CV 4 Flashcards
HTN dx is confirmed if
SBP 130 or more
OR
DBP 80 or more
must have 3 times this is elevated over a period of time
HTN macrovascular damage - pulses
decreased or absent peripheral pulses PAD
coarctation of the aorta BP findings
SBP will be higher in the arms than legs with a bound pulse; SBP on the legs will be lower, and the pulses will be weaker, look for diminished femoral pulses
HTN - first line therapy if they also have CKD with proteinuria
ACEI or ARB
primary hyperaldosteronism aka
conn syndrome
primary hyperaldosteronism/conn syndrome - s/sx
HTN with hypokalemia is usually the only sign of this condition (d/t urinary K wasting); normal to elevated Na levels
HTN urgency is defined as
SBP >180 and/or DBP >120 without target organ damage
orthostatic hypotension is diagnosed if
reduction of 20 or more in SBP and/or reduction of 10 or more in DBP
in isolated systolic HTN in older adults, which medications are preferred
2
low dose thiazide diuretics or CCB
HTN - lost weight if BMI is
over 25
HTN w/ DM recommended drug classes
4
ACEI
ARB
thiazide diuretics
CCB
HTN w/ CKD rec drug classes
2
ACEI
ARB
HTN w/ HFrEF rec drug classes
5
diuretics
ARNI
ACEI
ARB
BB
HTN w/ post acute myocardial infarction recommended drug class
3
BB
ACEI
aldosterone
classic finding for MVP
mid systolic or non-ejection click w/ late systolic or holosystolic murmur
best dx test for MVP
3D TTE
MVP lifestyle changes
avoid caffeine and stimulants, alcohol, cigarettes; aerobic exercise training; reduce stress
MVP w/ palpitations can be treated with
BBs
PAD
gradual (decades) narrowing and/or occlusion of medium-to-large arteries in the lower extremities
gradual (decades) narrowing and/or occlusion of medium-to-large arteries in the lower extremities
PAD
intermittent claudication
worsening pain on ambulation that is instantly relieved by rest
intermittent claudication is a sign of
PAD
PAD skin changes
atrophic skin changes; some have skin discoloration/gangrene on one or more toes or a nonhealing wound/ulcer; shiny and hyperpigmented ankles; hairless; cool to touch
PAD CV findings
3
- decreased to absent dorsal pedal pulse
- increased cap refill time
- bruits over partially blocked arteries
ABI is used to elevated what
severity of PAD
dx ABI score for PAD
less than or equal to 0.9
pulsus paradoxus
fall in SBP of more than 10 mmHg during the inspiratory phase
fall in SBP of more than 10 mmHg during the inspiratory phase
pulsus paradoxus
pulsus paradoxus is an important physical sign of
cardiac tamponade
important physical sign of cardiac tamponade
pulsus paradoxus
Raynaud’s phenomenon
reversible vasospasm of the peripheral arterioles on the fingers and toes due to an exaggerated response to cold temps or emotional stress
Raynaud’s phenomenon cause
unknown; may be associated with an increased risk of autoimmune conditions (thyroid, anemia, RA, lupus)
Raynaud’s phenomenon non pharm tx
4
- avoid touching cold things
- avoid cold weather
- quit smoking
- manage stress
Raynaud’s phenomenon med
CCB (nifedipine, amlodipine)
superficial thrombophlebitis
inflammation of a superficial vein and confirmed thrombosis
adult pt c/o acute onset of an indurated vein, localized redness, swelling, and tenderness on the extremity
superficial thrombophlebitis
superficial thrombophlebitis non pharm tx
2
- warm compress
- elevate limb
superficial thrombophlebitis meds
2
NSAIDs
anticoags based on VTE risk
