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14 Cards in this Set

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Left axis
>-30
Right axis
>90
Cocaine induced vasospasm
no BBlocker, causes unopposed alpha stim
Printzmetal
CCB, nitrate, d/c smoking
Causes of Pericarditis
Inf: coxasakie, echo, adeno, EBV, VZV, HIV, TB, bacterial endocarditis, Fungus

Neoplastic 35%, usually metastatic

Uremia

CV: MI, Dressler's(10days), aortic dissection, trauma, radiation

Effusion: CHF, cirrhosis, nephropathy, hypothyroid, amyloid
Peridcarditis EKG
Diffuse STelevation, pr depression, TWI, low voltage, electical alternans

enzyme leak if myopericarditis
Pericarditis dx
Bun, Cr, ANA, RF, pericardiocentesis if >2cm
bx if suspect tb or malignancy
Pericarditis Tx
nsaid, +- colchicine 0.5mgbid
consider steroids
drainage for infection
Pericardial window if recurrent
Pericardial exudate criteria
Tp>3g/dl
TPeff/Tpserum>0.5
LDHeff/LDHserum>0.6
glc<60
Causes of Tamponade
malignancy, uremia, idiopathic

prox aortic dissection, myocardial rupture

Rapid effusion more likely to cause tamponade
Tamponade pathophys
equalization of pressures in all cardiac chambers.

decreased blood flow from ra to rv causes blunted y descent
Pulsus Paradoxus
increased venous return on inspiration is normal causing bulging of septum into LV and decreased CO.

Tamponade cause decrease in SBP by 10mmhg or greater on inspiration because of decreased LV filling
Beck's Triad(tamponade)
JVP, distant heart sounds, hypotension
Treatment for tamponade
give fluids, pericardiocentesis