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23 Cards in this Set
- Front
- Back
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pt sick x 2 wks, dark urine, fingertip pain?
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- IE
- duke's criteria major: BCx x 2, echo+, +new murmmur -minor: bad valves (hx of rheum, IVDU), fever, vascular phenomenom, immunologic (GN), +BCx x1 |
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enlarged heart silhouette
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- pericardial effusion (Can occur w/out tamponade)
- water bottle shaped - won't be able to feel PMI |
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young pt with signs of CHF?
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- increased JVP, SOB, LE edema
- most likely dilated cardiomyopathy 2/2 viral myocarditis - MC = coxsackie; others: CMV, adeno, echo, hep C, influenza, parvovirus, EBV - do echo: dilated ventricles with diffuse hypokinesia, decreased EJ |
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structural heart dz?
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- concentric hypertroph = chronic pressure overload e.g. aortic stenosis, HTN
- eccentric hpertroph = chronic volume overload e.g. valvular injury |
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cocaine induced ischemia?
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- if ST changes but no increase in cardiac enzymes => tx = benzo, asa, nitrates
- if cocaine MI => cardiac cath |
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VT?
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- regular wide complex tachycardia
- if heme stable - amiodarone - note: carotid massage for SVT (narrow complex) |
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old woman with diarrhea and new arrhythmia?
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- check for digoxin tox
- ECG: scooped ST segments, increased PR, decreased QT, T inversion |
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tx of afib?
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- rate control!
- BB or CCB - if afib <48 hrs then can cardiovert - if stable in afib >48hrs then do rate control, anticoag for 3-4 wks and then cardioversion |
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mass in heart with mid systolic rumble?
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- intracardiac tumor e.g. atrial myxoma
- NOTE: myxomatous valve degen = MVP: midsystolic click |
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loud S2
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- pulm HTN
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D4 in AS?
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- 2/2 forceful contradction against thick ventricle
- tx aortic valve replacement |
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BP goal?
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- <140/90. If DM or CKD then <130/80
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anticoag in afib?
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- ASA alone if healthy
- if risk for stroke, anticoag with heparin and then warfarin |
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lidocaine in ACS managment?
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- prevents wide VT but increased risk asystole and no improvement in prognosis
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peripheral edema as med SE?
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- amlodipine 2/2 dilation of peripheral vessels
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niacin SE?
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- vasodilation 2/2 release histamines, prostaglandins, take ASA to decrease sx, improves in 2-4 wks
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pt presents with MI and pulm edema
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- MI can cause flash pulm edema
- next step i furosemide b/c also venodilates to decrease preload |
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med to decrease ventricular remodeling s/p MI?
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- ACE-I
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pt with increased BP, weight gain, HYPOK+
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- cushing= adrenal cortical dz
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adrenal cortex vs medulla?
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- cortex = cortisol, etc
-medulla: catecholamine production |
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restrictive cardiomyopathy
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- amyloidosis, sarcoidosis, hemochromatosiis, scleroderma
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marfan vs ehlers-danlos with aortic dissection
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- MARFAN CAUSES, NO EHLERS-DANLOS
- but mcc is HTN |
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hyperTH related afib?
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- BB not cardioversion
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