Internal med cardiology Flashcards
angina pectoris
stable, predictable chest pain that occurs when the heart is under stress
treatment of stable angina
goes away with rest and NTG
Diagnosis of stable angina
- EKG is the initial test of choice, but can often be normal (could show ST depression)
- stress testing is the best noninvasive test
- coronary angiography is definitive
etiology of infectious myocarditis
MC viral and bacterial
presentation of myocarditis
- SOB
- CP
- fever/chills
- pericardial friction rub
- tachycardia
- heart failure
diagnosis of myocarditis
- echo
- biopsy
treatment of myocarditis
- consult cardiology
- NSAIDs
- ACEI/BB
etiology of noninfectious myocarditis
- meds
- drugs
- toxic substances
MCC of HF
ischemic cardiomyopathy
presentation of ischemic cardiomyopathy
systolic HF
diagnosis of ischemic cardiomyopathy
echo
management of ischemic cardiomyopathy
- revascularization
- defibrillator
etiology of dilated cardiomyopathy
- idiopathic
- viral
- bacterial
- genetic
presentation of dilated cardiomyopathy
- HF
- arrhythmias
diagnosis of dilated cardiomyopathy
- BNP
- echo
treatment of dilated cardiomyopathy
- CHF management
- defibrillator
presentation of HCM
- CP, syncope, SCA
- murmur louder with valsalva
diagnosis of HCM
echo
management of HCM
- BB
- septal ablation
what should be avoided in HCM?
diuretics and vasodilators
etiology of restrictive cardiomyopathy
- amyloidosis/sarcoidosis
- radiation
presentation of restrictive cardiomyopathy
RHF
diagnosis of restrictive cardiomyopathy
- echo/cardiac MRI
- biopsy
treatment of restrictive cardiomyopathy
- treat underlying cause
- diuretics
etiology of infective endocarditis
staph aureus
s/s of infective endocarditis
- fever/chills
- night sweats
- murmur
- petechiae or splinter hemorrhages
- janeway lesions
- osler nodes
- roth spots
MC affected valve in endocarditis in IVDU
tricuspid
if a young patient has a stroke, suspect …
endocarditis
major criteria of endocarditis
- positive blood cultures
- evidence of involvement on echo
- murmur
minor criteria of endocarditis
- IVDU
- fever
- vascular sx
- immunologic sx
- single positive blood culture
diagnosis of endocarditis
- 2 major criteria
- 1 major and 3 minor
- 5 minor
management of endocarditis
- native valve: pen G, gent, vanc
- IVDU: naf, gent, vanc
- prosthetic valve: rifampin, gent, vanc
Endocarditis prophylaxis
amoxicillin for oral procedures, I&D, respiratory procedures
diagnosis of HTN
stage 1: 130-139/80-89
stage 2: >140 or >90
how to determine if patients need HTN drugs?
- if stage 1: assess ASCVD risk and if over 10%, then treat
- if stage 2: treat
management of HTN
- non AA: thiazide, ACE/ARB, CCB
- AA: thiazide or CCB
indications for statin therapy
- prior ASCVD
- LDL over 190
- age 40-75 with DM and LDL>70
- age 40-75 without ASCVD or DM, whose LDL is 70-189 and ASCVD is >7.5
if prior ASVCD…
high intensity statin
if LDL is over 190…
high intensity statin
if 40-75 and DM and LDL>70…
- medium intensity statin
- high intensity if over 50 and multiple risk factors
etiology of pericarditis
viral
s/s of pericarditis
- CP worse when laying on back
- friction rub
- fever
- diffuse ST elevation
diagnosis of pericarditis
- EKG
- echo
treatment of pericarditis
NSAIDs
major manifestations of rheumatic fever
- carditis
- polyarthritis
- chorea
- erythema marginatum
- sq nodules
minor manifestations of rheumatic fever
- prior rheumatic fever
- polyarthralgia
- fever
- leukocytosis
- evidence of strep infection
treatment of rheumatic fever
- PCN G
- ASA or NSAIDs
