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29 Cards in this Set
- Front
- Back
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aortic regurg
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- classic heart sound: diastolic descrescendo murmur at 3rd left intercostal space
- handgrip => increase peripheral vascular resistance, afterload => increase regurg - widened pulse pressure - tx: vasodilators e.g. nifedipine, ACE - BB worsen |
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widened pulse pressure
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- aortic regurg
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mitral valave prolapse
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- progresses to mitral regurg and paroxysmal afib
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rhem cuases?
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- mitral stenosis > mitral regurg
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** interferior wall MI
** anterior wall MI |
- II, III, aVF; MC is RCA > LCA; look for bradycardia and hypoT suggesting involvement of SA node and RV
- V2, V3, V4; LAD |
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pulsus paradoxus
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- large drop in SBP with inspiration,
- cardiac etiology: tamponade, pericardial effusion - pulm etiology: tension, PTX, severe asthma |
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pt with hx COPD now with lower extremity edema?
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- COPD => chronic hypoxia => pulm artery constriction => pulm HTN => right ventricular hypertrophy, RVF => increased JVP, HSM, LE edema
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next step in pulseless electrical activity?
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- afib: nonshockable => CPR, O2, Epi, vasopressin, atropine
- VF or VT: defib, if not serious hemodynamic compromise (not pulseless, BP-less) can cardiovert |
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Meds for those s/p MI?
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- ASA, BB, ACE-I, statin
- clopidogrel for unstable angina, non-ST MI, PCI (antiplatelet, antagonizes ADP) - data shows ASA+Cloppidogrel is best |
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Kid with deafness and episode of syncope?
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- jervell-lange-nielson syndrome = congenital deafness and congenital QT prolongation 2/2 ion channel defects => torsades => syncope-death
- BB t x if asympt, if sympt = BB + DDD pacemaker |
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biggest decrease HTN by?
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- weight loss > exercise > salt restriction > EtOH
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asympt PVCs
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- worse prognosis, but even worse if suppress
- if sx then BB |
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cardiogenic shock and ddx?
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- CS= LV failure = decrease CO with increased PCWP
- volume overload: increased PCWP, CO -ARDS: normal or low PCWP |
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electrolyte abnormalities in heart failure
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- hypoNa2+ = very severe heart failure, water restrict
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sx of ventricular wall rupture
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- sudden PEA, blood fills heat sac => decreased SV => hypotension => increased sinus tachy
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pt s/p MI with persistent ST segment elevation?
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- ventricular aneurysm; can have mitral regurg 2/2 aneurysm alterations
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edema in CHF? vs other edema?
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- CHF: decreased renal perfusion => RAA activation => kidney arterioles constrict => increased Na absorption => increased water retention
- edema 2/2 hypoalbuminemia: decreased plasma colloid pressures, seen in proteinuria (nephrotic syndrome, liver failure) |
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tx Prinzmetal?
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- Diltz
- greatest RF is smoking |
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MI that causes MR?
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- anterolatearl MI => papillary muscle ischemia
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tx of heme stable brady?
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- atropine => then transQ pacing
- etiology: healthy, vagal activity, sick sinus syndrome, hypoglycemia, meds (digitalis, BB, CCB) |
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MCC endocarditis 2/2 rheum?
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- viridans group = streptococci, enterococci, coag neg staph (staph epi)
- hx of GU procedure => bacteremia 2/2 enterocooci |
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cres-decres at LLB
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- HCOM
- outflow obstruction 2/2 hypertrophied interventricular septum and abnormal mitral valave leaflet mvmt |
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myocarditis
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- causes sx of CHF
- MC of CHF in young people is viral myocarditis 2/2 coxsackie |
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young person with sx of CHF?
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- viral myocarditis
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kussmaul
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- increased JVP with inspiration
- 2/2 right ventricular failure, hear clear lungs |
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MOA nitro
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- dilation of capitance vessels (veins) => venous pooling => decreased ventricular preload => decreased heart size => decreased O2 requiremetn
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aortic stenosis in young kid?
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- CP with exertion, RSB systolic murmur, 2/2 bicuspin valve
- CP 2/2 incraesed O2 demand 2/2 increased LF |
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myocardial perfusion scanning
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- dipyridomole dilates vessels, dye goes in except thsoe with dz b/c already max dilated
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MC death in pts with acute MI?
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- complex ventricular arrhythmias
- reentrant arrhythmia e.g vfib |
