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62 Cards in this Set
- Front
- Back
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Right-to-left shunts (early cyanosis)
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Teratology
Transposition Truncus Children may squat to Increase Venous Return |
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Left-to-right shunts (late cyanosis)
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1. VSD
2. ASD 3. PDA VSD > ASD > PDA Progressive Pulmonary HTN --> R->L Shunt (Eisenmenger's) |
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Eisenmenger's syndrome
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Uncorrected VSD, ASD or PDA leads to progressive pulmonary hypertension. As pulm. resistance increases, shunt changes from L->R to R->L
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Teratology of Fallot
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PROVe:
Pulmonary stenosis RVH Overriding aorta VSD "boot-shaped" heart |
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Transposition of great vessels
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Aorta leaves RV & pulmonary trunk leaves LV
Not compatible with life unless shunt allows adequate mixing (VSD, PDA or patent foramen ovale) |
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Coarctation of aorta
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Preductal vs Postductal
Preductal (Infantile) close to heart Postductal (Adult) distal to ductus arteriosus. Notching of ribs, HTN in upper extremities, weak pulses in lower extremities |
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Patent Ductus Arteriosus
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"machine-like" murmur
use Indomethacin to close use PGE to keep open (ie in transposition of great vessels) |
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Hypertension Risk Factors
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++age, obesity, diabetes, smoking, genetics, black > white > asian
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Hypertension predisposes to
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Atherosclerosis
stroke CHF renal failure retinopathy aortic dissection |
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Types of Angina
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Stable: @exertion. secondary to atherosclerosis
Prinzmetal: @rest. secondary to coronary artery spasm Unstable: Thrombosis w/o necrosis. worsening chest pain |
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ECG of MI
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ST elevation - transmural
ST depression - subendocardial Q waves - transmural/old |
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Biomarkers of MI
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Troponin: 4hrs - 10days
CK-MB: 24hrs LDH: 2-7days AST: nonspecific |
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Complications of MI
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Cardiac arrhythmia
LV failure & pulm. HTN Cardiogenic shock Rupture of free wall/septum/papillary muscle 4-10days -> tamponade Thromboembolism - mural thrombus Fibrinous pericarditis - frisction rub (3-5days) Dressler's syndrome - autoimmune -> fibrinous pericarditis (weeks) |
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Dilated Cardiomyopathy
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Most common.
Systolic dysfxn "Balloon" on CXR |
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Hypertrophic cardiomyopathy
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Assymetric hypertrophy involving septum
Diastolic dsfxn "Banana" on ECG Sudden death in young athletes |
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"Baloon" shaped heart on CXR
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Dilated Cardiomyopathy
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"Banana" shaped LV on Echo.
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Hypertrophic Cardiomyopathy
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Sudden death in young athlete
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Hypertrophic Cardiomyopathy
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Holosystolic high-pitched blow. Loudest at apex.
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Mitral Regurgitation.
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Crescendo-descrescendo systolic murmur following click. Radiates to carotids.
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Aortic stenosis
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Pulsus parvus et tardus
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Aortic stenosis
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Holosystolic murmur.
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VSD
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Late systolic murmur with midsystolic click.
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Mitral prolapse. Common.
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"Diastolic high-pitched blow"
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Aortic regurgitation
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Widened pulse pressure
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Aortic regurgitation
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"Opening snap with delayed diastolic rumble"
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Mitral stenosis
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"Continuous machine-like murmur
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PDA
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Most common primary tumor in adults
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Myxoma
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"ball-valve" obstruction
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myxoma
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Most frequent primary cardiac tumor in children
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rhabdomyoma
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most common heart tumor
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metastatic
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pulsus paradoxus
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Seen in Cardiac Tamponade
-Note pulsations via auscultation that is not felt in radial pulse- |
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electrical alternans
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Seen in cardiac tamponade
-beat-to-beat alterations of QRS complex height- |
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"Round white spots on retina surrounded by hemorrhage"
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Roth's Spots.
Seen in bacterial endocarditis |
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"small erythematous lesions on palm or sole"
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Janeway Lesions.
Seen in bacterial endocarditis |
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"Tender raised lesions on finger or toe pads"
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Osler's nodes
Seen in bacterial endocarditis |
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Splinter hemorrhages on nail bed
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Bacterial endocarditis
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"Rapid onset of large vegetations on previously normal valves"
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Acute Bacterial Endocarditis.
S. Aureus likely organism |
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"Insidious onset of small vegetations on abnormal or diseased valves."
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Subacute Bacterial Endocarditis
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Endocarditis associated with IV drug use.
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Tricuspid valve endocarditis
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Fever
Erythema marginatum Valvular damage ESR elevation Polyarthritis Subcutaneous nodules Chorea |
Rheumatic Fever
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Diffuse ST elevation in all ECG leads
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pericarditis
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Causes of Serous Pericarditis
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SLE
Rheumatoid arthritis Infection Uremia |
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Causes of Fibrinous pericarditis
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uremia
MI rheumatic fever |
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Causes of hemorrhagic pericarditis
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TB
malignancy |
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"Young asian female with fever, arthritis, night sweats, myalgia, skin nodules, ocular disturbances, weak pulses in upper extremities"
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Takayasu's arteritis
=Thickening of aortic arch and/or proximal great vessels |
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"Elderly female with unilateral headache, jaw claudication, impaired vision"
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Giant Cell Arteritis
aka Temporal Arteritis =vasculitis of medium & small arteries >> branches of carotid. |
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Direct general agonist (a1, a2, b1, b2)
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Epinephrine (inscreased systolic & decreased diastolic)
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alpha1, alpha2 & beta1 agonist
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Norepinephrine (elevated systolic & diastolic)
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beta1 & beta2 agonist
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Isoproterenol (lowers systolic & diastolic)
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Beta1 agonist
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Dobutamine (shock, CHF)
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Alpha1 agonist
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Phenylephrine (vasoconstrictor)
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Beta-blockers
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Propranolol, metropolol
Lowers CO, HR & Contractility Lowers O2 demand Use after MI Toxicity: asthma, bradychardia, impotence |
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Calcium Channel Blockers
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Nifedipine, verapamil, ditiazem
Use for: HTN, Angina, Arrythmia (not nifedipine) |
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ACE Inhibitors
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Prevents inactivation of vasodilator.
Use for: HTN, CHF, diabetic renal disease |
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Nitrates
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Use for: Angina
lower EDV / BP increase contractility / HR lowers O2 demand |
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Cardiac drug working on Na/K ATPase pump
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Digoxin
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Cardiac drug working on voltage-gated calcium channel
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Calcium channel blocker
Beta agonist |
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Class I antiarrhythmics
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Na channel blockers
1A: Quinidine 1B: Lidocaine 1C: Flecainide, Encainide |
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Class II antiarrhythmics
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Beta Blockers
Propranolol Esmolol Metoprolol Atenolol Timolol |
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Class III Antiarrhythmics
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K channel blockers
Sotalol, amiodarone Used when other antiarrhythmics fail |
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Class IV Antiarrhythmics
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Ca channel blockers
Verapamil, diltiazem |
