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72 Cards in this Set

  • Front
  • Back
silent MIs often occur in
diabetic patients
criteria for family history of CAD
MI before age 40 in men
MI before age 55 in women
max heart rate =
220 - patient's age
inferior wall MI on EKG
ST elevation in II, III, and avF
cor pulmonale on EKG
ST depression in II, III, and avF
anteroseptal MI
ST elevation in V1, V2, and V3
lateral wall MI
ST elevation in V4, V5, and V6
Posterior wall MI
ST depression in V1 and V2
heparin does not
dissolve clots already present;
rather, it prevents future ones from forming
LMW heparin is given
SubQ every 12 hrs
PT/PTT does not need to be checked
is highly immunogenic
can't be used in the same pt twice within a 6 month period
58 y/o man who was discharged from the hospital after MI 2 weeks ago presents with fever, chest pain, and generalized malaise. EKG shows diffuse ST-T wave changes. Think:
Dressler's syndrome
treat with NSAIDs
a 62 y/o smoker presents complaining of 3 episodes of severe heavy chest pain this morning. Each episode lasted 3 to 5 minutes, but now he has no pain. He has never had this pain before. Think:
unstable angina
A 62 year old man presents with frequent episodes of dull chest pain on and off for 8 months. He says the pain wakes him from sleep. Think:
prinzmetal's angina
coronary vessels are angiographically normal
CO =
diastolic dysfunction
accounts for 40-60% of heart failure
signs/symptoms of heart failure with normal EF
more common in women
ass. with HTN, left vent. hypertrophy, dilated cardiomyopathy, and ischemia
treat the HTN
most common cause of RHF is
rule of 1/3s for viral or pregnancy-induced dilated cardiomyopathy
1/3 get worse
1/3 stay the same
1/3 improve
RHF vs. cirrhosis
signs are similar
pts with cirrhosis usually do not have trouble lying flat and will not have JVD
1st line therapy for acute pulmonary edema
restrictive cardiomyopathy vs. constrictive pericarditis
do biopsy
causes of paradoxical splitting (P2 occurs before A2)
conditions that delay LV empyting
hypertrophic cardiomyopathy
aortic stenosis
very few murmurs decrease with squattin
hypertrophic CM does
most common cause of viral myocarditis
Coxsackie B
pulsus paradoxus
transient fall in measure BP > 10 mm Hg ass. with inspiration (due to reached SV during inspiration)
tamponade physiology
during inspiration, venous return to the RA increases. in tamponade, the transiently enlarged RA bulges leftward, reducing left ventricular volume and output, causing BP to fall with inspiration
pericardiocentesis yielding clotting blood probably came from
the RV, not the pericarial sac
Kussmaul's sign
failure of jugular venous pressure to fall during inspiration
dilation of the LV is a major cause of
balloon valvuloplasty in mitral stenosis
is an effective intervention; it has a low incidence of restenosis, in contrast to aortic stenosis
patient with mitral regurg has a good prognosis if
LV function is preserved
a young woman presents with atypical chest pain and mid-systolic click. Think:
mitral valve prolapse
Mean survival for patients with aortic stenosis and:
Angia -->
Syncope -->
Heart Failure -->
Angina --> 5 years
Syncope --> 2-3 years
HF --> 1-2 years
LV strain pattern on EKG
ST segment depression and T wave inversion in I, avL, and left precordial leads (V5, V6)
patients with aortic stenosis should be considered for valve replacement for:
persistent symptoms
aortic orifice < 0.7 cm^2 body surface area
gradient > 70 mm Hg
conditions with wide pulse pressure
aortic regurgitation
wet beriberi
hypertrophic subaortic stenosis
Acute valvular disorders (acute MR or AR) result in
severe decompensation into CHF due to the absence of hemodynamic compensation; emergent surgery is required
a rumbling diastolic murmur can be due to
mitral or tricuspid stenosis; TS will increase with inspiration
pt with a DVT has a stroke. he has a fixed S2 split. Think:
ASD, right-to-left embolization
right-sided bacterial endocarditis is most frequently associated with
nonsterile technique in IV drug abusers
a holosystolic murmur can be due to
mitral or tricuspid regurg
#1 cause of death in patients with CHF is
v-fib usually occurs after
pt has hyperkalemia and peaked T waves: 1st step? why?
calcium because is stabilizes cardiac membranes
causes of prolonged QT
Hypokalemia, hypocalcemia, hypomagnesemia
cause of short QT
causes of Torsades
Other meds (tricyclics)
Intracranial bleed
No known cause
Type I antiarrhthymics
Electrolyte abnormalities
Syndrome of prolonged QT
causes of a-fib
Pulmonary disease
Rheumatic heart disease
Anemia, atrial myxoma
this can be used to temporarily slow a rapid supraventricular rhythm
Don't give these to someone with WPW. Do give this...
don't give ABCD
beta blockers
calcium channel blockers
do give procainamide
causes of mobitz I
inferior wall MI
dig toxicity
increased vagal tone
causes of mobitz II
inferior wall or septal MI
conduction system disease
causes of 3rd degree heart block
inferior wall MI
dig toxicity
conduction system disease
Bradycardia (one INCH)
inferior wall MI
increased intracranial pressure
normal variant
carotid sinus hypersensitivity
over 90% of HTN is
essential or idiopathic
HTN due to pheo
is characterized by ectopic production of epi and NE causing wide swings in BP
a 24 y/o woman with preeclampsia treated with IV drip of magnesium complains of difficulty breathing and has diminished reflexes. next step?
stop magnesium and give IV calcium
(2/3) (dBP) + (1/3) (sBP)
nitroprusside can cause
cyanide toxicity
Type A aortic dissection
involves ascending aorta and can extend to descending
Type B aortic dissection
involves only the descending aorta
aortic dissection due to syphilis occurs because
treponema infect the vaso vasorum of the aorta
causes of arotic dissection
aortic coarctation
cocaine, congenital, connective tissue
always do this when you suspect MI
get a chest film; some of these patients will have aortic dissection and thrombolysis may kill them
strong association between strep bovis and
colon cancer
endocarditis prophylaxis is given to patients with valvular heart disease and those with a previous history of endocarditis 30 minutes prior to
dental procedures
GI procedures
urologic procedures
IV drug users:
right-sided ABE most often affects the tricuspid valve, septic pulmonary emboli are common
most common valve affected by rheumatic heart disease is
mitral > aortic > tricuspid
JONES criteria for Rheumatic fever
Joints - arthritis
o - carditis
Nodules- subQ nodules
Erythema marginatum
Syndenham's chorea
HDL level > 60
is cardioprotective
all isolated hypercholesterolemia is
type IIa
patients with very high TG levels (> 1,000) are at risk of
developing pancreatitis