Cardio Conditions Flashcards by Elizabeth Sager

Describe the etiology/RF for hypertension

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Describe the clinical presentation & PE for hypertension

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Describe the range of BP from normal to stage 2 HTN

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Describe malignant HTN

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Describe the non-pharm treatments for HTN

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Describe the 4 main classes of first line antihypertensives

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Describe the etiology & RFs for aortic aneurysm

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Describe the clinical presentation of aortic aneurysm and aortic aneurysm rupture

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Describe the PE for an aortic aneurysm

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Describe the testing and screening procedures for aortic aneurysm and rupture

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Describe the treatment for aortic aneurysm and rupture

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Describe the etiology of aortic dissection

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Describe the clinical presentation of aortic dissection

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Describe the diagnostic testing for aortic dissection

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Describe the treatment for aortic dissection

Stanford A = surgical

Stanford B = medical management
- BP control goal 100-120 systolic (BB, CCB, IV nitroprusside)
- arterial pressure, central venous pressure

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What are some contraindications to aortic dissection surgical repair

CVA, severe valve disease, recent MI, pregnancy, advanced age

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Describe the etiology of rheumatic heart disease

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Describe the clinical presentation and PE of rheumatic heart disease

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Describe the diagnostic testing for rheumatic heart disease

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Describe the treatment for rheumatic heart disease

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Describe the etiology of mitral/tricuspid regurgitation

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Describe the clinical presentation of mitral/tricuspid regurgitation

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Describe the murmur heard in mitral and tricuspid regurgitation

Mitral best heard at apex, tricuspid best heard at LLSB

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Describe the treatment for mitral/tricuspid regurgitation

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Describe the etiology of a mitral S3 gallop murmur

Diastolic Gallop sound in early diastole as a result of extra blood filling back into ventricle & splashing (every 3-4 beats)

Describe the mitral valve prolapse murmur

mid to late systolic click of the valve and late systolic murmur

Describe the etiology of aortic stenosis

Describe the clinical presentation of aortic stenosis

Describe the murmur heard in aortic stenosis

Auscultation: - ejection click following S1 best heard at left lower sternal border - systolic crescendo-decrescendo ejection murmur heard at URSB 2nd ICS that radiates to carotid arteries bilaterally

Describe the treatment for aortic stenosis

Describe the etiology of pulmonic stenosis

Describe the clinical presentation of pulmonic stenosis

Describe the murmur for pulmonic stenosis

Describe the etiology of mitral stenosis

Describe the clinical presentation of mitral stenosis

Describe the murmur for mitral stenosis

Describe the treatment for mitral stenosis

Describe the etiology of aortic regurgitation

Describe the clinical presentation of aortic regurgitation

dyspnea, PND, orthopnea

Describe the murmur heard in aortic regurgitation

Early diastolic decrescendo murmur, heard best at 3rd LICS, high pitch blowing, can include S3 sound

Describe the treatment for aortic regurgitation

Describe the etiology of an S4 atrial gallop

Diastolic murmur L atria contracting against a stenotic L ventricle, often a sign of diastolic HF

Describe the etiology of SVT

can be triggered by stimulants, alcohol, digoxin, MI, pericarditis, valvulopathy, PE, COPD

Describe the treatment for SVT

Describe the etiology of premature atrial contraction

Describe the etiology of premature ventricular contraction

Describe the clinical presentation of PAC and PVC

Describe the treatment for PVCs

beta blocker if symptomatic, to reduce frequency

Describe the etiology of wolff parkinson white syndrome

Describe the clinical presentation of WPW syndrome

Describe the treatment for WPW syndrome

Describe the etiology of idioventricular conduction delay

Describe the RFs for IV conduction delay

Describe the etiology of RBBB

Describe the EKG for RBBB

Describe the etiology of LBBB

Describe the EKG in LBBB

Describe the etiology of tachy/brady syndrome

Describe the clinical presentation of tachy/brady syndrome

Describe the etiology of v-tach

Describe the clinical presentation of V-tach

Describe the treatment for v-tach

Describe the etiology of v-fib

Describe the etiology of acute aortic stenosis

Describe the clinical presentation of acute aortic stenosis

Describe the treatment for acute aortic stenosis

Describe the etiology of long QT syndrome

Describe the etiology of a third degree AV block

Describe the clinical presentation of a third degree AV block

Describe the treatment for third degree AV block

Describe the etiology of a-fib with rapid ventricular response

sxs: palpitations, chest pain, pre/syncope, dyspnea

Describe the treatment for a-fib with rapid ventricular response

Describe the treatment for WPW syndrome

Describe the etiology & RFs for acute MI

Describe the clinical presentation of an acute MI

Describe the EKG findings for a STEMI vs NSTEMI

Describe the treatment for STEMI & NSTEMI and some complications

Describe the etiology of PE

Describe the diagnostic testing for PE

Describe the treatment for PE

Describe the etiology of cardiogenic shock

Describe the clinical presentation of cardiogenic shock

Describe the etiology of Kawasaki syndrome

Describe the clinical presentation of kawasaki syndrome

Describe the diagnostic testing for kawasaki syndrome

Describe the treatment for kawasaki syndrome

IVIG & ASA mainstay

Describe the EKG for hypokalemia

Describe the etiology of an anterior MI

describe De Winter T waves seen in anterior MI

Describe which leads show ischemia in septal, anterior, lateral, anteroseptal, anterolateral territories

Describe the etiology for a lateral STEMI

Describe the etiology for an inferior STEMI

Describe the EKG for an inferior STEMI

Describe the etiology of right ventricular infarction

Describe the etiology and EKG for posterior MI

Describe the etiology of subendocardial infarction

Describe the etiology of brugada syndrome

Describe the EKG for brugada syndrome

Describe the etiology of takotsubo cardiomyopathy & EKG findings

Describe the etiology of an anterior fascicular block

Describe the EKG for anterior fascicular block

Describe the etiology of posterior fascicular block

R axis deviation associated with MI, S1Q3

Describe the etiology of a bifascicular block

describe the etiology of atrial septal defect

describe the clinical presentation of atrial septal defect

Describe the murmur & diagnostic testing for atrial septal defect

Describe the etiology of patent foramen ovale

Describe the etiology of ventricular septal defect

Acyanotic Common, Communication between ventricles (single or multi), shunting L to R Location class - peri/membranous - muscular defects - outlet defects (subpulmonic) - inlet defects (AV canal)

Describe the clinical presentation of ventricular septal defect

Symptoms depend on size & pressure differentials Causes pulmonary HTN if L to R is extreme (Eisenmenger syndrome)

Describe the murmur and diagnostic testing for VSD

Murmur: small 2-3/6 harsh, blowing, holosystolic, heard best at LLSB, sometimes 4/6 thrill, small defects result in louder murmur, larger can be absent or 1-2/6 EKG may see LVH because of increased workload CXR - normal or CHF and L hypertrophy

Describe the etiology of patent ductus arteriosus

Describe the clinical presentation of patent ductus arteriosus

Describe the murmur and diagnostic testing for patent ductus arteriosus

Describe the treatment for patent ductus arteriosus

Describe the etiology for coarctation of the aorta

Describe the clinical presentation for coarctation of the aorta

Describe the murmur and diagnostic testing for coarctation of the aorta

Describe the treatment for coarctation of the aorta

Describe the etiology of truncus arteriosus

Describe the murmur and diagnostic testing for truncus arteriosus

Describe the etiology of hypoplastic left heart syndrome

Describe the etiology of tetralogy of fallot

Describe the clinical presentation for tetralogy of fallot

Describe the murmur and diagnostic testing for tetralogy of fallot

Describe the etiology for total anomalous pulmonary venous return

Describe the diagnostic testing for total anomalous pulmonary venous return

echo

Describe the etiology for transposition of great vessels

Describe the diagnostic testing for transposition of the great vessels

Describe the treatment for transposition of the great vessels

Describe the types of heart failure

Describe the clinical presentation of heart failure

Describe the physical exam of heart failure

Describe the diagnostic testing for heart failure

Describe which medications to avoid in heart failure

Describe the treatment for acute decompensated heart failure

Describe the etiology of cor pulmonale

Describe the clinical presentation of cor pulmonale

Describe the diagnostic testing for cor pulmonale

Describe the treatment for cor pulmonale

Describe the etiology of atrial fibrillation

Describe the clinical presentation of the types of atrial fibrillation

Describe the diagnostic testing for atrial fibrillation

Describe the treatment for atrial fibrillation

Describe the causes and RFs for atrial fibrillation

Describe the etiology and risk factors for metabolic syndrome

Describe the clinical presentation of metabolic syndrome

Describe the treatment for dyslipidemia

Describe the treatment for elevated LDL

cholesterol absorption inhibitor (ezetimibe 10mg QD)

Describe the treatment for high triglycerides

Describe the etiology & clinical presentation of stable angina

reversible ischemia

Describe the diagnostic testing for stable angina

Describe the treatment for stable angina

Describe the etiology of unstable angina

Describe the clinical presentation of unstable angina

Describe the diagnostic testing for unstable angia

describe the treatment for unstable angina

Describe the etiology of PAD

Describe the clinical presentation of PAD

Describe the PE & diagnostic testing for PAD

Describe the treatment for PAD

Describe the etiology of critical limb ischemia

Can be a presentation of PAD pts Significant ischemia that threatens the limb, insufficient arterial flow d/t thrombosis of atherosclerotic artery

Describe the clinical presentation of critical limb ischemia

Pain, paresthesia, pallor, paralysis, pulselessness, poikilothermia (cold) Rest pain, ischemic ulceration, gangrene

Describe the treatment for critical limb ischemia

Catheter directed thrombolysis or surgical revascularization if limb is salvageable Amputation if limb is not salvageable

Describe the etiology of venous thromboembolism

Describe the clinical presentation of VTE

Describe the diagnostic testing for VTE

Describe the treatment for VTE

Describe the etiology of buerger's disease

Describe the clinical presentation of buerger's disease

Describe the treatment for buerger's disease

Describe the etiology of varicose veins

Describe the treatment for varicose veins

Describe the etiology of superficial thrombophlebitis

Describe the etiology of chronic venous insufficiency

Describe the clinical presentation of chronic venous insufficiency

Describe the treatment for chronic venous insufficiency

Describe the difference between venous & arterial insufficiency

Describe the etiology of acute infectious pericarditis

Usually initially diagnosed as non-specific chest pain Infectious - viral: coxsackie, EBV, HCV, HIV, parvo B19, covid - Bacterial: pneumo, meningo, gono, staph, strep, coxiella (major concern for TB) - rare fungal & parasitic

Describe the etiology of non-infectious pericarditis

Non-infectious - pericardial injury syndromes (post-MI, trauma) - systemic: SLE, RA, sjogren’s - malignancy (MC lung, breast, lymphoma) - metabolic: uremia, hypothyroidism - traumatic: penetrating or radiation injury (chemo, cardiac meds, isoniazid, phenytoin, PCNs)

Describe the clinical presentation & PE for acute pericarditis

Describe the diagnostic testing for acute pericarditis

Chest pain workup CXR: typically normal or evidence of effusion CBC & Inflammatory markers: leukocytosis, elevated CRP, ESR Troponin not elevated Consider D-dimer Echo: usually normal unless large effusion EKG: classically diffuse ST elevation or PR segment depression (except in aVR & V1 - ST depression), may have no ST changes but have diffuse T wave inversion

Describe the diagnostic criteria for acute pericarditis

Describe the treatment for acute pericarditis

Describe the etiology of constrictive pericarditis

Describe the clinical presentation & diagnostic testing for constrictive pericarditis

Describe the treatment for constrictive pericarditis

Describe the etiology of pericardial effusion

Describe the clinical presentation of pericardial effusion

Describe the diagnostic testing for pericardial effusion

Describe the treatment for pericardial effusion

Describe the etiology for cardiac tamponade

Describe the clinical presentation of cardiac tamponade

Describe the diagnostic testing for cardiac tamponade

Describe the treatment for cardiac tamponade

Define pulsus paradoxus

Describe the etiology of myocarditis

Describe the clinical presentation of myocarditis

Describe the diagnostic testing for myocarditis

Describe the treatment for myocarditis

Describe the etiology of infective endocarditis

Inflammation of endocardium (can lead to regurgitation) Vegetations on valves/devices - microorganisms, fibrin, platelets, inflammatory cells, granulomas Non-infectious is rare (malignancy, hypercoagulable states - can cause embolic stroke) Causes: rheumatic valvular disease (mitral MC), congenital, MVP, IVDU (tricuspid MC) MC: staph aureus, epidermidis, viridans (rare oral flora HACEK)

Describe the clinical presentation of infective endocarditis

Fever, chills in 90%, malaise, myalgia, arthralgia, constitutional sxs, highly variable Acute: sudden onset within a week Subacute: slower onset (4 weeks) HF from valvular insufficiency, renal impairment, metastatic infection (osteomyelitis, organ abscess, septic arthritis), systemic embolization

Describe the diagnostic testing/PE for infective endocarditis

Murmur: new or worsening, 85%, regurgitant Splenomegaly, petechiae, splinter hemorrhages of fingernails, janeway lesions (painless, flat red macule son palms/soles, last longer than Osler), Osler nodes (tender, erythematous nodules on palms/soles/digits), Roth spots (pale retinal patch surrounded by darker ring of hemorrhage from inflammation of small arteries) Blood cultures before abx (3 samples from different sites), echo will show vegetations (TEE better) Duke Criteria (2 major, 1 major & 3 minor, or 5 minor)

Describe the treatment for infective endocarditis

Inpatient, ABCs IV abx (4-6 weeks) Remove devices if indicated +/- surgical debridement if refractory to abx, valve replacement Repeat blood cultures until negative for 1-2 days in a row IV fluid resuscitation, antipyretics, empiric anticoag NOT recommended dt risk of ICH Prophylactic abx prior to dental procedures w/ hx of endocarditis

Describe the etiology of dilated cardiomyopathy

Describe the clinical presentation of dilated cardiomyopathy

Describe the diagnostic testing & murmur for dilated cardiomyopathy

Describe the treatment for dilated cardiomyopathy

Describe the etiology of restrictive cardiomyopathy

Describe the clinical presentation of restrictive cardiomyopathy

Describe the diagnostic testing/heart sounds for restrictive cardiomyopathy

Describe the treatment for restrictive cardiomyopathy

Describe the etiology of amyloidosis

Describe the clinical presentation of amyloidosis

Describe the diagnostic testing for amyloidosis

Describe the etiology of hypertrophic cardiomyopathy

Diastolic failure Heart muscle becomes bulky, large, and impairs adequate pumping leading to fatal arrhythmias Historical indicators: low exercise tolerance, SOB with exertion, dizziness with exercise, fatigue, hx syncope with exercise RF: genetic (autosomal dom) Patho: physiologic response or inherited inability for cardiac muscle to contract properly, ventricular spaces shrink, SV/CO reduced - intermittent outflow obstruction can develop obstructing mitral valve

Describe the clinical presentation of hypertrophic cardiomyopathy

Describe the murmur & diagnostic testing for hypertrophic cardiomyopathy

Auscultate sitting, lying, valsalva - high pitched crescendo-decrescendo midsystolic ejection murmur at LLSB exacerbated with valsalva, S4 Echo: gold standard, shows septal thickness, LV wall thickness > 1.3 Confirmatory tests: genetic testing, cardiac biopsy will show myofibril disarray (not parallel)

Describe the treatment for hypertrophic cardiomyopathy

Identify the leads where Q waves/ST elevation will be seen for the following areas of infarction & associated arteries

Identify the valvular dysfunctions/causes of the following systolic/diastolic murmurs

Describe the etiology/RF for RBBB

Describe the clinical presentation for RBBB

Describe the EKG for a RBBB

Describe the etiology/RF for a LBBB

Describe the clinical presentation of a LBBB

Describe the EKG for a LBBB

Describe the treatment for a RBBB & LBBB

treat underlying condition, pace if symptomatic

Describe the etiology for a left anterior fascicular block

Describe the EKG for a left anterior fascicular block

Describe the etiology of a left posterior fascicular block

Describe the EKG for a left posterior fascicular block

Describe the etiology of sick sinus syndrome

Describe the clinical presentation of sick sinus syndrome

Describe the EKG findings in sick sinus syndrome

Describe the treatment for sick sinus syndrome

treat underlying condition or pace

Describe the etiology of cardiogenic shock

Describe the clinical presentation of cardiogenic shock

Describe the diagnostic testing for cardiogenic shock

Describe the treatment for cardiogenic shock

Describe the most common cause of cardiogenic shock

Describe some of the mechanical circulatory supports for cardiogenic shock treatment

- intra-aortic balloon pump - impella device - VA-ECMO (veno-arterial extracorporeal membranous oxygenation) - LVAD (left ventricular assist device - HeartMate3)

Describe how an intra-aortic balloon pump works for cardiogenic shock

- short term support following MI - balloon inserted via femoral artery & synced to EKG - inflates during diastole to back-fill the coronary arteries - deflates during systole to suction blood forward

Describe how an impella device works in cardiogenic shock

- percutaneous ventricular assist device - increases blood flow in line with aortic circulation via femoral artery into left ventricle - encourages continuous forward flow (like a jetski motor) - risk of hemolytic anemia

Describe how VA-ECMO treats cardiogenic shock

- temporary cardiopulmonary bypass via femoral vein & artery - deoxygenated blood is pulled from the right atrium, passes through gas exchange membrane, and is injected into iliac artery - allows adequate tissue perfusion while greatly reducing cardiac preload/afterload

Describe how an LVAD treats cardiogenic shock

- surgically inserted impellor - blood pulled froom apex of LV, spun through impellor, injected into aortic root - continuous flow support - numerous complications (infection, suction events, thrombus, hemolytic anemia, battery failure)

Cardio Conditions Flashcards

(245 cards)