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296 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Most striking PE feature of pericarditis |
Pericardial friction rub |
O |
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ECG finding of pericarditis |
Diffuse ST-elevation in all leads, except AVR, AVF, V1 |
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Hamman's sign |
Pericardial friction rub |
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Bread and butter pericarditis: type of pericarditis |
Fibrinous |
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Most common type pericarditis (though not in the Philippines) |
Fibrinous |
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Five types of acute pericarditis |
Serous Fibrinous/serofibrinous Purulent/suppurative Hemorrhagic Caseous
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Pericarditis type due to surgery |
Hemorrhagic pericarditis |
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Pericarditis type due to TB |
Caseous Pericarditis |
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In subxiphoid approach to pericardiocentesis, how is the needle inserted |
Left of the xiohoid process, upward and backward direction in a 45 degree angle to the skin |
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Which structure is targeted in pericardiocentesis |
Cardiac notch |
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Why is the cardiac notch the ideal site for pericardiocentesis |
It is devoid of pleura. To prevent pneumothorax and damage to the lungs, care must be taken not to pierce the pleura. |
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In the infrasternal angle approach to pericardiocentesis, the needle is pierced through where |
5th or 6th ICS near sternum, with needle towards left shoulder |
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Most common cause of myocarditis |
Coxsackievirus B |
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Inflammation of myocardium |
Myocarditis |
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Two types of chronic pericarditis
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Adhesive mediastinopericarditis Constrictive pericarditis |
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Type of acute pericarditis that may lead to constrictive pericarditis |
Purulent/supurative pericarditis |
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Histopathological findings of myocarditis |
Interstitial inflammatory infiltrates with focal myocyte necrosis |
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Murmur of PDA |
Continuous harsh machinery murmur |
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Obstruction in descending aorta just opposite the ligamentum arteriosum |
Coarcatation of the aorta |
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Two types of coarctation of the aorta |
Infantile (preductal) Adult (postductal) |
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Greatest risk factor for congenital heart disease |
CHD in a parent or preceding sibling |
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Infantile coarctation of the aorta: pre or post ductal |
Preductal |
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Post-ductal: adult or infantile coarctation of aorta |
Adult |
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Most common type of Coarctation of aorta |
Infantile (preductal) |
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Lower body cyanosis: Infantile or Adult coarctation of aorta |
Infantile |
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Most common genetic risk of Congenital Heart Disease |
Down syndrome |
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Snowman appearance in CXR is in this disease |
TAPVR |
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ASD murmurs |
Mid systolic murmur of upper sternal border Fixed widely split S2 |
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Most common congenital heart disease associated with congenital rubella syndrome |
PDA |
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Cyanosis: R to L or L to right shunting |
R to L |
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Most common cyanotic congenital heart disease |
Tetralogy of fallot |
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Components of TOF |
Pulmonic stenosis R ventricular hylertrophy Overriding the VSD by the aorta Ventricular septal defect |
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L to R shunting: cyanotic or acyanotic |
Acyanotic |
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VSD most common in: adults or children |
Children |
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Most common congenital heart disease seen in adults |
ASD |
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Xray finding of TOF |
Boot shaped heart |
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Boot shaped heart of TOF is due to which of its components |
RVH |
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Definitive management for TOF |
Blaylock-Taussig Shunt |
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What disease: Pulmonic stenosis R ventricular hypertrophy Overriding the VSD by the aorta Ventricular septal defect |
TOF |
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Anomalous connections by pulmonary veins to systemic veins |
TAVR |
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TET spells of TOF occurs when |
Crying or feeding |
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Severity of TOF cyanosis depends on what |
Pulmonic stenosis |
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Components of Ebstein's anomaly |
Tricuspid valve displacement Artrialized R ventricle ASD |
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CXR finding of Ebstein's anomaly |
Wall to wall/ box-shaped heart |
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How to stop tet spells |
Squatting Propanolol |
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Why does squatting reverse cyanosis in tet spells |
Increases TPR causing reversal of R to L shunt |
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Drug that may cause Ebstein's anomaly |
Lithium |
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Egg shaped cardiac silhouette is in what heart disease |
TGA |
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Box shaped heart xray finding is in what disease |
Ebstein's anomaly |
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What disease: Tricuspid valve displacement Artrialized R ventricle ASD |
Ebstein's anomaly |
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Disease: switching of aorta and pulmonary arteries |
TGA |
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Most common variant of TAPVR |
Supracardiac |
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Four types of TAPVR |
Supracardiac Infradiaphragmatic Cardiac Mixed |
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CXR finding of TAPVR |
Figure of 8/ Snowman appearance |
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Most common type of ASD |
Secundum |
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Types of ASD |
Primum Secundum Sinus venosus |
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Most common ASD in Down sydrome |
Primum |
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Types of VSD |
Membranous Infundibular Ventricular septum |
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Most common type of VSD |
Membranous |
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Most common heart disease in Down Syndrome |
ECD |
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Multiple VSD appearance |
Swiss-cheese septum |
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Upper extremity hypertension: Infantile or adult coarctation |
Adult |
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Rib notching: Infantile or adult coarctation |
Adult |
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Genetic disorder associated with Coarctation of Aorta |
Turner's syndrome |
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Congenital heart disease most common in Noonan syndrome |
Pulmomary stenosis |
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Associated with Turner's syndrome: infantile or adult coarctation |
Infantile |
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CXR finding of coarctation of aorta |
3-sign Rib notching |
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Type of MI due to a thrombus |
STEMI |
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Type of MI due to atherosclerosis |
NSTEMI |
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Most common complication of MI |
cardiac arrhythmia |
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Most common cause of in-hospital death in MI |
Cardiac arrythmia |
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ECG leads of inferior wall |
II, III, avF |
Tuti sa floor |
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ECG leads of septal wall |
V1-V2 |
Septal is ThiN |
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ECG leads of anterior wall |
V3-V4 |
MaR boobies in front |
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ECG leads of lateral wall |
V5-V6 |
Love Bundles on lateral |
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ECG leads of right ventricular wall |
V3R-V4R |
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Wall corresponding to ECG leads V1-V2 |
Septal wall |
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Wall corresponding to ECG leads II, III, avF |
Inferior wall |
Tuti sa floor |
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Wall corresponding to ECG leads V3-V4 |
Anterior wall |
1993 = Mar = boobies |
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Wall corresponding to ECG leads V3R to V4R |
Right ventricular wall |
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Wall corresponding to ECG leads V5-V6 |
Lateral wall |
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The ductus arteriosus is derived from which aortic arch |
6th |
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Truncus arteriosus is often seen in patients with DiGeorge syndrome; This association suggests a common embryologic defect involving early development of which embryonic cells |
Neural crest cells |
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Three types of aortic stenosis |
Subvalvular Valvular Supravalvular |
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A patent ductus arteriosus connects which two vessels |
Pulmonary artery and descending thoracic aorta |
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PDA: usually proximal or distal to the left subclavian artery |
Distal |
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Swiss Cheese septum occurs in which type of VSD |
Muscular |
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Three types of angina pectoris |
Stable (typical) angina Prinzmetal variant Unstable (crescendo) angina |
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Most common form of angina |
Stable (typical) angina |
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Angina that may be imminent MI |
Unstable (crescendo) angina |
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Angina caused by coronary artery spasm |
Prinzmetal variant (May also be unstable angina) |
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Angina at rest/unrelated to physical activity |
Unstable (crescendo) angina Prinzmetal variant |
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Angina associated with activity, relieved by rest |
Stable angina |
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Significant luminal narrowing due atherosclerosis that produces anginal symptoms |
75% |
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Angina not relieved by nitrates |
Unstable (crescendo) angina |
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Drug of choice for Prinzmetal angina |
Calcium channel blockers |
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Major risk factors for MI |
Hypertension Smoking Diabetes Hyperlipidemia |
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Point in women's life that they are most protected from MI |
Reproductive years |
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Irreversible myocardial damage happens how long after an infarct |
20-30 mins |
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The least perfused layer of the heart, most vulnerable to ischemia |
Subendocardial zone |
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Three patterns of myocardial infaction |
Transmural Subendothelial Multifocal microinfarction |
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Type of infarction pattern in cocaine users |
Multifocal microinfarction |
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Type of infarction associated with ST elevation |
Transmural |
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Type of ECG pattern associated with subendocardial infarction |
NSTEMI |
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Blockage of which artery leads to infarction of the cardiac apex |
LAD |
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Most commonly involved vessel in myocardial infarction |
LAD>RCA |
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Most common cause of death in patients with PDA |
Congestive heart failure |
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Treatment of choice for an infant with coarctation of the aorta |
Resection with primary anastomosis |
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Most common location of coarctation of aorta |
Distal to the left subclavian artery |
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Treatment of choice for recurrent COA (after surgical repair) in an preschool-aged child? |
Balloon dilatation alone |
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Killips class III and class IV mortality rate |
38% and 81% |
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Killips III description |
pulmonary edema |
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Killips IV description |
Cardiogenic shock |
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Neurodegenerative disease that presents with parkinsonism and autonomic dysfunction |
Multiple systems atrophy (Shy Drager Syndrome) |
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Most common valvular abnormality |
Calcific aortic stenosis |
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Most common cause of aortic stenosis |
Calcification |
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The calcific process of aortic stenosis begins in which part of the valve |
Valvular fibrosa |
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Substance that deposits in calcific aortic stenosis |
Hydroxypatite (same calcium salt found in bone) |
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The four most common valvular abnormalities |
Aortic stenosis Aortic insufficiency/regurgitation Mitral stenosis Mitral insufficiency/regurgitation (prolapse) |
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Calcific deposits in the mitral valve develop in which part of the valve |
Fibrous annulus |
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Characteristic mitral valve prolapse anatomic change |
Interchordal ballooning (hooding) of mitral valve leaflets |
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Most common congenital heart valve defect |
Bicuspid aortic valve |
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Most common valvular lesion causing syncope and angina in exercise |
Aortic stenosis |
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Valve orifice narrowing in aortic stenosis that is of clinical importance |
1 cm^2 |
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Three cardinal symptoms of aortic stenosis |
Exertional dyspnea Angina pectoris Syncope |
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Characteristic murmur of aortic stenosis |
Ejection (mid) systolic murmur, loudest at second right ICS |
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Right sided murmurs increase during: inspiration or expiration |
Inspiration |
RIght, LEft |
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Cardiac murmurs that increase during expiration: right-sided or left-sided |
Left-sided |
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Disease: Ejection (mid) systolic murmur Pulsus parvus et tardus 2nd ICS R |
Aortic stenosis |
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Gold standard for diagnosis of valvular disease |
Transthoracic echocardiography |
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Corrigan's pulse |
Rapidly rising "water-hammer" pulse, which collapses suddenly as arterial pressure false rapidly during late systole and diastole |
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Quincke's pulse |
Capillary pulsation, an alternate flushing and paling of the skin at the root of the nail while pressure is applied to the tip of the nail |
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Quincke's pulse and Corrigan's pulse are characteristic of which cardiac lesion |
Aortic regurgitation/ insufficiency |
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Traube's sign |
Booming "pistol-shot" sound heard over the femoral arteries |
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Duroziez's sign |
To-and-fro murmur when femoral artery is lightly compressed with stethoscope |
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Watson's water hammer pulse seen in chronic severe aortic regurgitation |
Corrigan's pulse |
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Capillary pulsation seen in chronic severe aortic insufficiency |
Quincke's pulse |
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Pistol shot sound heard over the arteries in aortic regurgitation |
Traube's sign |
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To-and-fro murmur heard when lightly compressing the femoral arteries in aortic insufficiency |
Duroziez's sign |
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Disease: Widened pulse pressure Corrigan's pulse Traube's sign Duroziez's sign Quincke's pulse |
Aortic regurgitation |
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Characteristic murmur of chronic aortic regurgitation |
High-pitched, blowing, decrescendo diastolic murmur, loudest at thrid ICS L sternal border |
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Most common cause of aortic regurgitation |
Dilation of the ascending aorta, often secondary to hypertension or aging |
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Austin flint mumur |
A soft, low-pitched rumbing mid to late diastolic murmur |
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Murmur frequently heard in isolated aortic regurgitation |
Mid-systolic ejection murmur at base of heart, and along carotids |
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Three main murmurs of aortic regurgitation |
High-pitched, blowing, decrescendo diastolic murmur Mid-systolic ejection murmur Austin flint murmur |
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A soft, low-pitched rumbling mid-to-late diastolic murmur |
Austin Flint murmur |
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Most common infectious cause of aortic regurgitation |
Infective endocarditis |
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Mueller's sign |
Systolic pulsation of the uvula |
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Systolic pulsation of the uvula seen in aortic regurgitation |
Mueller's sign |
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Hill's sign |
BP in lower extremity (popliteal pulse) is greater than BP in upper extremity (brachial pulse) by 30 mmHg |
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Demusset's sign |
Headbobbing with diastole |
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Headbobbing in aortic regurgitation |
Demusset's sign |
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Most common cause of mitral stenosis |
Rheumatic heart disease |
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Auscultatory triad in mitral stenosis |
Opening snap Diastolic rumble Increased S1 - best heard at apex |
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Most common cause of mitral valve insufficiency |
Myxomatous degeneration (mitral valve prolapse) |
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Disease: Rust colored sputum Atrial fibrilation Dysphagia for solids Fish mouth opening Right sided failure |
Mitral stenosis |
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Barlow's syndrome other name |
Mitral valve prolapse |
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Billowing mitral leaflet syndrome |
Mitral valve prolapse |
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Mid systolic click in MVP is heard near S1 during these conditions |
Anxiety Standing Valsalva |
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Mid systolic click in MVP during reclining and squatting is heard near: S1 or S2 |
S2 |
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Anxiety, standing and valsalva: increased or decreased preload |
Decreased |
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Mitral regurgitation is more common in: males or females |
Males |
MR |
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Mitral valve prolapse is most associated with which genetic disorders |
Connective tissue disorders: Marfan's Ehler-Danlos Osteogenesis imperfects |
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Valvular lesion most associated with Marfans |
Mitral valve prolapse |
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Most common cause of acquired heart disease in developing countries |
Rheumatic heart disease |
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Major criteria for rheumatic fever |
JONES criteria Joint pains Carditis Subcutaneous nodules Erythema marginatum Sydenham chorea |
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Pathophysiology of RHD |
Molecular mimicry of M protein to myosin in the body causes antibody response against own tissues |
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Most common presentation of rheumatic fever |
Polyarthritis |
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Most common cardiac symptom of rheumatic fever |
Carditis |
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Human leukocyte antigens associated with susceptibility to rheumatic fever |
HLA-DR7 HLA-DR4 |
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Hallmark of rheumatic carditis |
Valvular damage |
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Most commonly affected valve in rheumatic heart disease |
Mitral valve |
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Manifestation in the Jones criteria that may still point to rheumatic fever in the absence of other manifestations |
Syndenham's chorea |
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Most common serologic tests for diagnosis of rheumatic fever |
ASO anti-DNAse B |
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Drugs for secondary prophylaxis of RHD |
Benzathine penicillin Penicilin V Erythromycin (for penicillin allergy) |
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Most common cause of infective endocarditis |
Bacteria |
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Most common cause of acute infective endocarditis |
S. aureus |
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Most common cause of subacute infective endocarditis |
S. viridans |
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HACEK group bacteria |
Haemophilus Actinobacillus Cardiobacterium Eikanella Kingella |
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HACEK is associated with which disease |
Infective endocarditis |
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Most common pathogen in endocarditis in IV drug users |
S. auerus |
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Most commonly affected cardiac valve in IV drug user |
Tricuspid valve |
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Classic hallmark of infective endocarditis |
Vegetations on heart valves |
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Most common pathogen in IE in valve prosthetics |
S. epidermidis |
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Most common valves affected in IE |
Aortic and mitral |
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Most consistent sign of IE |
Fever |
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Diagnostic criteria for infective endocarditis |
Modified Duke criteria |
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Jones criteria is diagnostic for which disease |
Rheumatic fever |
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Modified Duke criteria is diagnostic for which disease |
Infective endocarditis |
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Most common malignancy associated with marantic endocarditis |
Small cell lung ca/ oat cell |
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Erythematous or hemorrhagic nontender macules on the palms or sole |
Janeway lesions |
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Janeway lesions: more common in acute or subacute IE |
Subacute |
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Osler's node: more common in acute or subacute IE |
Acute |
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Tender subcutaneous nodules usually found on the distal digital pads |
Osler's nodes |
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Retinal hemorrhages in eyes seen in IE |
Roth spots |
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Most common classical peripheral manifestation of infective endocarditis |
Petechiae |
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Irregular thickening induced by subendocardial lesions, exacerbated by regurgiant jets, usually in the left atrium |
MacCallum plates |
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Freely mobile, evanescent nodules consiting of Aschoff bodies attached to the tendon sheaths near bony prominences |
Subcutaneous nodules |
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Painless: Osler's nodes or subcutaneous nodules |
Subcutaneous nodules |
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Osler's nodes: painful or painless |
Painful |
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Foci of swollen eosinophillic collagen surrounded by T cells, plasma cells, Anitschow cells and giant cells |
Aschoff bodies |
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Anitschow cells |
Also caterpillar cells; activated macrophages/histiocytes containing abundant cytoplasm, round nuclei with slender wavy ribbon of chromatin |
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MacCallum plaques |
Irregular thickening of the subendocardium |
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Activated macrophages/histiocytes containing abundant cytoplasm, round nuclei with slender wavy ribbon of chromatin |
Caterpillar cells/ Anitschow cells |
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Histologic hallmark of rheumatic activity |
Aschoff bodies |
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Aschoff bodies |
Foci of swollen eosinophilic collagen and inflammatory cells |
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Carcinoid heart disease most commonly involves which part of the heart |
Endocardium, Right sided valves |
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Most common cause of congestive heart failure |
Ischemia |
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Most common cause of right-sided heart failure |
Left-sided heart failure |
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Peripheral edema is more commonly seen in: left-sided right sided heart failure |
Right-sided failure |
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Pulmonary hypertension is more commonly seen in: left-sided or right-sided failure |
Left-sided failure |
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Pulmonary congestion is more commonly seen in: left or right-sided heart failure |
Left-sided failure |
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Liver congestion is more commonly seen in: left or right-sided failure |
Right-sided failure |
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Heart failure with reduced ejection fraction (HFrEF): systolic or diastolic failure |
Systolic failure |
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Diastolic failure: reduced or preserved ejection fraction |
Preserved ejection fraction |
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The most useful index of LV function |
Ejection fraction |
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Aka pulmonary heart disease |
Cor pulmonale |
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Acute cor pulmonale: RV dilatation or RV hypertrophy |
RV dilatation |
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RV hypertrophy: acute or chronic cor pulmonale |
Chronic |
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Most common symptom of cor pulmonale |
Dyspnea |
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Carvallo's sign |
Increase in intensity of holosystolic murmur of tricuspid regurgitation with inspiration |
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Tachycardia + hypertension in acute MI |
James reflex |
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Bradycardia + hypotension in acute MI |
Bezold-Jarisch reflex |
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Most sensitive and most specific test for myocardium damage |
Trop I |
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Trop I peaks when |
12 hrs |
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Most common arrythmia that causes mortality in out-of hospital setting |
Ventricular fibrilation |
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Most common cause of heart transplant |
Dilated (congestive) cardiomyopathy |
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Disease: diminished myocardiac contractility, impaired systolic pump function, cardiac enlargement dilatation of all 4 chambers |
Dilated (congestive) cardiomyopathy |
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Most common form of cardiomyopathy |
Dilated (congestive) cardiomyopathy |
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Histologic findings of dilated cardiomyopathy |
Interstitial and perivascular fibrosis Myocyte necrosis Cellular infiltration |
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Most common etiology of dilated cardiomyopathy |
Idiopathic |
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Second most common cause of dilated cardiomyopathy |
Alcohol |
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Most common toxin associated with chronic dilated cardioyopathy |
Alcohol |
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Acute cardiac rhythim and/or conduction disturbance associated with heavy ethanol consumption, no clinical evidence of heart disease |
Holiday heart syndrome |
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Most common arrhythmia seen in Holiday Heart syndrome |
Atrial fibrillation |
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Second most common arrhythmia seen in Holiday heart syndrome |
Atrial flutter |
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Causes of atrial fibrilation |
Ethanol Valvular heart disease Ischemic heart disease Cardiomyopathy/coccaine Thyroid disorders |
EVICT |
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Most common symptom of holiday heart disease |
Palpitations |
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Least common cardiomyopathy |
Restrictive |
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Largest protein expressed in humans |
Titin |
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TTN mutation is associated with which cardiac disease |
Dilated cardiomyopathy |
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Most common manifestation of iron excess |
Dilated cardiomyopathy |
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Most commonly affected part of the heart in takotsubo cardiomyopathy |
Left ventricular apex |
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Most common cause of cadiomyopathy among drugs |
Chemotherapeutic drugs |
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Cardioprotective drug given in chemotherapy |
Dextrazoxane |
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Disease: myocardial hypertrophy of interverntricular septum abnormal diastolic filling intermittent ventricular outflow obstruction narrowed subaortic area |
Hypertrophic cardiomyopathy |
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Common cause of sudden cardiac death in young athletes |
Hypertrophic cardiomyopathy |
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Most common mutation in hypertrophic cardiomyopathy |
cardiac beta-myosin heavy chain gene on chromosome 14 |
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Disease: sudden death in children and young adults often during or after physical exertion |
Hypertrophic cardiomyopathy |
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Hallmark chest findings in hypertrophic cardiomyopathy |
Systolic murmur at the left sternal border and apex |
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Most common complaint in hypertrophic cardiomyopathy |
Dyspnea |
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Treatment for hypertrophic cardiomyopathy |
Beta blocker Verapamil |
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Hallmark of restrictive cardiomyopathy |
Abnormal diastolic function |
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Most prominent symptoms of restrictive cardiomypathy |
Exercise intolerance Dyspnea |
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Most common cause of restrictive cardiomyopathy die to hemochromatosis |
Beta-thalassemia |
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Apical ballooning syndrome |
Takotsubo (stress) cardiomyopathy |
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Most common typs of pericardialeffusion |
Serous |
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Most common cause of hemorrhagic pericarditis |
Malignant neoplastic involvement of the pericardial space |
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Nonadherent epicardial plaque seen in healing acute pericardial lesions |
Soldier's plaque |
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Disease: pericardial sac is obliterated and the parietal layer is tethered to mediastinal tissue |
Adhesive mediastinopericarditis |
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Disorder: Arrhythmogenic right ventricular cardiomyopathy Hyperkeratosis of plantar palmar skin surfaces mutations in gene for desmosome-associated protein plakoglobin |
Naxos syndrome |
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Disease: RV failure Rhythmic disturbances (Vtach or vfib) Sudden death |
Arrhythmogenic ventricular cardiomyopathy |
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Hypercontracting: DCM or HCM |
HCM |
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most common cause of acquired heart disease in children in countries |
rheumatic heart disease |
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component of cardiac valve cells to which m protein reacts |
n-acetylglucosamine |
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pathognomonic cells for rheumatic fever |
Anitschkow cells |
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Anitschow cells are what type of cells |
histiocytes |
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histologic marker of severe carditis in rheumatic heart disease |
Aschoff bodies |
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disease: maccallum plaques anitschkow cells Aschoff bodies |
rheumatic heart disease |
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human leukocyte antigen seen in both rheumatic heart disease and rheumatoid arthritis |
HLA-4 |
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Drug of choice for prophylaxis of rheumatic fever |
penicillin |
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choice drug for treatment of arthritis, arthralgias, fever in rheumatic fever |
nsaids salicylates |
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best antibiotic for secondary prophylaxis of rheumatic heart disease |
benzathine penicillin |
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Pathogen seen in endocarditis that is also seen in colorectal cancer |
streptococcus bovis |
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management for acute endocarditis |
Surgery |
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management for subacute endocarditis |
Antibiotics |
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single positive blood culture needed for this organism to diagnose infective endocarditis |
coxiella burnetii |
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the only rickettsia bacteria that can be transmitted through fomites |
coxiella burnetii |
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roth spots are seen in which organ |
Retina |
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roth spots are diagnostic of which disease |
infective endocarditis |
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disease: Osler's nodes roth spots rheumatoid factor janeway lesion |
infective endocarditis |
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most common blood abnormality in infective endocarditis |
anemia |
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second most common manifestation of endocarditis |
heart murmur |
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type of endocarditis with fever greater than 39.4 degrees |
acute endocarditis |
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empirical therapy for acute and localities in an injection drug users |
gentamicin + vancomycin |
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empirical therapy for blood culture negative subacute nve |
gentamicin + ampicillin sulbactam or ceftriaxone |
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drug for penicillin susceptible streptococci in endocarditis |
penicillin ceftriaxone or vancomycin |
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Antibiotic treatment for hacek organisms in infective endocarditis |
ceftriaxone or ampicillin sulbactam |
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drug for coxiella burnetii endocarditis |
doxycycline + hydroxychloroquine |
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drug for bartonella in infective endocarditis |
doxycycline plus gentamicin |
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early marker of renal injury also considered a risk factor for renal disease progression and cardiovascular disease |
urinary albumin /creatinine ratio |
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Ankle brachial index indicative of peripheral arterial disease |
less than 0.9 |
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peripheral arterial disease associated with excessive smoking |
Buerger's disease |
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nonpharmacologic intervention that has the highest systolic blood pressure lowering effect hypertensive patients |
dash diet (dietary approaches to stop hypertension) |
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sodium limitation in dash diet |
1500 mg per day |
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dash diet decreases blood pressure by this amount in hypertensive patients |
11 mm hg |
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