PANCE- Cards Flashcards
? is the MC form of cardiomyopathy
This MC is a ? type of dysfunction
What PE finding is the hallmark for this MC
Dilated, involving all four chambers
Systolic
S3 gallop
Dilated cardiomypathy is the MCC of ?
What are the two MCCs of dilated cardiomyopathy
What will CXR show
Transplant
Idiopathic > Alcohol (B1 thiamine deficient)
Balloon-heart: megaly w/ pulm congestion
How is dilated cardiomyopathy Tx
What med is used to increase contractility
What are the indications for ICD
Loop ACEI BB Spironolactone
Digitalis
EF <35%
HOCM is ? type of dysfunction
How does this condition develop
What will be seen/heard on PE
Diastolic
Autosomal dominant sarcomere defect
S4 w/ apical lift, Prominent A-wave
HOCM is made softer by ?
HOCM is made louder by ?
What meds are used upon Dx
Inc venous return/preload: squat/hand grip
Dec venous return: stand, valsalva
Metoprolol and/or Verapamil to dec contractility and HR
What meds are avoided in HOCM
What med is c/i
When are ICDs considered
Dec preload: ACEI/ARB Nitrate Diuretic
Digoxin- inc contraction worsens obstruction
Syncope, Sudden arrest
HOCM is the MCC of young athlete death d/t ?
? surgical procedure is used for Tx
What non-surgical procedure is used for Tx
V-Fib
Myomectomy- young Pt refractory to meds
Alcohol septal ablation
Define Restrictive Cardiomyopathy
What side of the heart is MC affected
What is the MCC
Resistance to diastolic filling
L > R
Amyloidosis, half are idiopathic
What PE finding may be seen w/ Restrictive Cardiomyopathy
What would be seen on Dx Echo
What would be seen on lab results if etiology was from Amyloidosis
Kussmaul’s: inc JVP w/ inhalation
Atrial dilation w/ diastolic dysfunction
Apple-green birefringence w/ Congo-red stain
How is restrictive cardiomyopathy Tx
Define Myocarditis
What two other manifestations can this present w/
Diuretic- congestion
Chelation- hemochromatosis
GCCS- sarcoidosis
Inflamed heart muscle MC from Coxsackie B leading to SHF Sxs
Pericarditis, Megacolon
How is Myocarditis definitively Dx
How is it Tx
How do R/L atrial enlargements appear on EKG
Endomyocardial Biopsy
Loop ACEI BB
L: M-shape in lead 2 w/ large terminal part
R: P-wave >3mm in lead 2 w/ larger initial part
R/L VH EKG characteristics
Two MC Peds murmurs
MC type of ASD
R: R>S or >7mm in V1
L: V1-S+V5-R= >35mm
MC: Stills
MC continuous: cervical venous hum
Ostium secundum
How do ASDs present on PE
What EKG sign can these show
When do these need surgical interventions
Wide, fixed split S2 w/out inspiration variance
Crochetage: notchig at peak of R wave in inferior leads
> 1cm/Sx/Volume overload- closed at 2-4y/o
ASDs are definitively Dx by ? but ? is best
Define PDA
? does this sound like on PE
Cardiac cath, Echo is best test
Patent ductus arteriosus between aorta and Pulm Artery
Bounding pulse,
Machinery murmur, Wide pulse pressure, Low DBP
How are PDAs Dx
What two factors allow these to remain patent after birth
How are these Tx in premature infants
Initial: Echo
Best: cardiac cath
Prostaglandin E1 production, Low arterial O2 content
Indomethacin + fluid restriction
MC congenital heart Dz of childhood
When are medical interventions indicated
Define Katz-Watchel Phenomenon
VSD- MC type is perimembranous
HF, Growth retardation= Digoxin+Diuretics
VSD EKG finding w/ RVH+LVH
Coarctation of Aorta MC occurs where
What are the two types
Older Pts may present w/ ? c/c
Insertion of Ductus Arteriosus distal to LSV origin
Post-duct: adult, narrowing distal to arteriosum
Pre-ductal: infant, narrowing proximal to arteriosum
Bilateral claudication
Gold standard to Dx Aortic Coarctation
Best confirmatory test
? is used pre-op for Tx
Angiography
Echo
Alprostadil- Prostaglandin E1
What are the 4 indications for emergent coarcation correction
Four parts of Tetrology
Why is this the only cyanotic heart Dz on blue print
HTN Megaly CHF Shock
PS RVH Overiding VSD
R-L shunt through VSD
Define Tet Spell
Tetrology of Fallot is associated w/ ? chromosome deletion
MCC of essential and secondary HTN
Hypercyanotic episode d/t inc systemic pressures
Chrom 22
E: Idiopathic, S: renovascular
Preferred, initial management of newly Dx HTN
MCC of cardiogenic shock and unique fact about Tx
How is Cardiogenic Shock Dx
WADE:
Weight loss Alcohol ≤2/d, ≤1/d DASH diet, Exercise ≥30min/day
Acute MI; only time Tx of shock does not use large amounts of fluids
Pulmonary wedge pressure >15mmHg
First line medical Tx for O-HOTN
What two meds can be added if additional therapy is needed
MCC of Acute MI
Fludrocortisone
Midodrine: alpha agonist
Droxidopa: pressor
Atherosclerosis
AV node received blood supply from ?
What is the Triad of an RV infarct
Door to EKG, PCI and Thrombolytics
RCA= during MI, brady/heart block
JVP w/ Clear lungs and Kussmaul sign
EKG: <10min
Thrombo: <30min
PCI: <90min
