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21 Cards in this Set

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  • Back
pt with unstable angina- next step?
- get coronary angiography followed by PCI or CABG
preop eval for low risk procedure?
- no eval is necessary regardless of pt's risk factors
pt with newly dx CHF via ECHO, next step?
- identify the etiology - most common is CAD so get cardiac stress test
hypotension in R ventricular infarction?
- give fluids
hypotension secondary to bardycardia from inferior infarct?
- give atropine or intravenous pacing
pt with EF of 35% but asymptomatic?
- tx of asymptomatic LV dysfunction is ACE-I (second choice is BB) --> delays onset of symptomatic HF
PEA
- presence of organized rhythm (e.g. afib) w/out sufficiency cardiac output to produce a pulse or BP --> brain not perfused so start CPR--> chest compressions first then secure airway second --> if pulse returns then cardioversion
when to defib vs cardiovert?
- defib is for shockable rhythms: vfib or pulseless vtach
- sync cardioversion is for unstable tachycardia (pt is tachy but with pulse)
side effects of furosemide, HCTZ, lisinopril, amlodipine, metoprolol?
- furosemide: SJS
- HCTZ: photosensitivity rash**
- lisinopril: angioedema, urticaria, worsening psoriatic rash
- amlodipine: fluid retention, urticarial rash
- metoprolol: urticaria
endocarditis in drug use?
- right sided involvement --> tricuspid vegetation, murmur with inspiration, septic pulmonary embolism
most common cause of nonsustained vtach?
- structural heart disease --> ECHO and stress test
pt with cardiac risk factors with episode of syncope work up?
- telemetry, cardiac enzymes, ECHO
- if evidence of ischemia then get angio
woman with hemoptysis and jugular vein distension
- mitral stenosis - hx rheumatic fever
- pulm congestion
Beck's triad for cardiac tamponade?
- hypotension, muffled heart sounds, increased JVP
BP in cardiac tamponade
- decreased SBP > 20 with inspiration (normal is 10-20mmHg drop with inspiration)
tx of cocaine related chest pain and HTN?
- benzos are first line
- if persists then IV phentolamine (alpha antagonist) or nitroprusside or nitroglycerin
most important predictor of adverse cardiac outcomes?
- DM > smoking, obesity, etc
types of syncope?
- neurocardiogenic: common faint, caused by prolonged standing, exertion, pain --> diaphoretic, lightheaded, standing --> faint --> regain consciousness when supine
- CV: arrhythmias, structural lesions, can precede by palpitations, otherwise usually no sx
- autonomic neuropathy: postural hypotension
- neurogenic: dz of cerebral circulation --> neurologic deficits
complications after acute MI?
- immediate: acute pericarditis, chordae tendinae rupture (hemodynamic instability)
- weeks to months: dressler's, ventricular aneurysm (persistant ST elevations)
pt with CP and new LBBB?
- LAD MI --> LBBB
- aka new acute MI --> immediate coronary angiography
Tx NSTEMI vs STEMI
- NSTEMI: ASA, anticoag --> coronary angiography w/in 24 hours unless hemodynamically unstable, heart failure, ongoing angina, arythmias
- STEMI- immediate coronary angiography