Miscellaneous Flashcards
Beck’s Triad
Muffled heart sounds
Hypotension
Inc JVP
(Cardiac Tamponade)
MC type of murmur
Midsystolic soft murmurs
Murmurs necessitating 2D echo
Loud systolic Holosystolic Late systolic All diastostolic Continuous murmurs
Malar telangiectasia is a cutaneous manifestation of which CVD
Severe MS
Peripheral edema + Normal venous pressure
Venous insufficiency (MCC) Lymphatic obstruction Venous obstruction
> 10mmHg decrease in SBP with inspiration
Pulsus paradoxus
seen in: pericardial effusion, cardiac tamponade, massive PTE, hemorrhagic shock, severe COPD, tension pneumothorax
Slow, notched or interrupted upstroke
Anacrotic pulse (Pulsus parvus et tardus)
*aortic stenosis
Cardiac cycle with two systolic peaks
Bifid/Bisferiens pulse
AR and HCMP
Normal BP difference between arms
<10mmHg
legs: <20mmHg
High BP differentials
Aortic dissection
Atherosclerotic or inflammatory subclavian artery disease
Supraclavicular AS
CoA
Reversed split S1
LBBB
Severe MS
LA myxoma
Wide split s2
RBBB
Severe MR
Associated with click sound
MVP
Pericardial knock
Constrictive pericarditis
Opening snap
Mitral stenosis
Increases the murmur of MVP and HOCM
Standing
Valsalva or coughing
Decreases the murmur of MVP and HOCM
Squatting
Passive leg raising
Handgrip exercise
Early diastolic murmurs
Aortic regurgitation
Pulmonic regurgitation
RAE on ECG
Tall peaked P waves (>/=2.5 mm) in limb and precordial leads
LAE on ECG
Biphasic P wave in limb leads or notched in limb leads
LVH on ECG
RV5 or RV6 >25mm
SV1 + RV5 or V6 >/=35mm
RVH on ECG
R>S on V1 with RAD or
R, RS, qR pattern in V1 or
ST depression and T wave inversion in the right to midprecordial leads
Triggered automaticity secondary to afterdepolarizations during and action potential
Torsades de pointes
Delayed afterdepolarizations
Digitalis toxicity
Reperfusion VT
Tacchyarrhythmia occuring primarily among patients with chronic pulmo disease
Multifocal atrial tachycardia
Drug-induced Mobitz Type 1
B blockers
Non Dihydropyridines
MC tachycardia caused by an acessory pathway
AV reentry tachycardia (AVRT)
*orthodromic
MC antidromic AV reentry
Preexcited tachycardia
CHA2DS2-VASc
CHF HPN Age: 75=2 DM Stroke Vascular Disease Age: 65-74=1 Sex female
Most frequent site of origin of idiopathic ventricular arrhythmias
RV outflow tract
Configuration of RV outflow tract ventricular arrhythmias on ECG
LBBB with inferior frontal axis
ICD placement in high-risk survivors of AMI
> 40 days after AMI and LVEF = 0.3 or EF = 0.35 + SYMPTOMATIC HF (FC II-III)
> 5 days after AMI + LVEF, nonsustained VT and inducible sustained VT or VF on electrophysiologic testing
Vtach + CAD
Occurs in the setting of a large prior MI with markedly depressed LVEF
DOC for Torsades de pointes
IV MgSO4
Highest risk for Torsades de pointes
Sotalol
First line treatment of symptomatic idiopathic VT
Catheter ablation
Can present with either preserved or depressed EF
CAD
HPN
PE finding which is an indicator of severity of hemodynamic compromise in heart failure
Presence of S3
Most useful index of LV function
Ejection Fraction
Role of exercise stress testing in patients with heart failure
Assess need for cardiac transplantation in advanced HF
*<14ml/kg/min peak O2 uptake, better survival
First principle of management of acute decompensated HF
Identify and address any precipitant
Worse outcomes for acute decompensated HF
BUN >43 mg/dL
Elevated trop I
Crea >2.75 mg/dL
SBP <115 mmHg
BECS
Cornerstone therapy of HFrEF
BBlockers
ACEI
Principal determinant of the clinical course, manifestations and feasibilitynof repair of VSD
Pulmonary vascular bed
Tetralogy of Fallot
VSD
RV outflow tract obstruction
RV hypertrophy
Aortic overriding the VSD
Downward displacement of TV into the RV
Ebstein anomaly
Midsystolic murmur, low-pitched, rasping, best heard at the 2nd right ICS radiating to the carotid arteries
Aortic Stenosis
Murmur not seen in AF
S4
Systolic murmur with cooing or “sea gull” quality
Ruptured chordae tendineae
MC valvular involvement in carcinoid syndrome
Pulmonic valve
Drug useful across all types of most common valvular heart diseases
Diuretics
Diagnostic criteria of myocarditis
Dallas criteria
lymphocytic infiltration with evidence of myocyte necrosis
CMP in amyloidosis
Restrictive CMP
Earliest symptom of most cardiomyopathies
Exertional intolerance due to inadequate cardiac reserve during exercise
Characteristic feature of restrictive CMP
Predominant right-sided congestive symptoms
4 principal features of acute pericarditis
Pericardial effusion
Characteristic chest pain
Characteristic ECG changes
Presence of pericardial friction rub
Murmur associated in ankylosing spondylitis
AR
Clinical manifestations in ASD
Angina
Syncope
Dyspnea
*Death in 1-2 years
Characterisitic PE findings of TR
Hepatomegaly with pulsations
Effectivity of diuretics in volume overload
Weight loss of 4.5 kg in 5 days
*if with resistance add thiazides
AF in acute alcohol intake
Holiday heart syndrome
Best describes the chest pain of acute pericarditis
Severe retrosternal often pleuritic and referred to the back and left trapezius
First line treatment of acute idiopathic pericarditis
Aspirin
If unresponsive: Colchicine
MC primary malignant tumor of the heart
Sarcoma
Ca with highest risk of cardiac metastasis
Malignant melanoma
2 causes of renovascular hypertension
Atherosclerosis Fibromuscular dysplasia (MC: medial)
MC congenital cardiovascular cause of hypertension
Coarctation of the aorta
MC form of SVT
Atrioventricular Nodal Reentrant Tachycardia (AVNRT)
McGinn-White sign
S1Q3T3 in Pulmo Embolism