Cardiology

Question 1

Aortic Regurgitation: Definition and Management

Answer 1

Bisferiens pulse. Diastolic murmur with higher lower diastolic pressure resulting in wide pulse pressure variation. Management: Normal heart rate, normal contractility and decrease afterload (increased afterload would worsen regurgiation). Treatment is Nitroprusside (decreases afterload, and preload, causes reflexive tachycardia so less time for regurgiation to happen).

Question 2

Management of HOCM

Answer 2

Keep the L ventricle full. Do not increase heart rate bc it will decrease diastolic filling time and increased contractility will worsen obstruction.

Question 3

TACO (Transfusion Associated Circulatory Overload)

Answer 3

Most common cause of mortality related to transfusions. Excessive blood volume (leading to increased left-sided heart pressures), new onset respiratory distress, increased CVP, evidence of pulmonary edema

Question 4

Pregnancy Cardiology Changes

Answer 4

Increase in stroke volume and heart rate. Increase in blood volume. Decrease in SVR and increase in CO. CVP remains unchanged.

Question 5

Intra-Aortic Balloon Pump

Answer 5

Placed in descending thoracic aorta, inflates during diastole to increase ADP. Indicated in RVF. Inflated with Helium. Contraindication includes aortic valve disease, severe peripheral disease, aorta diseases

Question 6

Elderly and Heart

Answer 6

Increased LVH and impaired diastolic filling. Decreased stroke volume with stress. Decreased sensitivity to beta receptors

Question 7

Mixed Venous Oxygen Saturation

Answer 7

When oxygen demand exceeds O2 supply, SVO2 decreases.

Question 8

Cardiac Transplantation

Answer 8

Only responsive to direct agonist stimulation on the heart. Sensitivity to B1 stimulation b/c no baroreceptors available (carotid sinus).