Cardio Step 1

Front 1

reduces Ang II production (no vasoconstriction) and reduces aldosterone release (no inc na/water reabsorption)?

Back 1

ACE inhibitor
(think HF -- lowers blood pressure)

Front 2

blocks Ang II receptor to prevent vasoconstriction of arterial system and thus lowers blood pressure

Back 2

ARBs (Ang II Receptor Blockers)

Front 3

Spironolactone

Back 3

blocks the aldosterone receptor - prevents increased intravascular volume via Na reabsortpion

Front 4

sx of decreased forward flow to the heart (decreased preload)

Back 4

fatigue, weakness, SOB

Front 5

sx of increased balckup of flow to the heart

Back 5

sob, pnd, orthopnea, edema, elevated JVP

Front 6

sx of inflammation of the heart or ischemic heart dz

Back 6

chest pain

Front 7

what is cor pulmonale?

Back 7

RHF secondary to a pulmonary cause

Front 8

causes of LVH

causes of RVH

hypertrophy of the heart is caused by the increased ______ on the heart

Back 8

hypertension, aortic stenosis (think increased afterload)

LHF, pulmonic valve stensosis, pulmonary htn

workload

Front 9

consequences of cardiac hypertrophy

tx?

Back 9

muscle outgrows blood supply leading to ischeia (angina, infarction result)

inability to relax and small chamber size lead to dec filling = diastolic dysfunction and decreased CO

decrease heart rate and contractile force = beta blockers and Ca channel blockers (CCBs)

Front 10

drugs that increase the force of ventricular contraction

Back 10

inotrophes (digoxin, digitalis, dopamine, dobutamine, amrinone, milrinone)

Front 11

drugs that decrease the rate of contraction to increase filling time

Back 11

beta blockers

Front 12

drugs that decrease preload by dilating veins

Back 12

nitrates

Front 13

drugs that decrease intravascular volume and thus preload

sx that monitor these drugs

Back 13

diuretics

SOB and edema

Front 14

drugs that dilate arteries and decrease afterload

Back 14

ace inhibitors and hydralazine

Front 15

cardiomyopathy caused by infiltrative dz?

list examples?

tx?

Back 15

restrictive cardiomyopathy (heart becomes stiff and difficult to relax) = diastolic dysfunction

amyloidosis, hemochromatosis, multiple myeloma, sarcoid, pompe's dz

tx underlying condition, otherwise use same approach as with heart failure = increase forward flow (ionotropes, b blockers) and decrease backup of flow (nitrates, diureticcs, ACEIs or hydralazine)

Front 16

causes of ventricular dilitation in general?

cuases of LV diltation

causes of RV dilation

tx?

Back 16

heart is handling more blood than usual = decreased forward flow + back up flow = systolic dysfunction

aortic regurg, mitral regurg

pulmonic regurg, tricuspid regurg, atrial septal defect, ventricular septal defect, VSC as a complication of MI

ventricular dilation can also be caused by ischemia

tx = same as for heart failure

1. increase foward flow
- inotropes = inc force of contraction
-b blockers = dec rate of contraction

2. decrease back up of flow
- nitrates - dilate viens
-diuretics - dec intravasc volume
- ACEIs, hydralazine - dilate arteries

Front 17

sound produced by the closure of the _____ valves is S1

sound produced by the closure of the _______ valves is S2

which (S1/S2) marks the beginning of diastole?

S3 is associated with?

S4 is associated with?

Back 17

atrioventricular (tricuspid, mitral)

aortic/pulmonic valves

S2

S3 = dilated heart/systolic dysfunction

S4 = hypertrophic heart/diastolic dysfunction

Front 18

aortic stenosis can cause __________

causes of aortic stenosis?

blood flow across the aortic valve occurs between S__ and S__

murmur type caused by aortic stenosis

affects on heart sounds or pulses?

sx?

Back 18

cardiac hypertrophy (think inc resistance to outflow from LV)

aging (senile calcification), congenital biscuspid aortic valve, rheumatic heart dz

S1 and S2 = systole

systolic ejection murmur or cresc/decresc murmur -- valve is hard to open and hard to close (think ppl through door)

diminished S2, diminished carotid pulse (parvus et tardus)

less flow to brain - syncope, dizziness, light headed; cardiac hypertrophy = agina, MI due to ischemic heart dz (poor perfusion); diminished outflow = weak, fatigue

Front 19

aortic regurgitation murmurs occur (before/after) S2

consequences of aortic regurg

causes of aortic regurg

Back 19

after = diastolic murmur

widened pulse pressure (diastole decreases), bounding pulses, Corrigan's pulse (carotids), heart failure sx, CARDIAC DILATION

aortic root dilation (marfans, E-D syndrome, Syph) or weakened valve

Front 20

mitral stenosis is a ___ murmur

nearly all cases are caused by ______

consequences of mitral stenosis

the opening snap associ with this murmur (inc/dec) with severity of the stenosed valve?

Back 20

diastolic murmur (after S2)

rheumatic fever

left atrial dilation, a-fib, pulmonary htn, SOB, RHF

earlier the snap = more severe

Front 21

what type of murmur is mitral regurg?

causes

other associated findings?

Back 21

systolic murmur, usually non-cresc (except with prolapse where it is initiated by a midsystolic click)

mitral valve prolapse, rheumatic fever, endocarditis, ishchemic heart disease

acute cuase = papillary muscle rupture 2ndary to ischemia) - no dilated left atrium here...just sob (er)

S3 due to dilated heart