Flashcards in Cardiology Deck (24)
If patient has chest pain and the etiology is not likely cardiac, most likely cause us?
Common GI disorders a/w chest pain?
GERD, ulcer disease, cholelithiasis, duodenitis, gastritis.
When a woman Is what age, rates of CAD will at least equal rates of men. Why?
55-60. By this time, protective effects of menstruation and naturally occurring estrogen have worn off. MENTSTRUATING WOMEN ALMOST NEVER HAVE MIs.
Estrogen replace DOES OR DOES NOT help CAD?
Administrating estrogen replacement does NOT translate beneficial effect on CAD. May improve LDLs but does not help CAD.
Overall, more men or women will die of heart disease?
What are the most clearly agreed upon risk factors for CAD?
Diabetes, htn, tobacco smoking, hyperlipidemia, first degree family hx of premature (impt) CAD - premature means men below 55 and women below 65, age above 45 in men and above 55 in women.
What is the worst risk factor for CAD?
What is the most COMMON risk for CAD?
What is the most dangerous lipid profile feature for risk for CAD?
High LDL (vs. elevated TGs, elevated cholesterol, decreased HDL and obesity).
PET scanning and elevated calcium scores on CT scan are what kind of risk factors for CAD?
Less reliable but probably risk factors. Calcium scores - experimental.
What is Tako-Tusbo cardiomyopathy?
Acute myocardial damage usually occuring in postmenopausal women immediately after an overwhelming, emotional, stressful event. Leads to left ventricular dyskinesis. Like ischemic disease, manage with beta blockers and ACE inhibitors.
What does re-vascularization do in Tako-Tsubo cardiomyopathy?
Nothing since coronary arteries are normal.
What are unreliable, unproven risk factors for CAD?
Chlamydia infection, elevated CRP, elevated homocystein levels. NOT benefit to measuring these or trying to therapeutically intervene. WRONG ANSWERS. Knowing these just as important.
Correction of which risk ractor will result in most immediate benefit to the patient?
Cessation of tobacco smoking. Within a year after stopping, CAD risk decreases by 50%. Within 2 year, decreases by 90%
What is the ppt of ischemic pain? What qualities of pain go against ischemic pain?
Dull/Sore, squeezing or pressure like. Qualities that go AGAINST: sharp/knife-life, lasts for a few seconds.
What features of chest pain rule out ischemia with a 95% NPP?
1) Pleuritic chest pain (changes with respiration) 2) positional 3) tenderness (changes with touch of chest wall)
If case describes chest wall tenderness, answer to "what is most likely dx / most accurate test"?
Chostocondritis, physical exam
If case describes radiation to back, unequal BP between arms, answer to "what is most likely dx / most accurate test"?
Aortic dissection, chest x ray with widened mediastinum, chest CT, MRI or Transesophageal exam confirms disease
If case describes pain worse with lying flat, better when sitting up in a young (?
Pericarditis, ECG with ST elevation everywhere, PR depression
If case describes epigastric discomfort, pain better when eating, , answer to "what is most likely dx / most accurate test"?
Duodenal ulcer disease, endoscopy
If case describes bad taste, cough, hoarseness, answer to "what is most likely dx / most accurate test"?
GE reflux, response to PPI's; aluminum and magnesium hydroxide; viscous lidocaine
If case describes cough, sputum, hemoptysis, answer to "what is most likely dx / most accurate test"?
Pneumonia, chest x-ray
If case describes sudden onset SOB, tachycardia, hypoxia answer to "what is most likely dx / most accurate test"?
PE, spiral CT, V/Q scan