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21 Cards in this Set
- Front
- Back
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pt with unstable angina- next step?
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- get coronary angiography followed by PCI or CABG
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preop eval for low risk procedure?
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- no eval is necessary regardless of pt's risk factors
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pt with newly dx CHF via ECHO, next step?
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- identify the etiology - most common is CAD so get cardiac stress test
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hypotension in R ventricular infarction?
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- give fluids
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hypotension secondary to bardycardia from inferior infarct?
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- give atropine or intravenous pacing
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pt with EF of 35% but asymptomatic?
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- tx of asymptomatic LV dysfunction is ACE-I (second choice is BB) --> delays onset of symptomatic HF
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PEA
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- 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
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when to defib vs cardiovert?
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- defib is for shockable rhythms: vfib or pulseless vtach
- sync cardioversion is for unstable tachycardia (pt is tachy but with pulse) |
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side effects of furosemide, HCTZ, lisinopril, amlodipine, metoprolol?
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- furosemide: SJS
- HCTZ: photosensitivity rash** - lisinopril: angioedema, urticaria, worsening psoriatic rash - amlodipine: fluid retention, urticarial rash - metoprolol: urticaria |
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endocarditis in drug use?
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- right sided involvement --> tricuspid vegetation, murmur with inspiration, septic pulmonary embolism
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most common cause of nonsustained vtach?
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- structural heart disease --> ECHO and stress test
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pt with cardiac risk factors with episode of syncope work up?
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- telemetry, cardiac enzymes, ECHO
- if evidence of ischemia then get angio |
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woman with hemoptysis and jugular vein distension
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- mitral stenosis - hx rheumatic fever
- pulm congestion |
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Beck's triad for cardiac tamponade?
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- hypotension, muffled heart sounds, increased JVP
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BP in cardiac tamponade
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- decreased SBP > 20 with inspiration (normal is 10-20mmHg drop with inspiration)
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tx of cocaine related chest pain and HTN?
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- benzos are first line
- if persists then IV phentolamine (alpha antagonist) or nitroprusside or nitroglycerin |
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most important predictor of adverse cardiac outcomes?
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- DM > smoking, obesity, etc
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types of syncope?
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- 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 |
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complications after acute MI?
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- immediate: acute pericarditis, chordae tendinae rupture (hemodynamic instability)
- weeks to months: dressler's, ventricular aneurysm (persistant ST elevations) |
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pt with CP and new LBBB?
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- LAD MI --> LBBB
- aka new acute MI --> immediate coronary angiography |
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Tx NSTEMI vs STEMI
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- NSTEMI: ASA, anticoag --> coronary angiography w/in 24 hours unless hemodynamically unstable, heart failure, ongoing angina, arythmias
- STEMI- immediate coronary angiography |
