HTN in a guy <40 is suspicious for?
coarctation of the aorta
Unexplained CHF
Proteinuria
LVH
Amyloid cardiomyopathy/restrictive
What blood smear findings would you expect in a pt with scleroderma?
Schistocytes (microangiopathic hemolytic anemia), thrombocytopenia
Persistent tachyarrhythmia w/ hemodynamic instabilit
Next step?
synchronized cardioversion
Chest pain d/t cocaine
Tx?
IV benzodiazepines
Improves agitation, reduce myocardial oxygen deman, alleviates cardiovascular syx
Why do statins cause myopathy?
inhibition of intracellular synthesis pathway
statins inhibit HMG-CoA to decrease the number of LDL receptors
However, statin also inhibits Q1- synthesis which is involved in muscle cell energy production and may contribute to the myopathy
What lab finding is suggestive of the severity of CHF?
Hyponatremia
d/t increased renin, ADH, and norepinephrine
Tx - fluid restriction, ACEI, loop diuretics
Infant that is diaphoretic with feeding
Murmur at LLSB and diastolic rumble over apex
VSD
All patients with HTN despite being on 3+ hypertensives should be evaluated for?
Renal causes.
HFpEF s/t longstanding HTN produces CHF syx d/t?
Diastolic dysfunction (inability of the heart muscle to relax and allow filling of the chamber) HFrEF - systolic dysfunction causes reduced EF
1st line antihypertensives in pregnancy?
Labetalol and methyldopa
Tx for stress provoked vasovagal syncope?
Avoidance of triggers
Physical counter pressure
