palpitations, arythmias, HF, syncope Flashcards
NYCA 1
asymptomatic
NYCA 2
symptoms with activity, comfortable at rest
NYCA 3
symptoms with less than normal activity, comfortable at rest
NYCA 4
Severe symptoms- present at rest
management of patients with chronic HF with PRESERVED ejection fraction?
Monitor EF with regular echos
management of asymptomatic patients with reduced EF
ACEi + beta blocker
ICD if EF < 30%
management of symptomatic patients with reduced EF
- diuretics
- ACEi, beta blocker,
- ICD for certain patients
Treatment of primary pneumothorzx with symptoms or > 2 cm?
aspirate or drain
Treatment of primary pneumothorax < 2cm and asymptomatic?
discharge
Secondary pneumothorax > 2 cm?
drain
secondary pneumothorax 1-2 cm
aspirate
secondary pneumothorax <1 cm
oxygen and observe
indications for valve replacement in aortic stensosi?
- symptomatic patient
- gradient > 50 mmHg
- < 1 m area
OTHERS
- getting mitral valve replacement
- severe LV dysfunction
- CABG/aortic root surg
what is mild aortic stenosis?
Gradient < 25 mmhg
-area > 1.5
what is moderate aortic stenosis?
- gradient 25-40
- area 1 - 1.5
what is severe aortic stenosis
- gradient > 40
- area < 1
where is the apex in mitral regurg?
inferiorlateral
and is forceful or thrusting
heart sounds in MR?
- soft S1
- loud P2
- S3
indications for valve repair in mitral valve regurg?
- symptomatic patient
- NYHA III-IV
- EF falling < 60% rapidly
- LV end-systolic dimension > 45 mmHg
mild mitral regurg?
regurg volume < 30ml or < 30%
mod mitral regurg?
regurg volume 30-60ml or 30- 50%
severe mitral regurg?
regurg volume > 60 ml or > 50%
monitoring for mild MR
yearly checkup
monitoring for moderate MR
yearly checkup, yearly echo
monitoring for severe MR
6 mo exam, history and echo
a big V wave is seen with which murmur
tricuspid regurg
parasternal heave occurs with which murmur
tricuspic regurg
diagnostic criteria for infective endocarditis?
Blood culture + atleast twice
Echo shows endocardial involvmenet
Fever Evidence from microbiology Vascular phenomenon Evidence from immunology Risk factors
Abs for infective endocarditis?
Vancomycin and gentamycin
which type of valve replacement does not require warfarin?
bioprosthetic or tissue valve
which type of valve replacement DOES require warfarin?
metallic
Someone with a metalic aortic valve replacement has an early diastolic murmur. What does this indiacte?
A failing valve
HFrEF ?
HF with EF < 40%
HFmrEF?
EF 40-49%
HFpEF?
EF > 50%
