Cardiac Normals

Question 1

Pulse pressure

Answer 1

SBP-DBP 40-60

Question 2

ABI

Answer 2

ankle BP/brachial BP

> 0.9

Question 3

Pulse pressure

Answer 3

40-60 mmHg

Low or narrow indicated hypovolemia
High or wide indicates sepsis or shock

Question 4

RCA occlusion/lesion

Answer 4

ii, iii, aVF(inferior)
V1, V2 (post LV)
V3R, V4R (RV)

Question 5

LDA occlusion/lesion

Answer 5

V1,V2,V3,V4(anterior LV or LM)

Question 6

CX occlusion or lesion

Answer 6

V5,V6, i, AVL (lateral LV)

Question 7

Inferior MI

Answer 7

RCA occlusion
ii, iii, aVF
Conduction issues and systolic murmur
2’1, 3’, SSS, SB

Question 8

RV infarct

Answer 8

RCA occlusion, get r sd ekg,

Pt may have JVD, Inc CVP, clear lung,

Give ivf and Inotropes

NO preload reducers, no nitro, careful with bb

Question 9

Anterior MI

Answer 9

LAD occlusion

V1-V4

Conduction issues and HF
2’2, RBBB
systolic murmur

Question 10

Retro bleed

Answer 10

Back pain, BP suddenly drops

Give 250ml bolus, 0.5mg iv atropine if needed, check CBC, act, aptt know normals inr and platelets, get consents for blood, 1:1 for every point below 8 of hgb, give ffp and platelets if massive trans, call IR

Question 11

Acute decomp systolic dysfunction

Answer 11

Lv fills ok, pump bad

Dilated, hormones cause vent remodeling

S/s:MVR, pulm edema low BP, high SVR,

Tx: reduce meds that contribute (levo etc) give ace I, diuretic, vaso dilators, positive inotropes

No bb or ccbs

Question 12

Tamponade

Answer 12

From pericarditis, heart surg, trauma

S/s: restless, poor LOC, narrow PP, Becks triad(low BP, increased JVD, muffled heart), low CO, high wedge, high CVP, pulses paradoxes

Tx pericardialcentesis, drain

Question 13

Aneurism

Answer 13

From HTN, smoking, obese, infections

S/s: abdomen pulsations, abd, scapula, low back pain, NV, shock, hoarse, dysphasia, dyspnea, sudden tearing pain chest back neck

Tx: CT/US, If <5cm TEE(abdomen), TTE(thoracic), beta blockers to slow growth

If >5cm surg repair, treat HTN and HR with labetalol or lopressor

Dissection if suddenly Inc cp back pain, weakness, low uo, diff cuff pressure in both arms