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Surgery > Heart > Flashcards

Heart Flashcards

0
Q

What quality and regularity of pulses are observed in aortic stenosis

A

Pulsus parvus et tardus (pulses are weak and late)

= narrow pulse pressure

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1
Q

What are signs and symptoms of heart disease (7)

A

Dyspnea, peripheral edema, chest pain, palpitations, hemoptysis, syncope, fatigue

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2
Q

Which valve problem has a wide pulse pressure

A

Aortic insufficiency

“Water-hammer pulse”

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3
Q

What does the apical impulse feel like in LVH

A

Increased and displaced laterally

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4
Q

What may be palpated in RVH

A

A parasternal heave

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5
Q

Studies used in detection of heart disease

A

CXR, ECG, echocardiography, cardiac catheterization

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6
Q

Which two drugs are used for cardiotonic effects in cardiac arrest

A

Epinephrine, calcium

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7
Q

Which drug reverses bradycardia from cardiac arrest

A

Atropine

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8
Q

How can the myocardium be protected from ischemia in cardiopulmonary bypass

A

Hypothermia and cardioplegia

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9
Q

When is surgery indicated for aortic stenosis

A

Presence of symptoms

Angina, syncope, dyspnea

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10
Q

Myxomatous degeneration, aortic dissection, bacterial endocarditis, rheumatic fever, or aortic root aneurysm may cause what

A

Aortic insufficiency

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11
Q

What signifies the severity of aortic insufficiency

A

The duration of murmur during diastole

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12
Q

Symptomatic aortic insufficiency with LVEF <50% and LV dilation requires what intervention

A

Aortic valve replacement surgery

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13
Q

Triad of apical diastolic rumble, opening snap and loud S1 indicates what

A

Mitral valve stenosis

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14
Q

Tx of mitral stenosis in less severe cases

More severe cases?

A

Less: commissurotomy (open or balloon mitral valvuloplasty)

More: mitral valve replacement

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15
Q

Leaflet thickening (proteoglycans) and chordae elongation is called what, and where is it commonly seen

A

Myxomatous degeneration

Commonly in mitral insufficiency

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16
Q

Dyspnea on exertion, fatigue, palpitations with holosystolic blowing murmur that radiates to axilla

A

Mitral valve insufficiency

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17
Q

Most important diagnostic test for mitral insufficiency

A

Echocardiography

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18
Q

Most accurate diagnostic test for tricuspid stenosis and insufficiency

A

Cardiac catheterization

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19
Q

What syndrome can produce pulmonic stenosis

A

Carcinoid syndrome

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20
Q

What causes multiple valvular disease

A

Rheumatic fever

TR and TS rare without mitral involvement

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21
Q

What ECG changes may be seen in CAD

A

ST segment changes, T wave changes

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22
Q

Which test evaluates induction of angina

A

Exercise stress test

23
Q

Which test delineates ischemic and infarcted areas of myocardium

A

Radio thallium scan

24
Q

Which two studies provide the most accurate info on the extent of CAD

A

Cardiac catheterization

Coronary angiography

25
Q

When is coronary obstruction physiologically significant on angiography

A

50% narrowed diameter

26
Q

Surgical Tx for CAD

A

Balloon angioplasty with stenting (single vessel disease)

Coronary artery bypass grafting (triple vessel)

27
Q

When is CABG preferred to catheter-based interventions

A

Anatomic considerations like chronic total occlusions, left main stenosis, extensive lesions

28
Q

What is the conduit of choice for CABG

A

Internal mammary artery

29
Q

Which MI complications warrant surgery

A

Ventricular aneurysm, ruptured ventricle, ruptured interventricular septum, mitral valve papillary rupture

30
Q

Which type of heart tumor is most common

A

Metastatic tumor

31
Q

Where do most metastatic heart tumors arise

A

Melanoma, lymphoma and leukemia

32
Q

Tx of cardiac tumors

A

Surgical excision if possible

33
Q

Signs of pericardial tamponade

A

Distended neck veins, hypotension, pulsus paradoxus, distant heart sounds

34
Q

Workup for blunt trauma to the sternum

A

ECG, cardiac enzymes, echocardiogram, cardiac catheterization (if new murmur).

35
Q

What may new murmurs indicate in blunt trauma and what is the tx

A

Valve rupture requiring surgical repair or replacement

36
Q

Tx for pericardial effusion

A

Pericardiocentesis or pericardiostomy

37
Q

How are chronic pericardial effusions managed

A

Pericardiotomy via thoracotomy or sternotomy

38
Q

Possible causes of pericarditis

A

Bacterial, viral infections, uremia, trauma, malignant disease, connective tissue disorders

39
Q

Tx for chronic constrictive pericarditis

A

Pericardiectomy

40
Q

Which first trimester infection may cause congenital heart disease

A

Rubella (togavirus) can cause patent ductus arteriosus

41
Q

What are the signs of congenital heart disease

A

Easy fatigability, poor feeding and weight gain, pulmonary infections, cyanosis

42
Q

What is the best study for congenital heart disease

A

Echocardiography

43
Q

Tx for PDA and indications

A

Ligation of the ductus

in premature infants with pulmonary dysfunction, CHF in first year of life, persistence until age 2-3

44
Q

Headaches, epistaxis, lower extremity weakness, dizziness

A

Symptoms of coarctation

45
Q

Which procedure is used to define the location of coarctation

A

Cardiac catheterization

46
Q

Possible surgical tx of coarctation includes

A

End to end anastomosis
Prosthetic patch graft
Subclavian flap procedure

47
Q

What can occur secondary to uncorrected ASD

A

Pulmonary vascular obstructive disease

48
Q

Systolic murmur in L 2nd intercostal space

Fixed split S2

A

ASD

49
Q

Diagnosis of ASD from cardiac catheterization comes from what observation

A

Step-up in oxygen saturation between VC and right atrium

50
Q

Tx of ASD

A

Surgical closure before school age

Percutaneous closure possible in cath lab

51
Q

What is Eisenmenger’s syndrome

A

Irreversible pulmonary vascular obstructive disease leading to reversal of flow across VSD

52
Q

When is closure of a septal defect necessary

A

When pulmonary blood flow is 1.5-2x greater than systemic blood flow

53
Q

What are the major causes of death in TOF

A

Cerebrovascular accidents and brain sepsis

54
Q

What tx can be performed in TOF before definitive correction

A

A systemic to pulmonary shunt

55
Q

What tx can be performed in TGA before definitive correction

A

Balloon atrial septostomy

To increase mixing of blood

56
Q

Tx of mitral valve regurgitation

A

Annuloplasty

Preferred to valve replacement

Surgery (17 decks)

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