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83 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Structural Heart Disease causing A Fib (4)
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Atrial Enlargement
Increased Atrial Pressure Myocardial Infiltration Atrial Inflammation |
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Loss of atrial kick
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A Fib
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A Fib and Stroke Prevention Meds
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Low Risk: Aspirin
Moderate Risk: Aspirin or Warfarin High Risk: Warfarin |
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A Fib rate control meds (3)
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BB
Verapamil Diltiazem |
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How to rule out thrombus before cardioversion?
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Transesophageal Echo
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Tx for concomitant CHF and asymptomatic A Fib?
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Digoxin
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Tx for r hythm maintenance and asymptomatic A fib?
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Amiodarone
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3 rate control Tx for asymptomatic A fib?
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BB
Diltiazem Verapamil |
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Rate control Tx for symptomatic stable A fib?
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IV Diliazem (CCB)
IV BB |
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Needed for cardioversion clearance?
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TEE
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Tx for unstable A fib?
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Cardioversion
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Cardioversion Rules for Afib
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If known Afib <48 hrs = cardiovert
If unknown or >48 hrs = 3 wks anticoagulate, cardioversion, 4 wks anticoagulate |
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Chronic Arrhythmia Management (3)
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Flecainide
Ilbutilide Amiodarone |
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CHF + Arrhythmia management
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Amiodarone
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First episode of Afib: Rate v. Rhythm control?
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Rhythm
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MS and Afib: Rate v. Rhythm control?
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Rhythm
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Afib exercise heart rate rate control goal
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90-115 bpm
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Afib resting heart rate rate control goal
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60-80 bpm
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Med for Afib + HF
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Digoxin
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Digoxin requires adequate ___
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Potassium
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Immune response to Group A Beta Hemolytic Strep Pharyngitis
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Rheumatic Fever
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Criteria for Rheumatic Fever
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Jones Criteria
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Major Jones Criteria (5)
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Migratory polyartheritis of large joints
Carditis Subcutaneous nodules Chorea Errythema marginatum |
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Minor Jones Criteria (4)
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Fever
Other arthralgias Elevated ESR/CRP Prolonged PR interval (heart block) |
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Negative throat culture and clinical suspicion of Rheumatic Fever
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ASO Titer (antistreptolysin O)
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2 murmurs associated with Rheumatic Fever
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MR
AR |
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Occurs 10-20 years after acute disease
MS/AS present |
Rheumatic Fever
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Rheumatic Fever Tx
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Aspirin and penicillin
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Sandpaper rash
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Scarlet fever
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Most common cause of Infective Endocarditis
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S. aureus
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Painful puritic lesions on the hands and feet associated with endocarditis
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Osler's nodes
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Flame hemmhorages associated with endocarditis
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Roth's spots
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Painless splinter hemorrhages on the nails associated with endocarditis
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Janeway lesions
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Endocarditis prophylaxxis needed for?
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Dental procedures
Airway or esophageal procedures (invasive) |
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Endocarditis meds
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Pen G or Amp +
Nafcillin or Oxacillin + Gent |
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IVDU Endocarditis Med
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Vanc
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Doxyrubicin associated Cardiomyopathy
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Dialated
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ETOH associated cardiomyopathy
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Dialated
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Unexplained dilation and impaired systolic function
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Dialated Cardiomyopathy
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Crackles
Elevated JVP S3 Gallop Cardiomegally (globular heart) |
Dilated Cardiomyopathy
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Tx for Dilated Cardiomyopathy
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Tx underlying disease
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Cardiomyopathy associated with Thyroid Dx
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Dilated
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Unexplained ventricular hypertrophy not due to HTN or AS
Usually involves asymmetric pattern (septal hypertrophy) |
Hypertrophic Cardiomyopathy
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Rapid upstroke
Bifid Carotid Pulse |
Hypertrophic Cardiomyopathy
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Hypertrophic Cardiomyopathy and position changes
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Increased with sudden standing or valsalva
Decreased with lying down |
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Echo shows asymmetric septal hypertrophy
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Hypertrophic Cardiomyopathy
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LVH
High voltage Q waves in I and aVF |
Hypertrophic Cardiomyopathy
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Tx for Hypertrophic Cardiomyopathy
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Avoid extreme exertion
BB |
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Arrythmia prophylaxis for HCM (2)
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ICD
Amiodarone |
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Impaired ventricular filling in a non-dilated, non-hypertrophied ventricle secondary to myocardial abnormality, typically with preserved systolic function
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Restrictive Cardiomyopathy
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CHF with preserved systolic function
Kussmaul's sign S3, S4 gallops MR/TR Thromboembolic events Signs of R heart failure |
Restrictive Cardiomyopathy
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Pleuritic chest pain
Friction rub EKG changes |
Pericarditis
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EKG shows global ST elevation with no reciprocal changes
PR depression |
Pericarditis
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Pericarditis chest pain better lying down or sitting up?
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Sitting up
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Pericarditis Tx
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High dose aspirin
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Chronic condition resulting in fibrosed, thickened, adherent, and/or calcified pericardium
Most often caused by cardiac surgery May follow TB, SLE, or radiation |
Constrictive Pericarditis
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Pericardial thickening and calcification on CT
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Constrictive Pericarditis
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Constrictive Pericarditis Tx
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Diuresis and salt restriction
Pericardiectomy |
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2 types of Pericardial effusion
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Transudative
Exudative |
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Transudative Fluid
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Clear/serous
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Exudative fluid
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Serosanguinous or bloody
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Transudative Pericardial Effusion (3)
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CHF
Hypoalbuminemia or hypopro Hypothyroidism |
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Exudative Pericardial Effusion (6)
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Infection
Malignancy Chest Irradiation CTD/CVD: SLE, RA HIV Trauma |
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Low voltage and flat T waves on EKG
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Pericardial Effusion
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Test of choice for Pericardial Effusion
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Echo
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Effusion and cardiac collapse
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Diagnostic and Tx of Pericardial Effusion
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Pericardiocentesis
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Exudative Labs?
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Too much stuff
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Transudative Labs?
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Too little stuff
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If young male and Pericardial Effusion, think...
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Viral
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If young female and Pericardial Effusion, think...
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SLE
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Pericardial effusion is so bad that the R side of the heart collapses
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Pericardial Tamponade
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Pulsus Paradoxus
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Pericardial Tamponade
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Hypotension
JVD Muffled Heart Tones |
Beck's Triad
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Pericardial Tamponade
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Hypotension
JVD Tachycardia Pulsus Parasoxus |
Classic Quartet
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Pericardial Tamponade
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Electrical alternans
(QRS amplitude and morphology vary) |
Pericardial Tamponade
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Diagnosis of Pericardial Tamponade
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Echo
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Pericardial effusion and compression of cardiac chambers on Echo
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Pericardial Tamponade
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Tx of Pericardial Tamponade
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Pericardiocentesis
(Infuse crystalloid IV solution) |
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Delayed pulse upstroke
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Pulsus Tardus
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AS
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Double pulsation occurring during systole
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Pulsus Bisferiens
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AR
HCM |
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Fall in systolic BP with inspiration
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Pulsus Paradoxus
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Cardiac Tamponade
COPD |
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Repeated variation in the amplitude of Pulse Pressure
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Pulsus Alternans
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Profound LV Dysfunction
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Weak pulse upstroke caused by diminished SV
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Pulsus Parrus
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Hypovolemia
AS MS LV Failure |
