JB Cardio Flashcards
AAA dx
Initial: abdominal US
Gold standard: Angiography
AAA PE
Smoker
Rupture: palpable pulsatile mass. Sudden severe constant back/flank/abd/groin pain and/or shock
Acute MI tx
Fluids, O2, ASA, NTG, BB, ACE, statin, anticoag, anti-platelet
Acute anterior MI EKG
ST elevation V1-V4
ST depression in 2 other contiguous leads
Antiarrhythmics AE (amiodarone)
Amiodarone: optic neuritis, thyroid dz, hepatitis, pulmonary fibrosis (eye, thy, liver, lung)
Na channel blocker OD: wide complex QRS
Thoracoabdominal aneurism tx
BB (labetalol)
Angina tx
Stable: Nitro/ BB/ CCB
Unstable: MONA
Aortic aneurism tx
BB, statin, daily low dose aspirin, plavix
anticoags
surgical revascularization <5cm
Aortic stenosis tx
aortic valve replacement
Complete heart block tx
Definitive: permanent pacemaker
PSVT tx
Vagal w/ maneuver or adenosine
Vfib tx
CPR and defibrillation (unsynchronized cardiovert)
VTach tx
Stable: amiodarone, lidocaine, procainamide
Unstable w/ pulse: synchronized cardiovert
No pulse: unsync cardiovert + CPR
Torsades: IV mag
Torsade’s de Pointes tx
IV magnesium sulfate
Afib tx
BB/CCB
Anticoag
Convert (pharm or electro)
ASD murmur
Systolic ejection crescendo decrescendo murmur @ LUSB.
Widely fixed split S2 that does not vary with respiration
Cardiac arrest tx
CPR
Defib if VTach or VFib
Cardiac Tamponade PE
Beck’s triad: JVD, muffled heart sounds, hypotension
Pulsus paradoxus
Cardiogenic shock tx
Emergent ECHO O2, isotonic fluids Inotropes Pressors ICU
Coarctation of aorta PE
Child w/ secondary HTN, bilateral lower extremity claudication, systolic murmur radiates to back/scapula or chest.
Systolic BP upper extremities > lower extremities
Delayed/weak femoral pulses
CXR: rib notching/ figure 3 sign
Coarctation of aorta tx
Surgery
CHF sx
Left: S3, rales (LUNG)
Right: JVD, ascites, edema (ROADS)
CHF sx
Left: S3, rales (LUNG)
Right: JVD, ascites, edema (ROADS)
CHF tx
Acute: LMNOP (lasix, morphine, nitro, O2, position/bipap)
Chronic: ACE/ARB, BB
CAD Dx
EKG –> stress test –> angiography (gold standard)
CAD tx
Stent or CABG
Dilated cardiomyopathy tx
HF tx: ACE, diuretics, BB, digoxin, AICD, heart transplant
Dissecting aortic aneurism dx
CT w/ contrast
MRI angiography (gold standard)
CXR: widened mediastinum
Dresslers syndrome tx
Aspirin or colchicine
Endocarditis tx
vancomycin
prophylaxis: amoxicillin DOC (clindamycin if penicillin allergy)
endocarditis dx
blood culture
EKG
Echo
Labs: increased ESR/RF
Giant cell arteritis dx
Clinical dx. increased ESR >100.
Temporal artery bx
Giant cell arteritis tx
high dose corticosteroids
HOCM tx
BB 1st line
surgical myomectomy
alcohol septal ablation
ICD placement
Kawasaki sx
Asian children
“warm + CREAM”: fever with 4/5 –> conjunctivitis, rash, extremity changes (arthritis), adenopathy, mucus membranes (strawberry tongue)
PDA PE
L to R shunt (non cyanotic)
continuous machine like murmur loudest @ LUSB.
wide pulse pressure, bounding pulses
PAD tx
cilostazol
PAD sx
Pale on elevation, ulcers on toes and points of trauma (lateral malleolus), thin shiny skin, hair loss, cool limbs, decreased/absent pulses
Raynaud’s tx
CCB (dihydro) nifedipine
Renal artery stenosis dx
CT/MRA/US
Renal arteriography gold standard (dont use if renal failure present)
Rheumatic fever MCC
Group A beta hemolytic strep
STEMI tx
repercussion therapy (PCI/ thrombolytics)
antithrombotics
Adjunct: BB, ACE, nitrates, morphine, statin, electrolyte replenish
superficial thrombophlebitis tx
Aseptic: NSAIDS
Septic: PCN + gentamicin
Tetrology of fallot sx
Cyanotic, RVH, VSD, overriding aorta
CXR: boot shaped heart
WPW tx
stable: vagal –> procainamide
Unstable: synchronized cardiovert
Radiofrequency ablation: definitive