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