CV 1 Flashcards
most AAA are asymptomatic but if there are symptoms what will patient c/o
3
abd pain
back pain
flank pain
a ruptured AAA is suspected in patients with classic triad of
acute abd pain
abd distention
hyemodynamic instability
persons at highest risk of AAA
older white males who are current or former smokers with HTN
initially imaging test for AAA
abd US
ACS refers to
clinical presentations ranging from STEMI, NSTEMI, and unstable angina
classic presentation of ACS
middle aged to older man who c/o onset of constant chest or substernal discomfort lasting more than 15 minutes that is described as squeezing, tightness, crushing, knot in center of chest, heavy pressure, or band like
best initial dx test for ACS
12 lead ekg
all patients with suspected ACS should be given what
ASA dose of 162-325 mg to chew or swallow
bacterial endocarditis aka
infective endocarditis
bacterial endocarditis risk factors -
3 generalized
cardiac factors (valvular abnormalities)
underlying conditions (IV drug use, cardiac device, immunos.)
recent dental or surgical procedure
bacterial endocarditis - pt presents with
4
fever and chills
new onset murmur
anorexia
weight loss
pt presents with fever, chills, new murmur, weight loss
bacterial endocarditis
bacterial endocarditis - skin findings
mostly on hands/fingers, toes/feet; subungual hemorrhages, petechiae on the palate, painful voilet colored nodes on the fingers/toes (Osler nodes), nontender red spots on palms/soles (Janeway lesions)
osler nodes is to
bacterial endocarditis
janeway lesions is to
bacterial endocarditis
osler nodes
painful voilet-colored nodes on the fingers and toes
janeway lesions
nontender red spots on the palms/soles
bacterial endocarditis - funduscopic exam may show
Roth spots (retinal hemorrhages)
first test done for suspected bacterial endocarditis
transthoracic echocardiogram
orthopnea
SOB when lying down
murmurs of HF
2
S3 gallop
paradoxical splitting of S2
HFrEF %
EF 40% or less
EF 50% or higher
HFpEF (diastolic HF)
r/o AAA in an older male who has what - mass
pulsatile abd mass that is more than 3 cm in width
causes of displacement of the point of maximal impulse PMI
3
severe left ventricular hypertrophy
cardiomyopathy
pregnancy, 3rd trimester
S3 heart sounds usually indicate
HF or CHF
S3 heart sounds - always considered abnormal if it occurs
after age 40
S3 heart sound can be normal in who
3
children
pregnant patients
some athletes (>35 years of age)
pathologic S4 is associated with
LVH due to increased resistance from the left ventricle
which heart sound is a sign of CHF
S3
which heart sound is a sign of LVH
S4
a physiologic split S2 is best heard where
at the pulmonic area
