Rapid Review Flashcards
Classic ECG finding in atrial flutter
Sawtooth P waves
Definition of unstable angina
Angina that is new, is worsening, or occurs at rest
Antihypertensive for a diabetic patient with proteinuria
ACEi
Beck’s triad for cardiac tamponade
Hypotension
Distant heart sounds
JVD
Drugs that slow HR
B-blockers
CCBs
Digoxin
Amiodarone
Hypercholesterolemia tx that leads to flushing and pruritus
Niacin
Murmur - HOCM
Systolic ejection heard along lateral sternal border that increases with lower preload (Valsalva)
Murmur - AR
Austin Flint murmur
Diastolic, decrescendo low-pitched blowing murmur that is best heard sitting up.
Increases with increased afterload (handgrip maneuver)
Murmur - AS
Systolic crescendo/decrescendo murmur that radiates to the neck
Increases with increased preload (squatting maneuver)
Murmur - MR
Holosystolic murmur that radiates to the axilla
Increases with increased afterload (handgrip)
Murmur - MS
Diastolic, mid-to-late low pitched murmur preceded by an opening snap
Treatment for AFib and AFlutter
If unstable, cardiovert
If stable or chronic, rate control with CCBs or B-blockers
Tx for VFib
Immediate cardioversion
Dressler’s Syndrome
An autoimmune reaction with fever, pericarditis, and increased ESR occurring 2-4w post MI
IV drug use with JVD and a holosytolic murmur at the L sternal border. Tx?
Treat existing heart failure and replace the tricuspid valve.
Diagnostic test for hypertrophic cardiomyopathy
Echo (showing thickened LV wall and outflow obstruction)
Pulsus paradoxus
A decrease in systolic BP of more than 10 mmHg with inspiration
Seen in cardiac tamponade
Classic ECG findings in pericarditis
Low-voltage, diffuse ST segment elevation
Definition of HTN
BP above 140/90 on 3 separate occasions 2 weeks apart
8 surgically correctable causes of HTN
1) Renal artery stenosis
2) Coarctation of the aorta
3) Pheochromocytoma
4) Conn’s Syndrome
5) Cushing’s Syndrome
6) Unilateral renal parenchymal disease
7) Hyperthyroidism
8) Hyperparathyroidism
Evaluation of a pulsatile abdominal mass and bruit
Abdominal US and CT
Indications for surgical repair of AAA
Greater than 5.5 cm
Rapidly enlarging
Symptomatic
Ruptured
Tx for ACS
ASA Heparin Clopidogrel Morphine O2 Sublingual Nitro IV B-blockers
Metabolic syndrome
Abdominal obesity
High TGs
Low HDL
HTN
Insulin resistance
Prothrombic or proinflammatory states
Appropriate diagnostic test?
1) 50 yo M with stable angina can exercise to 85% of maximum predicted HR
2) 65 yo F with LBBB and severe osteoarthritis has unstable angina
1) Exercise stress treadmill with ECG
2) Pharm stress test (dobutamine echo)
Target LDL in patient with diabetes
Less than 70
Signs of active ischemia during stress testing
Angina
ST segment changes on ECG
Lower BP
ECG findings suggesting MI
ST segment elevation (depression means ischemia)
Flattened T waves and Q waves
Coronary territories in MI
Anterior wall (LAD/Diagonal)
Inferior (PDA)
Posterior (L circumflex/oblique, RCA/marginal)
Septum (LAD/diagonal)
Young patient with angina at rest and ST segment elevation with normal cardiac enzymes
Prinzmetal’s angina
Common symptoms associated with silent MIs
CHF
Shock
AMS
Diagnostic test for pulmonary embolism
Spiral CT with contrast
Protamine
reverses effects of heparin
Prothrombin time
Coagulation parameter affected by warfarin
Young patient with FHx of sudden death collapses and dies while exercising
Hypertrophic cardiomyopathy
Endocarditis ppx regimens
Oral surgery - amoxicillin for certain situations
GI or GU procedures - not recommended
Virchow’s triad
Stasis
Hypercoagulability
Endothelial damage
Most common cause of HTN in young women
OCPs
Most common cause of HTN in young men
Excessive EtOH
Figure 3 sign
aortic coarctation
Water-bottle shaped heart
Pericardial effusion. Look for pulsus paradoxus
