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25 Cards in this Set
- Front
- Back
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Q waves in HOCM
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sign of septal thickening
NOT infarction |
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Initial therapy HCM/HOCM
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BBs
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Diuretics: HCM vs. HOCM
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HCM --> help
HOCM --> harm |
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HOCM with syncope - treatment
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1. Implantable defibrillator
2. Ablation - catheter puts alcohol in septum 3. Surgical myomectomy (last resort) |
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Most specific finding - restrictive cardiomyopathy
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Kussmauls sign: increase in JVD on inhalation
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Restrictive cardiomyopathy - Diagnosis
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- echo
- EF normal or increased - EKG = low voltage |
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Echo finding - Amyloid
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- speckling of septum
- also on MRI |
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Most accurate test - restrictive cardiomyopathy
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endocardial biopsy
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Amyl nitrate
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- arteriolar vasodilator
- decreases afterload - like ACEI/ARB - improves AR, MR - worsens MVP, HOCM |
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What things have NO effect on mitral stenosis?
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- ACEIs
- amyl nitrate - handgrip |
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Most common cause pericarditis
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virus
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Pericarditis Presentation
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- sharp chest pain
- worse with inhalation - worse lying flat - better sitting up |
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Pericarditis - EKG
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- diffuse ST elevation
- PR segment depression (most specific) |
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Pericarditis - Treatment
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1. Treat cause
2. NSAIDs 3. colchicine decreases recurrence |
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In tamponade which side collapses first?
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right b/c thinner walls
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Most specific physical finding for tamponade
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Pulsus paradoxus: >10 mmHg decrease in systolic on inspiration
(inhalation increases venous return) |
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Electrical alternans
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EKG tamponade
- alternating height of QRS |
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Most accurate test - tamponade
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- R heart cath (not done)
- equalization diastolic pressures |
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Pericardial Tamponade - Treatment
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1. Pericardiocentesis
2. IV fluids (NO diuretics!!) 3. "window"/hole for recurrent |
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What causes constrictive pericarditis?
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TB
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Constrictive pericarditis - Diagnosis
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calcification on CXR
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Pericardial "knock"
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extra heart sound in diastole, constrictive pericarditis
- can't fill |
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Most accurate test - constrictive pericarditis
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CT or MRI
(CXR first) |
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constrictive pericarditis - echo
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- myocardium moves normally
- excludes RV hypertrophy or cardiomyopathy |
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Constrictive pericarditis - Treatment
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surgical removal pericardium
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