High Yield Cardio

Question 1

Aortic Stenosis

Answer 1

Calcific degeneration AGE!!
Bicuspid (notch1) nodules as base 
Crescendo decrescendo systolic murmur 
ANGINA, SYNCOPE, DOE 
LVH

Question 2

Aortic Regurg

Answer 2

diastolic decrescendo 
HYPERTENSION, age 
Widened pulse pressure 
DYSPNEA, FATIGUE, Diminished Exercise Tol
DCM

Question 3

Mitral Regurg

Answer 3

High pitched holosystolic (apex, trill) 
Myxomatous Degeneration, MVP 
Ischemic 
RF 
DCM (LA) -> incre PCWP

Question 4

Mitral Stenosis

Answer 4

ARF - fish mouth valve (99%)
low diastolic rumble
DCM (LA)

Question 5

Tricuspid valve

Answer 5

IVDU or RF

Question 6

Myocarditis

Answer 6

VIRAL: coxsackie 
ARF - aschoff body 
Dipheria (exotoxin) 
Lyme (immune complexes) 
Chagas ( accumulation but no damage) 
ADRIANMYCIN- vacuolization, myeline figures 
Sarcoid, Giant cell, hemochromatosis

Question 7

Endocarditis

Answer 7

RF- vegetations on closure line + subendothelial thickening
Infective - bulky, friable, flow surfaces 
inflammation and necrosis 
NBTE- vegetations on closure line 
not destructive. Systemic Emboli!
LSE- (SLE) veg on mitral valve-> regurg 
Carcinoid heart disease (liver met) 
Loeffler- eosinophils

Question 8

Pericarditis

Answer 8

UREMIA 
Viral: Coxsackie, Echo 
Dressler's Syndrome or Post MI 
SLE inducing drugs: hydralazine, procainamide
DIFFUSE ST ELEVATION 
Positional pain, Parastern Rub

Question 9

Targets of neurohormonal abnormalities in HF

Answer 9

NE
Angiotensin II
Aldosterone

Question 10

DCM

Answer 10

ALCOHOL
genetic (ie. ARVC plakoglobulin genes for desmosomes)
hemochromatosis
Tako Tsubo

Question 11

HCM

Answer 11

Disarray of myofilaments
Harsh systolic murmur
GENETIC - B myosin HC MYH7
Myosin binding protein

Question 12

RCM

Answer 12

Amyloidosis (Ig LC, Transthyretin, Amyloid A)

Sarcoid

Question 13

Left to Right Shunts

Answer 13

Pulmonary Hptn
VSD - fetal alcohol, delayed onset murmur
ASD- 2-foramen ovale, 1-downs
PDA- Rubella, machine like murmur, cyanosis of legs later in life
AVSD- endocardial cushion failure, downs

Question 14

Right to Left Shunt

Answer 14

EARLY CYANOSIS 
Trunc: failure septation, VSD present 
Trans: PDA to stay alive! 
Tri: hypOplasia of RV. need ASD or VSD
Tetra: Pulm sten, RVH, Over aorta, VSD
Tot: HCM of R and hypo of LA. ASD

Question 15

Coarctation of Aorta

Answer 15

Turners (XO), bicuspid aortic valve
Infantile: hptn upper, blue lower
Adult: hptn upper (collateral), low BP LE

Question 16

Unstable Angina

Answer 16

DAMAGED/RUPTURED PLAQUE
@rest
90% critical stenosis

Question 17

Stable Angina

Answer 17

75% critical stenosis

exercise induced

Question 18

Ischemic worries….

Answer 18

#1 Arrhythmia 
#2 Rupture 
#3s Aneurysms, thrombus, emboli