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21 Cards in this Set
- Front
- Back
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How does LVH relate to sudden cardiac death?
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It is an independent risk factor
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Treatment for LVH
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-Weight loss
-Sodium restriction -All classes of antihypertensive drugs, except minoxidil and hydralazine |
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Peripheral Artery Disease - Management?
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-Any class of antihypertensive
-aspirin -Aggressively manage all risk factors |
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Relationship between dementia and hypertension?
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-Dementia and cognitive impairment more common in people with hypertension
-Delayed progression of cognitive impairment with effective HTN management |
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Does HRT increase HTN?
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No
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Do OCP's increase hypertension?
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They can
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Treatment of hypertension in pregnancy
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-Close monitoring
-Methydopa, beta-blockers, and vasodilators preferred -ACEI's and ARB's contraindicated in pregnancy |
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Management of hypertension in pediatric patients
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-Attempt lifestyle modification first
-when starting drugs, same meds as adults, but smaller doses -No reason to restrict activity if HTN controlled |
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Reasons to hospitalize with Hypertensive Urgency and Emergency
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End organ damage possible
-Encephalopathy -MI/unstable angina -Pulmonary edema/eclampsia -Stroke -Life threatening arterial bleed or aortic dissection |
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Treatment for Hypertensive Emergencies not requiring hospitalization
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Immediate combination anti-hypertensive therapy
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Symptoms of Heart Failure
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-Fluid retention
-Shortness of breath -Fatigue with exertion |
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Aggressive treatment of blood pressure reduces the risk of heart failure by what percentage?
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50%
(56% in diabetics) |
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Aggressive treatment of blood pressure reduces the risk of MI by what percentage?
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80%
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ACE inhibitors are recommended for the prevention of heart failure in patients with what risk factors?
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-CAD
-PVD -Stroke -DM |
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What 2 classes of antihypertensives are recommended for all patients with a prior MI?
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ACE inhibitors and betta-blockers
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Define systolic heart failure
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-signs and symptoms of heart failure with reduced left ventricular ejection fraction
-Most commonly associated with LV chamber dilitation |
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Define diastolic heart failure
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-signs and symptoms of heart failure with preserved left ventricular ejection fraction
-most commonly associated with a non-dilated LV chamber -may be the result of valvular disease |
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Treatment for diastolic heart failure
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-treat standard and pulmonary hypertension
-consider ischemic disease -no medications specifically indicated for treatment of diastolic HF |
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Treatment for systolic HF
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-ACE inhibitors
-alternatives to ACEI's : ARB's, hydralazine -betablockers (use in all post MI patients) -Aldosterone antagonists (unless renal failure or hyperkalemia) -ICD/pacemaket (EF<35%) -Diuretics for fluid management |
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When should prophylactic ICD (pacemaker) placement be considered in HF
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EF<35% with mild to moderate symptoms
Prognosis and functional status need to be considered If biventricular pacing is needed, consider defibrillation |
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When is biventricular pacing recommended?
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Sinus rhyth
-widened QRS -Severe LV dysfunction (EF<35%) -persistant, moderate to severe HF despite optimal medical therapy |
