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48 Cards in this Set
- Front
- Back
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Treatment of MI
What to give if ventricular tachycardia |
Amiodarone
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Morphine helps with pain and controlling ___
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Pulmonary Edema
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When is heparin indicated in setting of chest pain and MI?
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-Unstable angina
-cardiac thrombus -severe congestive heart failure *** do not give if active bleed |
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Pericarditis
EKG shows Which lab value classically elevated Most common cause is |
EKG diffuse ST-segment elevation
ESR Coxsackievirus |
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Initial treatment of unstable angina
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-Oxygen, aspirin, nitro
-beta-blocker, clopidogrel, heparin, and glycoprotein IIb/III1 inhibitor -ACEi or ARB |
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Angina caused by pain at rest and ST elevation, normal cardiac enzymes is likely ____
cause treatment |
Prinzmetal
Coronary artery spasm nitroglycerin and calcium channel blockers |
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Buzz words
Widened pulse pressure, LVH, LV dilation, S3 |
Aortic regurgitation
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Slow pulse upstroke, S3/S4, ejection click, LVH, cardiomegaly, syncope
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Aortic stenosis
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Buzz word
Opening snap, loud S1, AF, LAE, PH dyspnea, cough, hempotysis |
Mitral Stenosis
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Buzz words Soft S1, LAE, PH, LVH
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Mitral regurgitation
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Endocarditis prophylaxis with amoxicillin recommended in dental procedures if
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prosthetic cardiac valve
previous infection endocarditis congenital heart disease transplant recipients who develop valvulopathy |
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Hyper coagulable states (5)
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1. Factor V Leiden
2. AT III deficiency 3. Protein C 4. hyperhomocysteinemia 5.Antiphospholipid antibodies |
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T/F superficial thrombophlebitis is a risk factor for pulmonary embolism?
Recurrence is a sign of |
False. pancreatic cancer
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Partial thromboplastin time measures-
Prothrombin time measures- |
PTT- intrinsic pathway, heparin (not LMW heparin)
PT- extrinsic pathway, warfarin |
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Reversal agents
Heparin/LMW heparin- Warfarin Aspirin |
Heparin- Protamine
Warfarin FFP or vitamin K Platelet transfusion |
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Factors involved in intrinsic pathway (PTT)
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VIII, IX, XI, XII
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Factors involved in extrinsic pathway (PT)
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III, VII
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Which disease associated with prolonged PT ONLY?
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Liver disease- all factors but 8 are low (PTT normal)
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Young woman (20-40) with for pulmonale and no other risk factors think of
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idiopathic pulmonary arterial hypertension
TX- prostacyclines (parental apoprostenol), antiendothelins (bosentant), phosphodiesterase inhibitors, CCB |
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Dilated cardiomyopathy most common type and causes include
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Alcohol
Myocarditis Doxorubicin |
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Drugs that worsen HOCM
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Positive inotropes (digoxin)
diuretics vasodilators |
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Treatment WPW syndrome
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procainamide or quinidine
*avoid digoxin and verapamil |
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Patent Ductus Arteriosus
Murmur: Keep open with Close with Associated with |
machine-like in upper left sternal border
Open- prostaglandin E1 Close- Indomethacin or surgery congenital rubella and high altitude |
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Ventricular septal defect *Most common
Murmur Tx associations |
holosystolic next to sternum
usually resolve on own watch for fetal alcohol, TORCH, Down syndrome |
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Atrial septal defect
Murmur Tx |
Fixed, split s2 and palpitations
asymptomatic until adult usually do not require correction |
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Tetralogy of Fallot *Most common cyanotic defect
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1. VSD
2. Overriding aorta 3. Pulmonary stenosis 4. RVH |
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Coarctation of aorta
murmur signs |
systolic heard over mid-upper back
rib notching upper extremity hypertension associated with Turner |
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R or L sided murmurs increase on expiration?
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Left sided
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Murmur S4 "TEN-nes-see" associated with
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Restrictive cardiomyopathy or LVH from HTN
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Patients present with bradycardia, lightheadedness, syncope with EKG burst of tachy-brady
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Sick Sinus Syndrome from impaired SA node automaticity
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Valve disorder resulting in LA dilation and a risk of AFib
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Mitral Stenosis
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Congestive heart failure with extra cardiac manifestations proteinuria and easy bruisibility point to
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Amyloidosis
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Heart condition with amyloidosis
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restrictive cardiomyopathy
increased ventricular wall thickness w normal left cavity |
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Sarcoidosis causes what changes in the heart
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Granulomatous infiltration of myocardium--> heart failure with both systolic and diastolic dysfunction
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Late MI complication 5d--> 3mo with persistent ST segment elevation and deep Q waves in same leads
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Ventricular Aneurysm
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Ascending aortic aneurysm due to
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Cystic medial necrosis (aging) or CT disorder Marfan Ehlers-Danlos
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Descending Aortic Aneurysm (40% of cause) due to
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Atherosclerosis
-risk HTN, hypercholesterolemia, smoking |
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EKG changes show increased voltage QRS, ST and T wave changes in left precordial leads
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Left ventricular hypertrophy
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Cases where left ventricular hypertrophy seen
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Symptomatic hypertension
Coarctation of aorta |
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Wide complex tachycardia with 2 fusion beats diagnostic of
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sustained monomorphic ventricular tachycardia
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First line treatment for stable Vtach
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IV Amiodarone
Or lidocaine or procainamide |
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Carotid massage is a useful maneuver in
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Regular, narrow complex tachycardia
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Venous overload, Kussmaul's sign (lack of inspiratory decline in CVP), pericardial knock and x and y descents on central venous tracing characteristic of
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Constrictive pericarditis
-common cause in Africa, China tuberculosis |
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Elevated BNP and an audible S3 are signs of
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increased cardiac filling pressures
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Holosystolic murmur accentuated with inspiration
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Tricuspid regurg
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Decreased tolerance to glucose and hyperglycemia is a side effect of which diuretic
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HCTZ
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This diuretic can affect lipids by increasing LDL and triglycerides, as well as increasing uric acid retention
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HCTZ
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Electrolyte abnormalities with thiazides
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Hyponatremia
Hypokalemia Hypercalcemia |
