Systemic CVD Flashcards
CAD most commonly results d/t which systemic Dz?
DM
What CVD manifestation are you most worried about in your DM pt? What is the pathology behind this problem?
MI/atypical ischemia
DMs have large CAD burden –> more risk of MI
More post-MI complications
What is the MC CVD COD in DM?
CAD
A pt presents with nausea, dyspnea, pulmonary edema, arrhythmias, and syncope. His blood sugar is 300mg/dL. What could this pt be suffering from? What treatment do you recommend?
CV manifestations of DM - MI
Maintain A1C (<7%)
Control dyslipidemia, HTN
Tx CAD (revascularization)
A pt presents with myocardial atrophy, ventricular hypokinesis, decreased pulse pressure, and generalized edema. He appears disheveled and looks like he has been sleeping on the streets. What could be causing his CV sx?
Protein energy malnutrition (PEM)
A pt w/ high homocysteine levels is at an increased risk for what? What can cause high homocysteine?
Atherosclerosis!
D/t Thiamine, B12, & B6 deficiency
A pt presents w/ tachycardia, high output heart failure, a wide pulse pressure, S3, and an Apical systolic murmur. He has a history of alcoholism. What systemic Dz do you suspect is causing his CVD problems?
Thiamine deficiency
A post-gastrectomy pt presents with signs of CVD. Based on his PMH what systemic Dz is she at risk for?
B12 deficiency
A 17 yo female presents w/ tachycardia, high output heart failure, a wide pulse pressure, S3, and an Apical systolic murmur. She is unusually thin and her BMI is 15. What is causing her cardiac sx? How do you treat?
Thiamine deficiency
Replace folate x 3 mo until normal levels reached
A pt presents with HTN, CAD, atherosclerosis, and CHF. He is extremely obese (BMI = 45). What is the pathology behind his CVD? What treatment would most effective for this pt?
Large blood volume –> increased CO –> increased V filling pressure (heart is over-burdened)
Weight reduction!!! Reduce BV, CO, HTN, hypertrophy
A pt presents with sinus tachycardia, palpitations, HTN, anxiety, hyperdynamic precordium, a widened pule pressure, and a loud S1. What systemic Dz do you suspect? What diagnostic tests should you run to confirm?
Hyperthyroidism
Lab tests for TSH & T4
A pt presents with a pericardial effusion, distant heart sounds, and weak arterial pulses. ECG shows low voltage, sinus bradycardia, and a long QT interval. CXR shows a “water bottle” heart and cardiomegaly, What Tx do you recommend?
Hypothyroid CVD
T4, slow progressive (to avoid angina)
What is the MC presenting sx of CVD d/t RA?
Pericarditis (MC)
Valvular vegetation
CHF
A pt presents with pericarditis and CHF. Labs were positive for rheumatoid factor and anti-CCP Abs. What treatment do you recommend for this pt?
RA CVD NAIDS DMARDS Glucocorticoids Urgent pericarditis - pericardiocentesis Constrictive pericarditis - pericardiodectomy
A pt presents with pericarditis, fibrous endocarditis, and atherosclerosis. He has a Hx significant for smoking and SLE. What treatment do you recommend?
Statins
Plaquenil
Smoking cessation, diet & exercise
Control HTN/CHF
What is the pathology behind advanced atherosclerosis that is common in SLE mediated CVD?
Autoimmune attack –> chronic inflammation –> oxidative damage to arteries
Chronic steroid use
A pt presents w/ pancarditis, mitral stenosis, endocarditis, arrhythmias, fever, arthralgia, scarlet tongue, a mitral murmur, and a pericardial friction rub. A few years ago the pt remembers having a really bad sore throat but he never got treated for it. What do you suspect?
CVD d/t Rheumatic Fever
A pt presents with mitral valve disease and a mitral murmur. She has a fever, arthralgia, and a scarlet, maculopapular rash on her trunk. What diagnostic test should you do? How would you treat if the tests are positive?
Throat swab/rapid strep test
ASO or ADB tiger
Treat for strep
A pt presents with pancarditis, endocarditis, fever, arthralgia, chest pain, and an aortic murmur. ECG shows an increased PR interval, and A-fib. Last month he was treated for strep throat, but appears to have failed therapy. What Tx might you recommend?
CVD d/t Rheumatic Fever
Treat GAS or long-term Benzathine PCN
Valve repaired/replacement if Tx fails
Tx HTN, HF, etc.
