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PANCE/EOC > Cardiology #1 > Flashcards

Cardiology #1 Flashcards

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1
Q

Dilated cardiomyopathy is MCC by what things?

A

Idiopathic, Coxsackievirus, Alcohol, Cocaine, B1 deficiency

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2
Q

Symptoms of Dilated cardiomyopathy

A

S3 gallop, heart failure symptoms

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3
Q

Diagnostics for dilated cardiomyopathy

A

-Echo (LV dilation), CXR (cardiomegaly)

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4
Q

Treatment for dilated cardiomyopathy

A

ACE, ARB, BB, Spironolactone, Diuretics, AICD if EF < 35%

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5
Q

Stress cardiomyopathy is the result of what

A

Catecholamine surge during stress (such as postmenopausal, death of family member)

-Transient regional systolic dysfunction of the left ventricle in absence of significant obstructive coronary artery disease or evidence of plaque rupture.

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6
Q

Treatment for stress cardiomyopathy

A

Aspirin + BB + Nitro + Heparin (mimics MI)

Supportive care is mainstay of treatment (BB or ACE for 3-6 months with serial imaging to assess for improvement)

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7
Q

What is on history of a patient with restrictive cardiomyopathy?

A

Infiltrative disease (amyloidosis, sarcoidosis, scleroderma)

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8
Q

Diagnostics for restrictive cardiomyopathy

A
  • Echo (initially) - diastolic dysfunction and marked dilation of both atria
  • Endomyocardial biopsy (definitive)
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9
Q

Hypertrophic cardiomyopathy pathophysiology

A

Diastolic dysfunction due to inappropriate LV and RV hypertrophy

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10
Q

What does an Echo for hypertrophic cardiomyopathy show?

A
  • Asymmetric ventricular wall thickness (especially septal), 15 mm or greater
  • Small LV chamber size
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11
Q

Treatment for hypertrophic cardiomyopathy

A

BB

If no response, myomectomy performed or alcohol septal ablation.

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12
Q

What does the murmur for hypertrophic cardiomyopathy sound like?

A

Harsh systolic murmur at LSB, Loud S4

  • Increased intensity with standing, Valsalva
  • Decreased intensity with squatting, supine
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13
Q

Myocarditis is MCC by

A

-Enterovirus (Coxsackievirus), Clozapine

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14
Q

Symptoms of Myocarditis

A
  • Viral prodrome followed by systolic dysfunction
  • S3 gallop
  • Pericarditis
  • Megacolon
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15
Q

Diagnostics for myocarditis

A
  • CXR: cardiomegaly
  • Echo: Ventricular systolic dysfunction
  • Endomyocardial biopsy: gold
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16
Q

Treatment for myocarditis

A
  • Supportive (systolic heart failure treatment)

- ACE/Diuretics/BB

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17
Q

Treatment for sinus tachycardia

A
  • BB if they have ACS

- Otherwise, treat the underlying cause (first line)

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18
Q

Treatment for sinus bradycardia

A
  • Atropine is symptomatic

- If asymptomatic, no treatment needed

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19
Q

What is sick sinus syndrome

A

Sinus arrest alternating paroxysms of tachycardia and bradycardia

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20
Q

Treatment for sick sinus syndrome

A
  • Stable: may not need treatment, often transient
  • Atropine if needed
  • Long term: pacemaker + ICD if alternating between tachycardia and bradycardia
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21
Q

What defines a first-degree AV block

A
  • Prolonged PR interval, but all followed by QRS complex

- PR Interval is > 0.20 seconds

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22
Q

Treatment for first-degree AV block

A

Atropine is first-line if symptomatic
-If asymptomatic, no treatment, observation.

-Pacemaker is definitive, if persistent or PRI > 0.30 seconds

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23
Q

What defines a second-degree AV block (Type I)

A

progressive lengthening of PR interval, dropped QRS complex

-This is known as a Wenkebach

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24
Q

Treatment for second-degree AV block

A

-Atropine, Pacemaker definitive

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25
Causes for second-degree AV block Type I
Inferior Wall MI, AV nodal blocking agents (BB, CCB, Lyme Disease)
26
What defines a second-degree AV block (Type II)
Constant PR interval before and after dropped QRS complex
27
Treatment for Mobitz Type II
Transcutaneous pacing or Atropine | -Permanent Pacemaker for long-term
28
What defines a third degree AV block
Regular P-P intervals and R-R intervals but they are not related to each other (AV Dissociation)
29
Treatment for 3rd degree AV block
Transcutaneous pacing followed by permanent pacemaker
30
Treatment for Atrial Flutter
Vagal maneuvers, BB, CCB - Unstable: Direct current synchronized cardioversion - Radiofrequency catheter ablation (definitive)
31
Symptoms of atrial fibrillation
Hypotension, AMS, refractory chest pain
32
What does an ECG show for atrial fibrillation? What is Ashman's Phenomenon on ECG?
Irregularly irregular rhythm with fibrillary waves (no discrete P waves) -Occasional aberrantly conducted beats (wide QRS) after short R-R cycles
33
Treatment for stable atrial fibrillation
BB, CCB (Diltiazem, Verapamil) -Digoxin only used when BB and CCB are contraindicated (CHF or severe hypotension)
34
Treatment for unstable A-fib
direct current synchronized cardioversion | -Echo needed prior to tell if there are atrial clots
35
Treatment for A-Fib determined by time present. Explain
- AF > 48 hours: anticoagulation for 3 weeks | - AF < 48 hours: elective cardioversion, anticoagulation for 4 weeks
36
What is the definitive treatment for A-Fib
Radiofrequency catheter ablation
37
Regarding the CHA2DS2-VASc score, a score of 2 or greater needs chronic anticoagulation. Explain this score.
``` Congestive heart failure (1) Hypertension (1) Age > 75 (2) Diabetes (1) Stroke (2) Vascular event such as MI, PAD (1) Age 65-74 (1) Sex Female (1) ```
38
What does an ECG for Paroxysmal Supraventricular Tachycardia show?
regular, narrow QRS tachycardia with no discernible P waves
39
Treatment or SVT
Vagal maneuvers, Adenosine - Unstable: Direct current synchronized cardioversion - Definitive: Radiofrequency catheter ablation
40
Three components of Wolff-Parkinson White Syndrome Pathophysiology of WPW
Delta wave, shortened PR, wide QRS -Accessory pathway (Bundle of Kent) preexcites the ventricles and leads to a delta wave
41
Treatment for WPW
- Stable (Procainamide) - Unstable (Cardioversion) - Definitive: Catheter Ablation
42
Treatment for Torsades de Pointes
IV Magnesium Sulfate
43
Treatment for V-fib
Unsynchronized cardioversion (Defibrillate) + CPR
44
Treatment for V-tach
- Stable: Amiodarone | - Unstable: Direct current synchronized cardioversion
45
Define a LBBB
R and R1 (upward bunny ears) in V4-V6 | STEMI Equivalent
46
Define a RBBB
-R1 and R1 in V1-V3 Upward bunny ears
47
Best test for Patent Foramen Ovale
Echo
48
What is a patent foramen ovale?
Unsealed opening between RA and LA
49
MC type of ASD
Ostium Secundum
50
Murmur of ASD
-Systolic ejection crescendo-decrescendo flow murmur at LUSB with wide, fixed split S2 that does not vary with respiration
51
Diagnostics for ASD
- Echo | - Catheter (Definitive)
52
Treatment for ASD
- < 5 mm may be observed | - > 1 cm surgical correction
53
What is a patent ductus arteriosus
-Persistent communication between descending thoracic aorta and main pulmonary artery
54
Murmur of PDA
-Continuous machine like murmur loudest at pulmonic area
55
Diagnostics for PDA
- Echo | - Catheter (Definitive)
56
Treatment for PDA
- NSAIDs | - Indomethacin
57
Symptoms of Coarctation of Aorta
-Bilateral claudication, syncope, DOE, failure to thrive, poor feeding, upper extremity hypertension with lower extremity hypotension
58
Murmur of Coarctation of Aorta
-Systolic murmur radiating to back, scapula, or chest
59
Diagnostics for Coarctation of Aorta
- CXR: rib notching, figure 3 sign - Echo - Angiography (gold)
60
Treatment for Coarctation of Aorta
- Prostaglandin E1 preoperatively | - Corrective surgery
61
Four factors of Tetralogy of Fallot
- Pulmonary stenosis - RVH - Overriding Aorta - VSD
62
Symptoms of ToF
- Tet spells (relieved with squatting) | - Cyanosis
63
Murmur of ToF
-harsh systolic murmur at Upper sternal border (VSD) and right ventricular heave
64
Diagnostics for ToF
- Echo (diagnostic of choice) | - CXR (boot shaped heart)
65
Treatment for ToF
- Prostaglandin E1 preoperatively | - Surgical repair
66
Pathophysiology of Transposition of Great arteries -What is the MC type of ToGA?
- Aorta arises from RV and pulmonary trunk from LV - Dextro-TGA: prior to surgical correction, survival dependent on presence of shunts between right and left circulations (PDA, ASD, VSD)
67
Diagnostics for Transposition
- Echo - CXR (egg on string) - Catheter (gold)
68
MC congenital heart disease in children
VSD
69
Murmur of VSD
-High pitched harsh holosystolic murmur at LLSB
70
Order of ECG strip
I avR V1 V4 II avL V2 V5 III avF V3 V6
71
Anterior Wall and Septal MI corresponds to which artery
LAD
72
Inferior Wall MI corresponds to what artery
RCA
73
Lateral Wall MI corresponds to which artery
LCA
74
What is stress cardiomyopathy in regards to ventricles?
-Transient regional systolic dysfunction of the left ventricle that can imitate MI but in absence of significant obstructive CAD or plaques
75
Risk Factors for Stress Cardiomyopathy
- Postmenopausal women - Exposure to emotional or physical stress - Death of relative, etc.

PANCE/EOC (63 decks)

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