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Cardiology > Cardiogenic Shock, Orthostatic Hypotension, & Syncope > Flashcards

Cardiogenic Shock, Orthostatic Hypotension, & Syncope Flashcards

1
Q

what is the most common cause of cardiogenic shock?

A

Acute MI

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2
Q

clinical condition of inadequate tissue perfusion due to the inability of the heart to pump an adequate amount of blood

A

cardiogenic shock

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3
Q

what is the most common presentation of cardiogenic shock?

A

severe dysfunction of the LV (anterior MI)

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4
Q

what do a majority of patients with cardiogenic shock present with on ECG?

A

acute STEMI

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5
Q

what are 2 major risk factors for cardiogenic shock?

A

ST elevation MI
left BBB

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6
Q

a patient presents with hypotension, oligura, cold clammy skin, and metabolic acidosis on labs. what are they likely experiencing?

A

cardiogenic shock

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7
Q

what changes in labs will indicate metabolic acidosis in cardiogenic shock? (2)

A

elevated lactate
decreased serum bicarbonate

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8
Q

what lab values will indicate renal hypoperfusion in cardiogenic shock? (2)

A

elevated blood urea nitrogen + creatinine

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9
Q

what diagnostic can be done for suspected cardiogenic shock if diagnosis remains unclear?

A

pulmonary artery catheterization

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10
Q

what is the medical treatment for cardiogenic shock? (3)

A

ventilatory support (raise pH)

norepi + dopamine for hypotension

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11
Q

what inotrope can be used in less sick patients for cardiogenic shock?

A

dobutamine

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12
Q

what is the mechanical treatment for cardiogenic shock in the presence of mechanical defects like MR or ventricular septal defect?

A

intra-aortic balloon pump

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13
Q

what are 3 treatments that can be used for cardiogenic shock to encourage reperfusion?

A

primary percutaneous coronary intervention

CABG

fibrinolysis

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14
Q

a significant reduction in BP upon standing; dropping 20 systolic or 10 diastolic, 3 mins after standing

A

orthostatic hypotension

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15
Q

in patients with orthostatic hypotension, a _____ _____ fails, leading to a decline in BP with assumption of upright posture

A

compensatory mechanism

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16
Q

what are 2 risk factors for orthostatic hypotension?

A

elderly
antihypertensive (side effect)

17
Q

a patient presents with coat hanger headache, dizziness, and weakness. what are they likely experiencing?

A

orthostatic hypotension

18
Q

what are 3 lifestyle modifications to treat orthostatic hypotension?

A

elastic stockings
raise head of bed
exercise

19
Q

what are 3 physical maneuvers to treat orthostatic hypotension?

A

increase salt + water intake
cross legs while standing
handgrip while standing

20
Q

what is the primary goal of treatment of orthostatic hypotension?

A

decrease symptoms

21
Q

what are 2 medications that can be used for orthostatic hypotension?

A

fludrocortisone
milodrine

22
Q

what medication can be used for orthostatic hypotension that is associated with meals?

A

octreotide

23
Q

abrupt and transient loss of consciousness associated with the absence of postural tone, followed by complete and rapid spontaneous recover

A

syncope

24
Q

patients with an underlying _____ cause of syncope have higher rates of SCD

A

cardiovascular

25
Q

what is the underlying mechanism in all syncope events?

A

cerebral hypoperfusion

26
Q

what is the mnemonic for etiologies of syncope?

A

Pressure
Arrhythmias
Seizures
Sugar
Output
Unusual
Transient

27
Q

what is the most common type of syncope?

A

reflex syncope

28
Q

causes vasovagal syncope due to stimuli triggering sudden vasodilation and bradycardia, resulting in hypotension

A

pressure

29
Q

causes sudden syncope with no warning + loss of consciousness

A

arrhythmias

30
Q

what is the difference between a seizure and syncope?

A

seizure patients have prolonged confusion/lethargy after seizure + aura

31
Q

what is the gold standard of diagnosing a seizure?

A

history

32
Q

what are 3 unusual causes of syncope?

A

anxiety
panic disorder
somatization disorder

33
Q

what are 3 transient causes of syncope?

A

stroke
transient ischemic attack (TIA)
subarachnoid hemorrhage

34
Q

Predicts risk for serious outcomes at 7 days in patients presenting with syncope or near-syncope

A

san francisco syncope rule

35
Q

what are the 5 parts of the san francisco syncope rule?

A

hx of CHF
hematocrit <30%
abnormal ECG
SOB
systolic BP <90 at triage

36
Q

what are 2 meds that can be used for syncope?

A

midodrine
fludricortisone

37
Q

what is the single most common cardiac cause of syncope?

A

bradycardia

Cardiology (19 decks)

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