Cardio Flashcards
(77 cards)
Treatment of constrictive pericarditis
Constrictive pericarditis is a product of chronic inflammatory changes in the pericardium that makes it a rigid box.
Peristernal “knock”
tx: Pericardiectomy
Right sided infarct
Right sided infarcts are preload-dependent
Morphine and nitroglycerin should NOT be given in these instances. They are both venodilators
Instead, support their blood pressure with fluid.
Syncope in a CAD patient
Sudden onset syncope in someone with known coronary artery disease or structural heart disease gets admitted for 24 hour telemetry monitoring to try to catch the arrhythmia (often, one is not caught and an event recorder is required to identify it).
Indications for Automatic Implantable Cardioverter Defibrillator (AICD)
Patients with CHF who are referred for AICD placement for primary prevention of cardiac arrhythmias.
class I w/ EF < 30%.
Class II-III with an EF < 35%
Those in class IV are not referred. Bad CHF
Presentation of pericardial tamponade
Hypotension, jugular venous distention, muffled heart sounds (Beck’s Triad)
Treatment of pericardial tamponade
An emergent ultrasound guided pericardiocentesis is the definitive therapy for pericardial tamponade. While cardiology is coming to the bedside to perform it, support their preload with intravenous fluid.
statin therapy for CAD patients
high potency statins are required in known coronary artery disease either rosuvastatin 40 or atorvastatin 80.
Aortic stenosis treatment
Symptomatic or severe aortic stenosis requires valve replacement becuz usually due to calcifications
Mitral valve stenosis is less often from calcification and can therefore respond to valvuloplasty more regularly.
Niacin side effect
Niacin-associated flushing can be treated with aspirin. However, the utility of adding this to a patient already on a statin is debatable.
Evaluation of patient for heart failure
The BNP is the first test in the evaluation of someone who has heart failure, followed by echocardiogram, then catheterization, stress test and PFTs as suggested by patient history.
Long term complication if patient is left with patent ductus arteriosus?
Machine like murmur
Large PDA causes large left-to-right shunt and can lead to pulmonary arterial hypertension
What is central retinal artery occlusion?
acute painless monocular visual loss
cherry-red fovea
Due to atrial fibrillation, infective endocarditis, paradoxical deep vein thrombosis, or atherosclerosis from major arteries
What is central retinal vein occlusion?
acute onset of painless blurred vision in one eye
“blood and thunder”
Retinal hemorrhages, edema, dilated retinal veins, and possibly cotton-wool spots
Aortic regurgitation
Wide pulse pressure
Diastolic decrescendo murmur @ left lower sternal border
Late diastolic rumble (Austin-Flint murmur)
Bounding pulses
Aortic stenosis
Weak S2, murmur decreases with valsalva
Crescendo–decrescendo systolic murmur with radiation to the neck/carotids
mitral regurgitation
Holosystolic murmur radiating to the axilla, increased with maneuvers that increase afterload, such as handgrip.
Which treatments is contraindicated in WPW and Afib?
In patients with Wolff-Parkinson-White with atrial fibrillation, use of atrioventricular nodal–blocking agents should be avoided, especially digoxin, as they can increase the risk of ventricular fibrillation.
Worsening of the murmur on inspiration suggests a
right-sided murmur
Aortic regurgitation
early diastolic murmur along the upper left side of the sternum.
Mitral regurgitation
holosystolic (pansystolic) murmur located at the apex that increases with maneuvers that increase afterload, such as handgrip
Mitral stenosis
mid to late diastolic murmur, best heard at the apex.
Tricuspid regurgitation
holosystolic murmur at the left lower sternal border that increases with deep inspiration
Prophylaxis for toxoplasmosis
Prophylaxis for toxoplasmosis is trimethoprim-sulfamethoxazole (CD4<100)
Toxoplasmosis will often present with flu-like symptoms and lymphadenopathy.
Once a patient is diagnosed with toxoplasmosis by MRI findings, treatment is with sulfadiazine and pyrimethamine.
Tumor marker for ovarian cancer
CA-125
