Rapid Review: Cardiology Flashcards
Classic ECG finding in atrial flutter
“Sawtooth” P waves
Definition of unstable angina
Angina that is new, worsening, or occurs at rest. Can have ECG changes but no cardiac enzyme abnormalities
Antihypertensive for a diabetic patient with proteinuria
ACE Inhibitor
Beck’s triad for cardiac tamponade
Hypotension, distant heart signs, and JVD
Drugs that slow heart rate
Beta blockers, calcium channel blockers, digoxin, amiodarone
Hypercholesterolemia treatment that leads to flushing and pruritus
Niacin
Murmur-hypertrophic cardiomypoathy
A systolic ejection murmur heard along the lateral sternal border that increases with decreased preload (Valsalva)
Murmur-aortic insufficiency
Austin Flint murmur–diastolic, decrescendo, low-pitched, blowing murmur that is best heard sitting up; increases with increased afterload (handgrip)
Murmur-aortic stenosis
A systolic crescendo/decrescendo murmur that radiates to the neck; increases with increased preload (squatting)
Murmur-mitral regurgitation
A holosystolic murmur that radiates to the axilla; increases with increased afterload (handgrip)
Murmur–mitral stenosis
A diastolic, mid to late, low-pitched murmur preceded by an opening snap
Treatment for atrial fibrillation and atrial flutter
In unstable, cardiovert. If stable or chronic, rate control with CCBs or Beta blockers
Treatment for ventricular fibrillation
Immediate cardioversion
Dressler’s syndrome
An autoimmune reaction with fever, pericarditis, and increased ESR occurring 2-4 weeks post-MI
IV drug use with JVD and a holosystolic mumur at the left sternal border. Treatment?
Bacterial endocarditis. Treat existing heart failure and replace tricuspid valve.
Diagnostic test of HCM
Echocardiogram
Pulsus paradoxus
A decrease in systolic BP of >10 with inspiration; seen in cardiac tamponade
Classic ECG findings in pericarditis
Low-voltage, diffuse ST segment elevation
Definition of hypertension
BP > 140/90 on 3 separate occasions 2 weeks apart
Eight surgically correctable causes of hypertension
Renal artery stenosis, coarctation of the aorta, pheochromocytoma, Conn’s syndrome, Cushing’s syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism
Evaluation of a pulsatile abdominal mass and bruit
Abdominal ultrasound and CT
Indications for surgical repair of abdominal aortic aneurysm
> 5.5 cm, rapidly enlarging, symptomatic, or ruptured
Treatment for acute coronary syndrome
ASA, heparin, clopidogrel, morphine, O2, sublingual nitroglycerin, IV Beta blockers
Metabolic syndrome
Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states
Appropriate diagnostic test:
- A 50 year old man with stable angina can exercise to 85% of maximum predicted heart rate
- A 65 year old woman with LBBB and severe osteoarthritis has unstable angina
- Exercise stress treadmill with ECG
- Pharmacologic stress test (dobutamine echo)
Target LDL in a patient with diabetes
Signs of active ischemia during stress testing
Angina, ST-segment changes on ECG, or decreased 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 branches), inferior (PDA), posterior (left circumflex/oblique, RCA/marginal), septum (LAD/diagonal)
A 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, and altered mental status
Diagnostic test of PE
Spiral CT with contrast
Reversal for heparin
Protamine sulfate
The coagulation parameter affected by warfarin
Prothrombin time
A young patient with a family history of sudden death collapses and dies while exercising
HCM
Endocarditis prophylaxis regimens
Oral surgery–amoxicillin for certain situations; GI or GU procedures–not recommended
Virchow’s triad
Stasis, hypercoagulability, endothelial damage
The most common cause of hypertension in young women
OCPs
The most common cause of hypertension in young men
Excessive EtOH
Figure 3 sign
Aortic coarctation
Water-bottle-shaped heart
Pericardial effusion. Look for pulsus paradoxus
