Cardio Flashcards
(47 cards)
echo findings of ie
oscillating mass on valve or adjacent structures, myocardial abscess, dehiscence of valves
risk of stent thrombosis duration of anticoagulation - bare metal stent/ des
bare metal stent - 1 month; drug eluting stent 1yr
prolonged qt definition and computation
bazzett’s formula - qt/sqrt of rr interval; male >0.45 sec female >0.46sec
Heparin dosing for mi vs vte
Mi - 60/12
Bolus: 60mg/kg then 12mg/kg/hr
Ptt 1.5-2 times of control
Vte - 80/18
Bolus: 80mg/kg then 18mg/kg/hr
Ptt 2-3 times control
Vte prophylaxis
5000units bid
2 most common autosomal dominant genetic mutations if vte
- Factor V leiden - activated protein c resistance
2. Prothrombin gene mutations
Most common cause of acquired thrombophilia
Antiphospholipid antibody syndrome
Each 2hr per day increment in watching tv increases risk of fatal pe by
40%
Most common gas exchange abnormalities in pe
- Hypoxemia
2. Increased a-a gradient
Causes of rise in pulmo artery pressure in pe
- Obstruction
2. Release of neurohormonal mediators - serotonin
Classification of pe
Massive pe (5-10%) - cardiogenic shock
*involves at least half of pulmo vasculature
Submassive pe (20-25%) - rv dysfunction but normal bp
Low risk pe (65-75%) - excellent prognosis
Most common symptom of pe
breathlessness
Most common symptom of dvt
Cramps
Diagnostic test for Low likelihood of vte
D dimer
High likelihood of vte diagnostic to request
Imaging (ctpa)
For wells score >4
Syndrome - Compression of the left proximal iliac by the right proximal iliac
May thurner syndrome
- presents with recurrent left thigh edema
Sensitivity of d dimer for pe and dvt
Dvt 80%
Pe 95%
D dimer less sensitive than pe because dvt thrombus size is smaller
Ecg abnormality pe
Sinus tachy - most common
S1q3t3 - specific
Rv strain and ischemia - most common abnormality t wave in version v1-v4
Cxr findings in pe
Hamptons hump - peripheral wedged shaped density
Westermarks sign - focal oligemia
Pallas sign - enlarged right descending pulmo artery
Ct scan finding associated with increased mortality in pe
Rv enlargement
*ct scan with iv contrast principal imaging test in pe
Triple rule out ct
Ecg synchronized acquisition
Rules out 3 major cause of chest pain: pe, mi, acute aortic syndrome
Lung scanning component andndiagnostic criteria
- ventilation scan: xenon or krypton labeled gas
- perfusion scan: particulate aggregates of albumin labeled with a gamma emitting radionuclide
High probability scan for pe: 2 or more segmental perfusion defects in the presence of normal ventilation
Pe sign in 2d echo
McConnells sign: hypokinetic rv free with hyperkinetic rv apex
Pulmonary angiogram pe finding
Intraluminal filling defect in more than 1 projection
Study which evaluates efficacy of anticoagulation vs catheter directed thrombolysis in preventing post thrombotic syndrome
ATTRACT
