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
