Em Rapid Review Cardiology

Front 1

What should always be considered in rapid A-fib with RVR (>200)?

Back 1

WPW

Front 2

What is Beck's triad and what is indicative of?

Back 2

Muffled heart tones, hypotension, increased CVP (JVD)

Front 3

What is the DeBakey classification of aortic dissection?

Back 3

I.Ascending aorta, aortic arch and descending aorta
II. Ascending aorta
III.Descending aorta distal to the left subclavian artery

Front 4

What is the most important risk factor for developing aortic dissection?

Back 4

Systemic hypertension

Front 5

What are ECG findings in pericarditis?

Back 5

Diffuse ST segment elevation and PR depression

Front 6

What is the most common cause of malignant pericardial tumors?

Back 6

lung cancer, breast cancer, leukemia and non-Hodgkin's lymphoma

Front 7

What is the most common cause of chronic aortic regurgitation?

Back 7

Rheumatic heart disease

Front 8

What is acute aortic regurgitation associated with?

Back 8

Fulminant endocarditis, aortic disease or trauma

Front 9

How is malignant hypertension diagnosed?

Back 9

Hypertension with evidence of acute and progressive end organ damage as a result of the hypotension

Front 10

What percentage of superficial thrombophlebitis is associated with DVT on presentation?

Back 10

1/5

Front 11

What percentage of Marfan's develope aortic dissection.

Back 11

44%

Front 12

When do AAAs typically occur?

Back 12

In 60s-70s

Front 13

What are the most common causes of aortic stenosis in patients under age 65?

Back 13

rheumatic fever and congenital bicuspid valve

Front 14

What is acute mitral regurgitation usually a complication of?

Back 14

Acute MI, bacterial endocarditis or trauma

Front 15

What is torsades de pointes?

Back 15

a polymorphic ventricular tachycardia associated with prolonged QT interval

Front 16

What MI patients have a higher in-hospital mortality?

Back 16

inferior MI and coexisting right ventricular infarction

Front 17

What is electrical alternans specific of?

Back 17

pericardial tamponade (sensitivity only 30%)

Front 18

What is helpful in diagnosing a pericardial effusion?

Back 18

ultrasound

Front 19

What is the most common presenting symptom of aortic dissection?

Back 19

pain

Front 20

What is the most common underlying pathologic condition found in AAA?

Back 20

atherosclerosis

Front 21

When does acute cardiogenic shock result?

Back 21

It results when more than 40% of the myocardium becomes necrosed from ischemia, inflammation, toxins or immune destruction.

Front 22

Where does rupture of a AAA usually occur?

Back 22

retroperitoneum

Front 23

What is the most common dysrhythmia associated with WPW?

Back 23

paroxysmal atrial tachycardia

Front 24

What are the classic symptoms of aortic stenosis?

Back 24

dyspnea on exertion, angina and exertional syncope

Front 25

What drugs are most commonly associated with torsades de pointes?

Back 25

class IA antiarrhythmics (quindine, procainamide) and Class IC agents

Front 26

When is thrombolytic therapy most effective?

Back 26

patients with prominent ST-segment elevations on initial 12-lead ECG

Front 27

What is the classic triad of a ruptured AAA?

Back 27

pain, hypotension and pulsatile abdominal mass

Front 28

How often does aortic regurgitation occur with aortic dissection?

Back 28

31%, most common with a type A dissection

Front 29

What percentage of untreated aortic dissection die?

Back 29

75% within 2 weeks of onset of symptoms

Front 30

What is the classic triad of PE and what percentage of people have it?

Back 30

20% of people have hemoptysis, dyspnea and chest pain

Front 31

What are the most common signs of a PE?

Back 31

dyspnea and tachypnea

Front 32

When do left ventricular aneurysms most commonly occur?

Back 32

after extensive anterior MIs

Front 33

What % of patients w/ acute MI will have high-degree AV block on admission to ED? What percentage will develop it w/i 24 hrs?

Back 33

8% present and 24% will develop it w/i 24 hrs and rest will develop it within 3 days of admission.

Front 34

What are the two major types of essential hypertension?

Back 34

Those with elevated renin and those without elevated renin

Front 35

What is the clinical presentation of actue mitral regurgitation?

Back 35

Fulminant CHF in previously healthy patient

Front 36

What are teh most common ECG findings in patients with PE?

Back 36

Tachycardia, non specific ST-T wave changes,
Classic: SI QIII TIII
S wave in lead I, q wave in lead III and inverted T in lead III
also t wave in versions in V1-V3 and inf. leads is very specific for PE

Front 37

What is the ventricular rate most commonly controlled with in stable conditions?

Back 37

digoxin

Front 38

What is the most common cause of v-tach

Back 38

monomorphic VTach associated with chronic cornary artery disease

Front 39

What is the key early sign of cardiogenic shock in anterior MI

Back 39

tachycardia

Front 40

What do q waves represent?

Back 40

myocardial necrosis

Front 41

What is the orgin of tricuspid stenosis?

Back 41

rheumatic in orgin, commonly coexists with mitral and aortic disease

Front 42

What is the most common cause of mitral stenosis?

Back 42

rheumatic heart disease

Front 43

What are the signs of significant mitral stenosis?

Back 43

dyspnea on exertion, orthopnea and hemoptysis

Front 44

What is the most common cause of chronic mitral regurg?

Back 44

rheumatic heart disease, often coexhists with mtiral stenosis

Front 45

What s the most common cause of aortic stenosis in patients >65?

Back 45

calcific degeneration of the valve cusp

Front 46

What is acute AR?

Back 46

a surgical emergency and requires valve replacement

Front 47

What % of natve valve endocarditis is caused by staph? What % of IV drug use?

Back 47

10-30% and over 80%

Front 48

When is valvular surgery indidcated?

Back 48

May be indicated in infective endocarditis, severe CHF from valvular incompetence, paravalvular leak around prosthetic valve, fungal endocarditis, persistent bacteremia despite abx

Front 49

What is the stanford classification system for aortic dissection?

Back 49

Type A involves ascending aorta, type B does not

Front 50

What should chest pain with neurological symptoms make you think of?

Back 50

dissection

Front 51

What is prinzmetal's angina assocated with?

Back 51

transient ST elevation

Front 52

What can anterior MIs be associated with?

Back 52

acute mitral regurgitation, ventricular septal defect and high grade AV blocks

Front 53

What can an inferior wall MI be associated with?

Back 53

GI symptoms, hypotension, bradycardia and Mobitz I

Front 54

What potentiates adenosine?

Back 54

tegretol (carbomazapine) and persantine

Front 55

What antagonizes adenosine?

Back 55

methylxanthines

Front 56

What should a short PR and a delta wave make you think of?

Back 56

WPW

Front 57

What does persistent and diffuse ST elevations mean?

Back 57

ventricular aneurysm

Front 58

What is a new systolic murmur after an MI?

Back 58

MR, caused by rupture of LV papillary muscle usually seen in inf. infarcts since RCA and Cx supplies this area

Front 59

What increases the murmur in hypertrophic cardiomyopathy?

Back 59

standing, valsalva and hypovolemia

Front 60

What should be avoided in WPW patients w/afib?

Back 60

digoxin, verapamil and diltiazem

Front 61

WHat are the treatments of choice for WPW with wide complex (antidromic) condition?

Back 61

Procainamide, cardioversion/catheter conversion