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24 Cards in this Set
- Front
- Back
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What causes jugular venous distention? What for cardiac problems commonly result in jugular venous distention? |
Increase in RAP -cardiac tamponade -PHTN -TS or TR -constrictive pericarditis |
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32-year-old female Atypical chest pain BP 112/ 50 Ht 6 ft wt 115 lb MVP What additional cardiac structure should be evaluated? |
Marfans syndrome AV and aorta - regurgitation -Dilitation - dissection |
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-39-year-old male -No cardiac history -Flu like symptoms for one week -A new systolic murmur -Abnormally thick anterior mitral valve leaflet -Mild MR What additional test will be helpful? |
Mitral valve endocarditis Blood cultures and a TEE |
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55-year-old female -increased dyspnea on exertion for 3 months -jugular venous distention -ascites -pericardial knock |
Constrictive pericarditis Dyspnea, ascites and jugular venous distention can all result from restriction to diastolic filling Pericardial knock is a classic constriction |
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-32-year-old female -fatigue -x-ray shows cardiomegaly -RAE -RVH dilitation -flattened IVs +Mid systolic closure of the pulmonic valve -no A wave What additional study should be performed? |
PHTN -micro cavitation (saline contrast) to rule out atrial level shunt as the cause |
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-22-year-old male -chest pain following exercise -concentric LVH (2.5 cm) -small LV cavity size -no pericardial effusion or SAM What additional non-invasive test may be helpful in diagnosis? |
Hypertrophic cardiomyopathy To identify an obstruction component valsalva should be performed CW at the LVOT |
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-38-year-old male -severe dyspnea on exertion for 2 months -dilated LV -increased e point to septal separation (EPSS on m mode) -B notch on the mitral valve. (M mode) -hypo contractile LV wall motion |
Dilated cardiomyopathy |
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58 year old female -cardiomegaly -dyspnea on exertion -LVH -bright myocardial appearance -LAE -small pericardial effusion |
Infiltrative (restrictive) cardiomyopathy |
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56-year-old female -shortness of breath -low frequency diastolic (rumbling) murmur -no history of rheumatic fever 3 possibly diagnosis |
1. Ms or TS maybe she did have rheumatic fever and doesn't remember 2. Left atrial myxoma can mimic MS 3. AI if the jet hits the mitral valve anterior leaflet the mitral valve opening can be restricted creating a *rumbling diastolic murmur called Austin Flint rather than *the typical blowing AI diastolic murmur |
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58-year-old male -systolic cardiac murmur -concentric LVH -mild to moderate thickening of the aortic leaflets with decreased opening -systolic doming of the aortic leaflets in the plax view |
Stenosis of A congenital bicuspid aortic valve *The Systolic doming is typical of the bicuspid aortic valve |
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31-year-old male -uncontrolled systemic hypertension -severe chest pain described as ripping Which non-invasive exam would be useful to confirm the diagnosis? |
Aortic dissection CT |
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What is marfan's syndrome? How does it affect the AV and the MV? |
Is it connective tissue disease characterized by -increase joint flexibility -elongation of the long bones -ocular lens problems -cardiac abnormalities -ascending aortic dilation -mitral valve prolapse -may have AI or MR -aortic dissections may also occur |
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18 year old male -palpitations -cardiomegaly -RAE -RV enlargement -tricuspid valve appears abnormally displaced towards the Apex What additional test should be performed in the echo lab? |
Epstein's anomaly Patients are often asymptomatic and this finding is a surprise accident Micro cavitation (saline bubble or contrast) study to identify the presence or absence of an associated ASD |
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Define acute bacterial endocarditis |
Infection of a normal valve. Before antibiotics became widely available patients with acute bacterial endocarditis usually died within 6 weeks |
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Define subacute bacterial endocarditis |
Infection of an abnormal valve Patients with -mitral valve prolapse -prosthetic cardiac valves -rheumatic heart disease |
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What is Chagas disease? What does it cause? What are the echo findings? |
Caused by a parasite bite that leads to myocarditis years later Epidemic in South America affecting over 20 million, so hx of living in South America would be important Cardiomyopathy Dilated, hypocontractile LV In some pts septum is normal but Apical and posterior walls are affected |
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What symptoms and physical findings are associated with left atrial myxoma? |
-obstruction of the mitral orfice -dyspnea -fatigue - weakness -diastolic murmur |
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Which other cardiac abnormality do the symptoms and physical findings of a left atrial myxoma mimic? |
Rheumatic mitral Stenosis |
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What is the most common primary malignant tumor? |
Sarcoma 25% of all primary cardiac tumors -angiosarcoma -rhabdomyosarcoma -fibrosarcoma |
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What is the most common benign cardiac tumor in children? What is the second most common? |
Rhabdomyoma -Derived from cardiac muscle cells, -Frequently multiple -Intracavity and or intramyocardial and may obstruct cardiac inflow and outflow -fibromyoma often intramyocardial |
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What is Ebstein's anomaly? What congenital lesion is often associated with it? |
Congenital malformation and Apical displacement of one or more tricuspid leaflets -degree varies -part of the ventricles become atrialized -annulus is positioned normally - TR usually moderate to severe Secundum atrial septal defect |
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Which views are the most helpful in assessing Ebstein's anomaly? |
4 chamber ( Apical or subcostal) |
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What conduction disturbance is associated with Ebstein's anomaly? |
Increased incidence of WPW syndrome usually with a right accessory pathway |
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Two weeks pay inferior MI 44 yo male SOB Chest pain New systolic murmur |
Rupture of papillary muscle producing severe-acute MR (90% of papillary muscle rupture occur after inferior MI |
