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Flashcards in cardiology Deck (64)
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1

ECG in Supraventricular tachyarrythmia (SVT)

narrow QRS

2

Tx for SVT

- vagal maneuvers (carotid massage) to block AV conduction
- adenosine to block AV conduction (6mg IV push)

3

untreated SVT can lead to

cardiomyopathy (also CHF, hypotension)

4

SVT pulse rate typically

between 100-300 bpm

5

ECG findings in Dilated Cardiomyopathy

Nonspecific ST-T wave changes

6

ECG in Hypertrophic Cardiomyopathy

abnormal and prominent Q waves, short P-R

7

Imaging (besides ECG) for cardiomyopathy

- 2-D echo-cardiography
- Cardiac MRI (useful in Dx and assessing severity)

8

Heart sounds in Hypertrophic cardiomyopathy

- Split S2, S4, harsh systolic ejection (crescendo-descrecendo) murmur - best heard along lower left sternal border or apex and best heart during valsalva
- palpable double apical impuse (@ PMI)

9

ECG in restrictive cardiomyopathy

- normal, or nonspecific ST-T wave changes
-low QRS voltage

10

Restrictive cardiomyopathy is caused mostly by

- amyloidosis, sarcoidosis
- myocardial fibrosis after open-heart surgery
- radiation

11

pathophys of hypertrophic cardiomyopathy

- autosomal dominant (chromosome 14)
- hypertrophy of myocardium (with GREATER hypertrophy of Interventricular Septum than Left ventricular wall)
- thus, L ventricle outflow may be obstructed

12

dilated cardiomyopathy is what

four chambered hypertrophy, unexplained dilation and impaired systolic function of one or both VENTRICLES

13

causes of dilated cardiomyopathy

- alcoholism
- genetic
- myocarditis
- drugs (chemo (doxorubicin), cocaine, heroin)
- organic solvents ("glue sniffers")
- peripartum (last trimester or within 6 months postpartum)

14

Symptoms/signs of Endocarditis

- fever (m/c), weakness, night sweats, weight loss, anorexia
- SOB, chest pain, regurgitation murmurs
- Vascular: SPLINTER hemorrhages in nail beds (linear, reddish brown lesion); JANEWAY's lesions (painless, 5mm pustular, hemorrhagic lesions on PALMS/SOLES); petechiae
- splenomegaly
- microscopic hematuria, flank pain
- immune complex vasculitis (Glomerulonephritis, ROTH's spot (retinal hemorrhage), OSLER's nodes (painful nodules on pads of fingers or toes)

15

what valve is most commonly effected in endocarditis

Mitral

16

what is the most common form of myocarditis

viral myocarditis (from parvovirus B19, coxsackie, HIV, polio, influenza, mumps)

17

What drugs can cause myocarditis

doxorubicin, catecholamines, cocaine

18

systemic diseases that can cause myocarditis

collaged vascular disease (SLE, RA), autoimmune, sarcoidosis

19

Signs of myocarditis

- fever, chest pain, pericardial friction rub, heart failure, elevated JVP, PE, murmurs (usu mitral), sudden death

20

ECG in myocarditis

nonspecific ST-T changes

21

blood work/imaging in myocarditis

- increased CK-MB and tropinins I and T
- Antibodies of pathogens
- LDH and AST (in acute)
- check WBC, ESR, ANA, RF
- echo shows dilated, hypokinetic chambers
- CXR
- Endomyocardial biopsy

22

Diagnosis of myocarditis

Endomyocardial biopsy (EMB) is the criterion standard for diagnosis

23

most common viral cause of Acute Pericarditis

Coxsackie B virus

24

Diagnostic triad of acute pericarditis

1. chest pain
2. friction rub
3. ECG changes (diffuse ST elevation and PR depression)

25

Test of choice for detecting pericardial effusion and diagnosing tamponade in acute pericarditis

Echocardiography

26

ECG changes in Acute pericarditis

- PR-segment depression (important, in 80% of cases)
- ST elevation initially

27

major diagnostic Jones criteria for diagnosis of rheumatic fever

(requires presence of 2 major or 1 major and 2 minor criteria)
Major diagnostic criteria:
1. carditis
2. polyarthritis (swollen large joints)
3. chorea (rapid movts in face and arms, don't occur until at least 3 months from onset of infection)
4. subcutaneous nodules (painless, firm collagen on bones/tendons- common at wrist, elbow, knees)
5. erythema marginatum (spares face, begins on trunk or arms, snake like appearance, worse with heat)

28

minor diagnostic Jones criteria for diagnosis of rheumatic fever

(requires presence of 2 major or 1 major and 2 minor criteria)
Minor criteria:
1. fever
2. arthralgia (no swelling)
3. increased ESR or CRP
4. leukocytosis
5. ECG with prolonged PR interval

29

forward heart failure

- inadequate cardiac output
- systemic edema (d/t kidneys not receiving blood and thus conserving salt and water)

30

backwards heart failure

- increased congestion of venous circ
- results in overfilling of ventricles
- systemic OR pulmonary edema