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Flashcards in CARDIOLOGY Deck (122)
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61

Late diastolic murmur with an opening snap (no change with inspiration)

Mitral stenosis

62

Systolic murmur heard best in the second right IC space

Pulmonic stenosis

63

Systolic murmur heard best in the second left IC space

Aortic stenosis

64

Late systolic murmur best heard at the apex

MVP

65

Diastolic murmur with a widened pulse pressure

AR

66

Holosystolic murmur that is louder wit inspiration at the left lower sternum

Tricispid regurg

67

Holosystolic murmur heard at the apex and radiates to the axilla

MR

68

When do PVCs become concerning for development of other ventricular arrhythmias?

>3 PVC/min

69

Anti-arrhythmic commonly used in Vtach?

Lidocaine or tocainamide, type IB.

70

Causes of sytstolic dysfunction

Caused by decreased contractility, increased preload, increased after load, HR abnormalities, or high output conditions such as anemia, hyperthyroidism

71

Causes of diastolic dysfuntion

Hypertrophy or restrictive cardiomyopathy.

72

Chronic constrictive pericarditis is most commonly caused by?

Radiation, heart surgery

73

Pathophys of Brugada Syndrome

Mutation in the gene that encodes for sodium ion channel in the cell membranes of the myocytes. Loss-of-function mutations in this gene lead to a loss of the action potential dome of some epicardial areas of the right ventricle. This results in transmural and epicardial dispersion of repolarization. The transmural dispersion underlies ST-segment elevation and the development of a vulnerable window across the ventricular wall, whereas the epicardial dispersion of repolarization facilitates the development of phase 2 reentry, which generates a phase 2 reentrant extrasystole that captures the vulnerable window to precipitate ventricular tachycardia and/or fibrillation that often results in sudden cardiac death.

74

Genetics of Brugada syndrome

AD, more common in males and higher prevalence in Asians

75

ECG of Brugada syndrome

Persistent ST elevations in V1-V3 with right BBB with or without terminal S waves. Prolongation of PR interval is also sometimes seen.

76

Why is there an elevated pulse pressure in aortic regurg:

Due to insufficiency of aorta, blood flows back into LA, lowering DBP. This widens the pulse pressure.

77

Treatment of AR

Decrease after load with a vasodilator like an ACE-I or CCB like nifedipine.

78

High levels of what are associated with 3x risk of atherosclerosis

Homocysteine

79

Unique symptoms of inferior wall MI

Bradycardia, diarrhea, lightheadedness.

Inferior wall MI is caused by infarction of posterior descending artery. The supply of PDA is posterior (duh) heart, and when this is irritated, it irritates the surrounding structures which happen to include the left vagus nerve. This is why you see vagal sx.

80

Pt is in vtach and pulseless

Non-synchronized CVN / defibrillation

Arrhythmia + no pulse.

81

Pt has PEA or asystole

Give 1 mg of IV epi during CPR.

82

NYHA Class I CHF

HF with no limitations on physical activity and no symptoms, even with exertion

83

NYHA Class II CHF

Slight limitations on physical activity and symptoms of heart failure with physical activity.

84

NHA Class III CHF

Symptoms such as angina, SOB and palpitations qitth physical exertion

85

NYHA Class IV heart failure

sx of heart failure even at rest

86


what is Heyde's syndrome

Combo of calcific aortic stenosis and GI bleeding due to colonic angiodysplasia. It is thought that aortic stenosis causes type 2 von willebrand syndrome which results in inefficient hemostasis in high flow areas. This results in bleeding from angiodysplastic lesions.

87

Medical treatment of PAD

Cilostazol to improve flow to LE and decrease claudication. CONTRAINDICATED IN HEART FAILURE.

88

Second line medical treatment of PAD

Pentoxifylline, also contraindicated in CHF. Ginko biloba. Thats fun.

89

When are compressing stockings effective in post op prevention of DVT?

In low risk post op general surgery or neurosurgery pts.

90

Where is the rash in Kawasakis

Truncal