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IPAP > IMC-Final > Flashcards

IMC-Final Flashcards

1
Q

Define Dilated Cardiomyopathy

Idiopathic dilated cardiomyopathy is the MC cause of ?

What will be seen on PE

A

Systolic dysfunction d/t dilation of all chambers and impaired contractility (LVEF <40%)

Indication for cardiac transplant
Heart failure

Megaly Rales S3 gallop JVP

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2
Q

What will be seen on EKG of Dilated Cardiomyopathy

Commonly, ? regurgitation develop and w/ ? risks

What would be seen on CXR

A

LBBB Arrhythmia Sinus tachycardia

MR- Afib
TR- ventricular arrhythmias

Globular megaly (balloon)
CHF
Pleural effusion R>L

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3
Q

Any dilated cardiomyopathy Pt w/ dyspnea needs ? lab drawn

? is the Dx modality of choice for RV dysplasia

When/why would a biopsy be most helpful

A

BNP- establishes prognosis/disease severity

Cardiac MRI

Transplant rejection

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4
Q

How is Dilated Cardiomyopathy Tx

CCBs are avoided and only used if ?

All DM w/ Dilated Cardiomyopathy need to be on ? diuretic

A

Loop ACEI BB
Digitalis for inc contractility

Afib/Flutter

Mineral corticoid antagonist:
Spirinolactone
Eplerenone

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5
Q

What 3 criteria need to be met to use Ivabradine to lower tachy rhythms in Dilated Cardiomyopathy

What medication is tradiationally used more often but is second in line for use

Normally nitric oxide therapy is avoided in AfAm Pts is avoided, however AfAm w/ Dilated Cardiomyopathy may be Tx w/ ? combo drug

A

LVEF <35%
Resting HR >70bpm
Chronic and stable HF

Digoxin- decreases recurrent hospitalizations and Afib rate control

Hydralazine-Nitrate

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6
Q

When can Pts w/ Dilated Cardiomyopathy induced Afib be converted w/ ?

When is ICD placement considered

Dilated Cardiomyopathy Pts are more at risk for ? compared to ischemic Cardiomyopathy Pts

A

Synchronized biventricular pacing if:
QRS >150msec w/ significant MR

Ischemic cardiomyopathy w/ LVEF >30% and on medical therapy

Emboli

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7
Q

Pts w/ Dilated Cardiomyopathy induced Afib should be Tx w/ ? anticoagulant unless ?

? is the MC cardiomyopathy

Half of the time this MC is caused by ? and the other half by ?

A

DOAC;
Warfarin if MS

Dilated- 95%

Idiopathic
Alcoholism

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8
Q

Define Hypertrophic Cardiomyopathy

What causes the outflow obstruction to be worse and causes ? type of dysfunction

What is the end consequence seen in Hypertrophic Cardiomyopathy

A

LV wall >1.5cm/15mm thick on Echo, MC in septal region

Narrowed w/ systole and
Anterior MV leaflet;
Diastolic dysfunction

Elevated LV diastolic pressure

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9
Q

How is Hypertrophic Cardiomyopathy acquired

This can be confused w/ athletic heart, how is it differentiated

Apical Hypertrophic Cardiomegaly is more common in ? populations

A

Autosomal dominant mutated genes of sarcomere/myosin heavy chains/Ca regulating proteins

Athletic heart- no diastolic dysfunction

Asian

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10
Q

What type of Hypertrophic Cardiomegaly seen in older adults is d/t ?

What CXR finding is specific to this type

What are the 3 common presenting Sxs if not sudden death

A

HTN

Sigmoid interventricular septum w/ cardiac knob below aortic valve

Postexertional syncope
Angina
Dyspnea

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11
Q

What is a poor prognostic sign in Hypertrophic Cardiomyopathy w/ elevated LA pressures

What would be seen on PE

? type of valvular murmur is commonly present

A

Afib

Bisferiens carotid pulse
Loud S4
Triple apical pulse
Prominent A-wave: atrial contraction; absent in AFib

MR

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12
Q

What type of murmur does HOCM cause

What causes the murmur to be louder/softer

These maneuvers are done to differentiate HOCm from ?

A

Loud systolic cresc-decresc murmur at LLSB

Inc: upright, valsalva (dec LV volume)
Dec: squat, hand grip, leg raise (inc LV volume)

AS- dec stroke volume= dec murmur
Inc w/ squat
Dec w/ valsalva, standing

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13
Q

? EKG finding is nearly universal in all HOCM Pts w/ Sxs

? EKG finding can mimic MIs

TTE is Dx for HOCM and needed to r/o ? other congenital heart dz

A

LVH

Inferolateral septal Q-waves- 1, aVL, V5-6 and <1 box wide

Ventricular noncompaction- ridges in cardiac walls causing LV to partially fill

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14
Q

? coronary artery issue is seen w/ HOCM

How is this Tx w/ meds

? type of pacing helps Tx these Pts in AFib and prevents progression of hypertrophy/obstruction

A

Arterial bridging- systolic squeezing of arteries

Metoprolol (initial for Sxs)
Verapamil
Dysopyramide (no mono use)
Diuretic

Short AV-delay biventricular pacing

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15
Q

What HOCM Pts are best managed w/ ICD

When is an ICD consideration warranted

How is HOCM Tx surgically

A

Any one of:
Malignant ventricular arrhythmia
Unexplained syncope w/ +FamHx sudden death

Wall thickness of 30mm
Unexplained syncope <6mon
Sudden death, 1* relative

Myotomy-myomectomy w/ Alfieri stitch (considerd best Tx w/ outflow relief)
Alcohol ablation in LCA

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16
Q

What are the indications for HOCM Pt to be considered for transplant

Pregnant Pts have increased issues when pressure gradient passes ?

How are these Pts medically managed

A

Progression to LV dilation
Intractable Sxs

> 50mmHg

Continue BB therapy

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17
Q

What is the next Dx step after a Dx of HOCM is made on Echo

What med classes need to be avoided in HOCM Tx

What drug is c/i in these Pts

A

Ambulatory ECG
Exercise stress test

Dec preload:
Diuretic ACEI Nitro ARBs

Digoxin- increased force will increase obstruction

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18
Q

Define Restrictive Cardiomyopathy

What is the MC cause

Restrictive Cardiomyopathy mimics ? Dx and is differentiated by ?

A

Impaired diastolic filling (MC- LV) d/t infiltrates w/ preserved contractile function

Amyloidosis

Constrictive pericarditis-
ventricular interaction accentuated w/ inspiration (absent in RC, which has inc pulmonary arterial pressure)

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19
Q

What two imaging results is suggestive of Restrictive Cardiomyopathy

? method of imaging can identify amyloid deposition in the myocardium and how is it confirmed

? imaging modality is used as a screening test method or if a Dx by Echo is uncertain

A

EKG w/ low voltage QRS
Echo w/ LVH

Technetium pyrophosphate imaging (bone scan), confirmed w/ biopsy

Cardiac MRI

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20
Q

How is Dx of Restrictive Cardiomyopathy made and w/ ? findings

How is systemic involvement of this condition confirmed

What medication has shown to decrease hospitalizations and improve quality of life

A

Echo w/ cardiac cath:
Normal chamber size
Reduced LVEF

Rectal, Adipose, Gingival biopsy

Tafamidis

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21
Q

What medication needs to be avoided in Tx of Restricted Cardiomyopathy

Why would CCS be used

How is primary cardiac amyloidosis w/out systemic involvement Tx

A

Digoxin- predisposes arrhythmias

Conduction abnormalities

Transplant

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22
Q

? is the MC etiology of Restrictive Cardiomyopathy worldwide

What type of extra heart sound does this condition have

? population is most susceptible to idiopathic Restrictive Cardiomyopathy

A

Tropical Endomyocarditis Fibrosis

S4

Northern European men

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23
Q

? is the MC type of ASD

What is a less common type

This less common type usually also has ? two defects

A

Ostium Secundum in mid-septum

Ostium Primum- lower septum

MV/TV clefts
VSD

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24
Q

? clot issue can occur in the ASD population

What will be heard on PE

ASDs are the ?MC murmur

A

Paradoxical embolization

Wide, fixed split S2 (lub dub-dub) w/out inspiration varying

2nd, after VSDs

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25
Q

ASD can remain ASx until later in life until ? c/c presents

What is seen on EKG

How are ASDs Dx

A

> 30- angina
50- RVF Afib Dyspnea

RAD RVH RBBB

Echo w/ bubble contrast

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26
Q

How are small ASDs Tx

When is surgical closure considered

How do PDAs present

A

<3mm spontaneously close
3-8mm spontaneously close by 3y/o

Mod/large w/ RV volume overload- surgical repair between 2-6y/o

Infant w/ FTT, tachy/tachy and machinery murmur

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27
Q

What causes PDAs

What will be seen on PE

How are these Tx

A

Persistent ductus arteriosus between aorta/PA

Wide pulse pressure w/ low DBP

Premature w/ significant shunt: Indomethicin w/ fluid restriction
Persists- surgical repair

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28
Q

Define VSD

What dictates the degree of shunting

When will a louder murmur be present

A

Left to right shunt d/t patent defect

RV pressure

Greater L-R gradient through smaller shunts

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29
Q

VSD sizes are made by comparing them to ? structure

What type of murmur is created in this defect

If VSD leads to P-HTN, ? valve defect will be present

A

Aortic root

Harsh holosystolic at 3-4LICS w/ systolic thrill

PR

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30
Q

? could cause for a Pt w/ VSD to suddenly present w/ AR and acute HF

VSD is ? MC

VSD that progresses to a R-L shunt is re-Dx as ?

A

VSD high in septum becomes blocked by prolapsed by right coronary cusp of AV

MC pathological murmur of childhood

Eisenmenger Syndrome

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31
Q

What medication is used for VSD induced Eisenmenger Syndrome w/ inc pulmonary pressure

When do VSD Pts need pre-dental prophylaxis from endocarditis

All Pts w/ R-L shunts need to have ? step taken when in he hospital in IV lines

A

Bosentan- endothelial receptor blocker

Residual VSD after patching
P-HTN and cysnosis

Filters to prevent bubbles/debris from becoming systemic

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32
Q

When is a VSD in infants Tx by medicine and surgery indicated

What are the 4 parts of Tetrology of Fallot

What makes this into a Pentad

A

CHF and retarded growth- diuretic and digoxin
Persists- surgery <6mon old

PS RVH Overiding VSD

ASD

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33
Q

? is the name of the procedure to reperfuse lungs w/ Tetrology of Fallot

What two types of abnormal JVP waves may be seen on PE

What will be seen on EKG prior to and after repair

A

Blalock Shunt

Increased A-wave
C-V wave from TR

Prior: RAD, RVH
After: RBBB

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34
Q

What annual screening do Pts w/ Tetrology of Fallot need

What type of spells do infants have

What is seen on CXR

A

EKG- QRS wider than 180msec= inc risk sudden death

Hypercyanotic tet spells

Boot-shaped heart

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35
Q

? is the MC cyanotic congenital heart Dz

What does this sound like on PE

How is an exacerbations and condition Tx

A

Tetrology of Fallot

Harsh mid-systolic ejection murmur at LUSB w/ loud S2

O2, knee to chest, fluid bolus
Morphine sulfate
Propranolol/Esmolol
Surgery

36
Q

What happens if Tetrology is left untreated

Even if repaired, what are four possible complications

What is the classic Coarctation presentation

A

Sudden death by 20y/o-
Sudden cardiac death
HF

HF
Arrhythmia
Residual obstruction
PR

Arm BP > leg BP d/t narrowing distal to L-subclavian artery

37
Q

Half of Coarcation Pts have ? deformity that puts them at risk for ?

? other presentation should signal this Dx

? type of murmur may be heard on exam

A

Bicuspid aortic valve;
Berry aneurysm

Young Pt w/ Secondary HTN induced LVF

Continuous murmur in superior, midline back

38
Q

What is seen on CXR of Coarctation

What is seen on EKG

How is this condition Dx

A

Scalloping/notching of inferior ribs
Figure-3 sign

LVH

Echo w/ Doppler

39
Q

? imaging result indicates intervention is needed for Aortic Coarctation

What happens if this condition is left untreated

What is a common complication seen years after surgical repair

A

Peak gradient >20mmHg

Death <50y/o d/t:
Rupture
Dissection
CVA

HTN d/t permanent changes to RAAS

40
Q

How are Aortic Coarctations Tx

How is this condition Tx in neonates

What are 4 indications for emergent repair

A

Balloon angioplasty w/ stents at 2-4y/o

Prostaglandin E1- keeps dutus arteriossus open to prevent HF/shock

HTN Megaly CHF Shock

41
Q

Coarctation is associated w/ ? genetic abnormality

What are the 3 types of this condition

Define Primary HTN

A

Turners- XO

Preductal: Turners
Ductal: when ductus closes
Post: MC in adults

SBP130/> or DBP80/> on two readings at two appts

42
Q

? is a predominant predictor for CV risk

This loss is specific for ? outcome

? RF places Pt at risk for cerebral hemorrhage

A

Loss of nocturnal BP dip

Thrombotic stroke

Inc morning BP

43
Q

How/why does alcohol cause HTN

How/why does smoking cause HTN

When do HTN screenings begin and w/ ? f/u

A

Inc plasma catecholamines

Inc plasma NorEpi

Start at 18y/o

q12mon: -RF
q6mon: +RF, previous SBP 120-129

44
Q

What are the 4 stages of HTN

How long do Pts needs to rest prior to taking BP

? finding is associated w/ higher mortality and needs work up

A 
ACC/AHA:
<120/80 and <80: normal
120-129 and <80: elevated
130-39 or 80-89: stage 1
140/> or 90/>: stage 2
JNC-8:
<120 and <80: normal
120-139 or 80-89: PreHTN
140-159 or 90-99: Stage 1
160/> or 100/>: Stage 2

> 5min and >30 after ingesting stimulant

> 15mmHg arm difference

45
Q

HTN can cause ? optic PE finding

According to ACC/AHA, when does HTN need Tx

What are the Tx goals according to ACC/AHA and JNC-8

A

AV nicking- arteriole crosses venule causing vein to bulge

All Stage 2
Stage 1 w/ comorbidities

AHA: -/+Comorbidity: <130/80
JNC-8:
<60 w/ CKD/DM: <140/90
60/>: <150/90

46
Q

Na intake limit when Tx HTN

How are non-AfAm or DM Pts w/ HTN Tx

How are AfAm w/ HTN (including DM) Tx and w/ ? Tx goal

A

<2.3g (1tsp)

ACEI/ARB
CCB
Thzd-like: Chlorthalidone, Indapamide

CCB and Thzd w/ goal of <130/80

47
Q

When are BBs c/i in HTN Tx and may cause ? s/e

? medicatioin is particularly indicated for HTN in angina Pectoris

? medication is particularly indicated for HTN in DM w/ proteinuria

A

Asthma; Impotence

CCBs

ACE/ARB

48
Q

HTN Tx where CCB is not tolerated d/t edema needs to be replaced w/ ?

HTN Tx where thiazide diuretic is not tolerated or c/i is replaced w/ ?

S/e and c/i for ACEI use

A

Non-DHP CCB

Spironolactone

Cough, angioedema;
Pregnancy

49
Q

Two s/e of using Hydralazine in HTN Tx

Mild/Mod Primary HTN has ? MC presenting Sx

When should the Dx of Secondary HTN be considered

A

Lupus-like syndrome
Pericarditis

HA

Develops at early age
Develops after 50y/o
Refractory after previously controlled

50
Q

? is the MCC of Secondary HTN

How long can lifestyle modification be used for HTN Tx before medication intervention is indicated

MCC of Cardiogenic Shock

A

Primary Aldosteronism

6mon

Acute MI

51
Q

Define OHOTN

? VS suggests etiology is d/tPOTS

? VS suggests etiology is d/t hypovolemia

? VS suggest autonomic impairment

A

SBP dec >20
DBP dec >10
Both 2-5min after standing from laying

Sxs w/out HOTN

HR inc >100bpm or by >30bpm

HOTN w/out compensatory HR inc by 10bpm/>

52
Q

DM w/ OHTON need ? f/u test

How is OHTON Tx

What meds may be used for Tx

A

Tilt table

Na/fluid increase

Fludrocortisone
Midodrine

53
Q

What Tx therapy is avoided during NSTEMIs

What are the mainstays of Tx

? is the most specific EKG finding for acute coronary syndromes

A

Fibrinolytics

Anti-platelet/coagulation

Dynamic ST-segment shifts

54
Q

ST elevation in aVR suggests ? issue

How long is ASA therapy continued after coronary syndromes

What are the P2Y inhibitors

A

Left main/3-vessel dz

1mon

Clopidogrel/Ticagrelor

55
Q

Pts need to be off of Clopidogrel/Ticagrelor for ? days prior to CABG

What P2Y inhibitor is faster but is also c/i in ? Pts

When is Clopidogrel preferred

A

5 days;
7 days if on Prasugrel

Prasugrel- Hx stroke/TIA

C/i to reveive Ticagrelor/Prasugrel

56
Q

What glycoprotein 2b/3a inhibitors are used for N/STEMIs

Define NSTEMI

What is seen on EKG

A

Tirofiban
Eptifibatide

Myocardial necrosis w/ elevated biomarkers w/out ST elevation/Q-waves

ST depression
T-wave inversion

57
Q

How are NSTEMIs worked up

What markers are used for Dx

What is the next step for NSTEMI/unstable anginaI Pts after Dx

A

Serial cardiac markers q8hrs

Myoglobin:
1-4hrs 12hrs 24hrs
Troponin
2-4hrs 12-24hrs 7-10d
CK/CK-MD:
4-6hr 12-24hr 3-4d

Delayed angiography <48hrs

58
Q

? is the MC used anticoagulation for UA/NSTEMI Tx

What is used if the above MC is c/i

? P2Y12 inhibitor is reversible

A

LMWH

Bivalirudin- if thrombocytopenia is used

Ticagrelor

59
Q

? antithrombotic therapies are administered in conjunction w/ PCI Tx for UA/NSTEMI

? antithrombotic is used for UA/NSTEMI Tx if Factor Xa inhibition is needed

What is the TIMI Risk Score used for and what are the RFs used for scoring

A

G2b/3a:
Tirofiban
Eptifibatide
Abciximab

Fondaparinux

UA/NSTEMI-

FamHx
Smoking
Obesity
DM
Age 
Sex 
High cholesterol
HTN
60
Q

What is are the components of a TIMI score

Timeline for STEMI Tx

A 
3/> considered high, angiography <72hrs:
Age 65/>y/o
Markers elevated
ECG w/ ST-depression
RFs (3/> more CV)
Ischemic pain x 2 <24hr
Coronary stenosis 50/>
ASA use past 7days

PCI <90min
Thrombolytic <120min

61
Q

All STEMI Pts must get ? Rx <24hrs of AMI onset

All N/STEMI Pts need to be started on ? class medication if not already on it

? Fibrinolytics are used for STEMI reperfusion

A

PO BBs
ACEI

Med/High statin

Reteplase
Alteplase
Tenecteplase
Streptokinase

62
Q

? Coronary Syndrome medication has no benefit to mortality

How are NSTEMIs Tx

Define STEMI

A

Nitro, only Sxs

BB Nitro ASA Heparin

Cardiac necrosis w/ Q-waves and ST-elevation

63
Q

Inferior MI is d/t ? vessel and seen ?

Lateral MI is d/t ? vessel and seen ?

Anterior MI is d/t ? and seen ?

Posterior MI is d/t ? and seen ?

Anteroseptal MI is d/t ? and seen ?

A

RCA, MC MI
2, 3, aVF

LCX,
1, aVL, V5-6

LAD,
1, aVL, V1-4

RCA/LCX,
V1-2 ST depression

LAD/septal branch,
V1-3

64
Q

? type of MI is the widow maker

? is the mainstay of STEMI Tx

Absolute c/i to fibrinolytic therapy

A

LAD

PCI: best <3hrs but can be <12hrs from Sx onset

Suspect A-dissection
Active bleeding
Malignant neoplasm
Ischemic stroke <3mon
Cerebral vascular lesion
HTN, cerebral
65
Q

Define Stable Angina

This can be causes by stenosis exceeding ?

Define Bezold-Jerish reflex

A

Predictable chest pain <15min that’s predictable and relieved w/ rest

> 70%

HOTN causing bradycardia and ischemia

66
Q

? transient murmur may be heard during Stable Angina

What is the characteristic EKG finding

? is the MC non-invasive imaging modality to evaluate inducible ischemia in angina PTs

A

MR d/t papillary muscle dysfuction

Reversible horizontal/down sloping ST depression

Stress test, MC w/ Bruce Protocol

67
Q

? Pts w/ angina should not have stress tests

? is a relative c/i for this procedure

? is the Rx of choice for managing acute angina but it’s use may be limited by ? s/e

A

Pain at rest
Pain w/ minimal activity

Sx aortic stenosis

Nitro;
HA

68
Q

Angina Pts taking Nitro need to avoid ? class of medication x 24hrs

? is the only antianginal medication proven to prolong life in Pts w/ coronary dz/post-MI

? medication is used for chronic angina and what is a perk and s/e of use

A

Phosphodiesterase inhibitors

BBs

Ranolazine- safe for use w/ ED meds;
QTc prolongation

69
Q

? chemicals are used for chemical stress test

? medication needs ASAP use during CHF

? causes BNP to be released and also falsely low

A

Dobutamin
Adenosine
Dipyridamole

Bisprolol
ACEI
Metoprolol succinate
Carvedilol

Inc ventricular pressure,
Obesity

70
Q

Pts presenting w/ acute exacerbation of CHF, what drug class is probably used first

HF is a syndrome of ?

Left HF has ? predominant and ? associated Sxs

A

Loops

Ventricular dysfunction

Dyspnea;
Low CO, inc pulm venous pressure

71
Q

Right HF have ? predominant Sxs

? valvular heart Dzs can lead to HF

What are the 4 NYHA HF classifications

A

Fluid retention

Degenerative AS
Chronic AR/MR

1: ASx
2: Sx w/ ordinary activity
3: Sxs w/ mild activity
4: Sxs at rest

72
Q

? is the best method to Dx CHF and w/ ? results

? is JVP measured

Why is BNP released in response to stretched ventricles

A

Echo,
Normal EF 55-60

Pt head at 45*
Measure pulse above sternal notch
Add 5”, >8cm- abnormal

Dec RAAS activation
Inc Na excretion

73
Q

How is Systolic HF Tx

How is Diastolic HF Tx

Since diuretics are the best at relieving HF Sxs, ? one is used w/ GFR <30

A

Loop ACEI BB

ACEI BB/CCB w/out diuretics

Metolazone to 20-30mL/min

74
Q

? are the K sparing agents

What is their MOA

Define Cor Pulmonale

A

Triamterene
Amiloride

Prevent K secretion from distal tubule

RVH/RVF secondary to lung d/o causing pulmonary artery HTN

75
Q

How is Cor Pulmonale Dx

? ER presentation may signal this Dx is present

What are the 5 groups of etiologies for this Dx

A

Right heart cath- gold standard
Echo- showing inc pressure in PA/RV

Angina unrelieved by nitrates

1: PA-HTN
2: heart Dz, MC
3: lung dz/hypoxemia
4: thromboembolism
5: unclear mechanism

76
Q

What are the two etiologies of Aortic Stenosis

? genetic marker has most notable associated w/ AS

AS is ? MC and can coexist w/ ? cardiomyopathy

A

Bicuspid/Unicuspid valve
Degenerative calcification

Notch 1

Surgical valve lesion in developed countries,
Hypertrophic

77
Q

? is the characteristic murmur of Aortic Stenosis

? phenomenon may occur

These Pts present w/ ? c/cs

A

Systolic ejection murmur radiating to neck/apex w/ paradoxically split S2

Gallavardin- high pitch at apex w/ MR sounding murmur

SAD:
Syncope Angina Dyspnea

78
Q

Aortic stenosis w/ aortic ejection sound suggests ?

? abnormal may be seen on lab results

? are the two MC presenting c/cs of Aortic Regurgitation

A

Congenital cause

Helmet cells- schistocytes d/t fragmented RBCs from hitting valve

Fatigue
Exertional dyspnea

79
Q

What will be seen on PE of Aortic Regurgitation

A

Water hammer pulse

Head bobbing- de Musset sign

Nail pulses-Quinckes

Murmur heard in femoral arteries- Duroziez sign

Mid-diastolic murmur- Austin flint

80
Q

When is medical therapy indicated for Aortic Regurgitation

What therapy is recommended

When is surgery indicated

A

SBP >140

Dec after load w/ ARB

Sxs
EF <55mm
End diastolic dimension >55mm

81
Q

MCC of Mitral Stenosis

What do these Pts present w/ as c/c

What is characteristic about the murmurs origin

A

Rheumatic fever

Dyspnea w/ exertion
Hemoptysis

Opening snap- rheumatic origin

82
Q

Pregnant Pts w/ symptomatic MS can be surgically repaired preferably ?

? is the surgical Tx of choice

? anticoagulant do Pts need if Afib develops

A

During 3rd Trimester

Balloon valvuloplasty w/ Maze procedure to prevent arrhythmias

Warfarin w/ INR goal 2.5-3.5

83
Q

What PE findings may be seen during MS

What does MR do to the heart

What is the consequential result

A

Accentuated S1 w/ palpable apex

Inc preload,
Dec afterload

LVH w/ inc EF

84
Q

? evaluation is needed prior to surgical repair of MR

What populations need this

What type of murmur is heard

A

Coronary angiography

Men >40
Menopausal w/ RF

Blowing holosystolic at apex w/ Split S2 and dec S1

85
Q

Two abnormal c/c indicating MR

How is this Tx medicinally

? part of the valve is the MCC of MVP and what syndrome is this if the MC is absent

A

Dyspnea w/ supine
Inc urination at night

Dobutamine
Nitroprusside

Middle cusp of posterior leaflet;
Barlow- multiple cusps prolapse

86
Q

? two heart d/os do Marfans have

How is this Tx

? surgical procedure is done pecutaneously

A

AR+MVP

BB
SSRI- OHOTN/anxiety

Alfieri

87
Q

Stopped on

A

Tricuspid/Pulmonic

IPAP (212 decks)

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