Cardiac Emergencies Lecture

Question 1

describe the etiology of acute aortic stenosis

Answer 1

Degeneration of valve in older population, congenital in younger

L ventricular outflow obstruction - fixed cardiac output - increased afterload - LVH - HF

Question 2

Describe the etiology of a 3rd degree AV block

Answer 2

AV dissociation (P waves not related to QRS) decreasing cardiac output

Can result from MI, cardiomyopathy, myocarditis, endocarditis, hyperkalemia, medications, post-cardiac surgery, post-catheter ablation

RF: lyme history, maternal lupus, sarcoidosis

Question 3

Describe the etiology of WPW

Answer 3

Accessory AV pathway most frequent left lateral and posterolateral in bundle of kent

Pre-excites ventricles leading to a slurred QRS

Question 4

Describe the etiology/RF for acute MI

Answer 4

Question 5

Describe the etiology of myocarditis

Answer 5

Inflammation of the heart muscle (most commonly viral - coxsackie B)

Peaks in infancy & adolescence

Bacterial (rickettsia, borrelia), fungal, scorpion, SLE, rheumatic fever, clozapine

Question 6

Describe the etiology/RF for cardiac tamponade

Answer 6

Pericardial effusion causing significant pressure on the heart

Marked reduction in diastolic filling & cardiac output

RF: malignancy, uremia, pericarditis, infection, connective tissue disease, trauma

Question 7

Describe the etiology of kawasaki syndrome

Answer 7

M>F, common in asian american kids, rare in adults, unknown cause

Cards impact: coronary artery aneurysm, depressed myocardial contractility, HF, MI, arrhythmias, peripheral artery occlusion, involves medium-sized muscular arteries

Question 8

Describe the etiology of endocarditis

Answer 8

Infection of endothelium/valves d/t colonization during bacteremia (MC mitral valve, tricuspid in IVDU)

Often staph in acute, strep viridans in sub-acute