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Flashcards in Cardiovascular Deck (155):
1

pulsus paradoxus

systolic BP decreases by 10 with inspiration

asthma
COPD
tamponade

2

Loeffler's

causes restrictive cardiomyopathy

3

SVC from

right common cardinal v.
right anterior cardinal v.

4

bulbus cordis becomes

smooth LV, RV

5

coronary sinus from

left sinus venosus

6

rubella heart defects

PDA, PAS "Ruby"

7

wide split S2, TR

Ebstein anomaly, 80% have PFO

8

DiGeorge syndrome heart

TOF, TA "T"

9

Increased TPR

flatten venous return slide (DIT pg 145)

10

ejection fraction

SV/EDV

>55%

11

pulmonary capillary wedge pressure

less than 12

12

NO LIP

treat acute CHF:
nitrates
oxygen
loop diuretics
ionotropes - milranone, dobutamine
position up

13

only symptomatic relief from CHF

diuretics
digoxin
vasodilators

14

3rd aortic arch
4th aortic arch
6th aortic arch

CCA, proximal ICA
aortic arch, proximal right subclavian
proximal pulmonary, ductus arteriosis

15

treat cardiogenic shock

dobutamine

16

Swan-Ganz cath

right IJ > left SC artery

17

venous a wave

venous c wave


x descent

venous v wave

y descent

not in afib, at S4

Tricuspid close, ventricles contract against, after S1

not in TR, during systole

filling against closed tricuspid, at S3

RA into RV, diastole

18

wide S2
fixed S2
paradoxical S2

PS, RBBB
ASD
AS, LBBB

19

isovolumetric contraction

at QRS

20

heard best in LLD

MS, MR, S3, S4

21

Calcium electrophysiology

phase 2 in myocardium
phase 0 in pacemaker
+20

22

Na electrophysiology

phase 0 in mycocardium
phase 4 in pacemaker (funny current w/K)
+50

23

K electrophysiology

phase 3
-75 to -95

24

aVL

-30 degrees

25

left axis deviation

-30 to -90
inferior MI, LVH, LBBB, left anterior fasc. block

26

right axis deviation

+90 to +180
RVH, massive PE, RBBB, LP fascicular block

27

first degree AV block

>200 from p
Lyme disease

28

Mobitz 1 (second degree)

dropped
=Wenckebach = "warning block"

29

Mobitz II (second degree)

no warning

30

jucntional escape

Q = R

31

cause torsades, prolong QT

IA, III
macrolides**
chloroquine**
haloperidol
risperidone
methadone**
--navir protease inhibitors
ondansetron**
TCA**

32

vasocontrict via constitutive NOS in endothelium

bradykinin, ACh, alpha-2, histamine
serotonin, shear stress

33

vasocontrict via inducible NOS in smooth muscle

LPS

34

MLCK inhibition

DHP CCB block calmodulin-Ca
B2 epinephrine and PGE2 increase cAMP, which inhibits MLCK

35

treat:
aortic dissection
severe hypertension

B blocker

IV nitroprusside, IV labetalol

36

Stanford A aortic dissection

Stanford B

ascending, needs surgery

B-blockers then vasodilators

37

aliskiren

renin blocker

for HTN only
no CHF, MI

38

Black patient with HTN

give thiazide and CCB

39

minoxidil

opens K channels, hyperpolarize
relaxes smooth muscle
for severe HT, for hair loss

40

HTN + migraines

CCB or B-blocker

41

RCA

SA nodal branch
AV nodal branch
Posterior interventricular a.
Right main branch

42

LCA

Anterior interventricular a.

Circumflex branch
-20% PIVA
-20% SA nodal
-20% AV nodal

43

Prinzmetal angina

give nifedipine

44

AAA needing surgery

5.5 cm
0.5 cm/6 mo

45

fibrates

decrease TAG
cause myalgias, cholesterol gallstones

46

resins

bind C dif toxin (cholestyramine)
cause gallstones

47

ezetimibe SE

increases LFT
diarrhea

48

MI ECG findings

ST elevated 1 mm in consec
T inversion
new LBBB
new Q waves (1 block wide or 1/3 QRS height)

49

3-14 days after MI

ventricular aneurysm?
wall rupture?
papillary rupture?
yellow-tan softening
macrophage infiltrate

50

neutrophils after MI

12-24 hrs
wavy fibers too
reperfusion injury causes contraction bands

51

Dressler syndrome

>2 wks after MI
pericarditis + fever
have a gray white collagen scar

52

days 1-2 after MI ECG

T wave inverts
Q wave deepens

53

Q wave

hours to weeks after MI

54

MI K and Na goals

K >4
Na >2

55

NSTEMI

avoid fibrinolysis
do PCI (UF heparin needed)

56

Fe, cocaine, alcohol, ischemia

dilated cardiomyopathy
90% have S3

57

Ashcoff bodies
Antichow cells

rheumatic fever granuloma
giant cells

58

Minor Jones criteria

arthralgia, fever, ESR/CRP, long PR

2 major, 1 minor

59

pericarditis

ST elevation
PR decrease

60

Kussmauls sign
pulsus paradoxus

constrictive pericarditis - lupus
cardiac tamponade - asthma, croup, COPD

61

syphilis heart

AS
AR
aortic calcifications, treebark aorta**
blocked aortic vas vasorum - thoracic AA

62

not in lungs
yes in gut/renal
after Hep B or C

polyarteritis nodosa
ANCA negative

63

foot drop

Churg Strauss
pANCA

64

saddle nose, perforate septum

Wegeners
cANCA

65

leptomeningeal angioma
eye hemiplegia, seizure, glaucoma

Sturge-Weber

66

Causes of Raynaud

MCTD
Beurgers (thromboangitis obliterans)
lupus
CREST

67

treat Raynaud

warm
DHP CCB

68

small red mole in older patient

cherry hemangioma

69

primitive pulmonary vein

smooth left atrium

70

dextrocardia from

left-right dynein defect

71

valves come from

endocardial cushions

72

Young Liver Synthesizes Blood

fetal erythropoiesis:
Yolk sac 3-8 wks
Liver 6 wks to birth
Spleen 10-28 wks
Bone marrow 18 wks to adult

73

ductus venosus

umbilical vein bypasses liver into IVC

74

allantois becomes

urachus, then median umbilical ligament

75

umbilical arteries become

medial umbilical ligaments

76

umbilical vein becomes

ligamentum tere hepatis in falciform ligament

77

posteriomedial papillary muscle blood

RCA PIVA

78

pulse pressure and arterial compliance

inversely proportional

79

pulse pressure factors

increased with hyperthyroid, AR, stiff aorta, sleep apnea, transiently with exercise

decrease with AS, cardiogenic shock, tamponade, HF

80

decreases contractility

increases contractility

acidosis, high CO2, low O2, low cAMP

less extracellular Na (less Na/Ca exchanger)

81

Law of LaPlace

Wall tension = P*R / 2*thickness

hypertrophy to decrease wall tension

82

decrease both preload and afterload

ACEI and ARB

83

Resistance

8*viscosity*length / pie*radius^4

84

vessels in parallel

1/TR = 1/R1 + 1/R2

85

organ removal fluid dynamics

increase TPR
decrease CO

86

heart and narcotic overdose

decrease contractility

87

heart and spinal anesthesia

decrease venous return

88

heart and exercise

decrease TPR

89

heart and sympathetic activity

increase venous return

90

heart and AV shunt

decrease TPR

91

TPR and mean systemic pressure

mean systemic pressure unchanged
CO changes at given preload

92

left sternal border

AR, PR

93

hand grip afterload

decreases hypertrophic cardiomyopathy murmur

later MVP

94

Valsalva decreased preload

increases hypertrophic cardiomyopathy
murmur

earlier MVP

95

rapid squat increase preload

increase AS murmur

decrease hypertrophic cardiomyopathy
later MVP

96

rheumatic fever heart

MR early
TR, MVP, AR, Afib
MS late

mitral >aortic>tricuspid
Aschoff and Anitschkow, ASO

type II HS reaction

97

S2 and OS

less time between is worse

98

QT interval

ventricles depolarized

99

U wave

hypokalemia, bradycardia

100

speed of heart conduction order

Purkinje > atria > ventricles > AV node

101

treat torsades

magnesium sulfate

102

Congenital long QT

Romano Ward syndrome - AD, cardiac only
Jervell/Lange-Nielsen - AR, sensorineural

103

Brugada syndrome

AD pseudo-RBBB with ST elevation in V1-V3
in Asian males
risk of V tach and sudden cardiac death

give ICD to treat

104

IC antiarrhythmics to treat

Afib

105

definitive treatment for atrial flutter

catherter ablation

106

Vfib management

CPR and defibrillate!

107

ANP


BNP

atrial myocytes after increased volume/P
cGMP vasodilate, lose Na at CT
dilate afferent, contrict efferent

ventricular myocytes after increased tension
longer half life,
HF diagnosis, nesiritide recombinant is Tx

108

aortic arch chemo/baroreceptors

via vagus nerve to solitary nucleus of medulla for low and high BP

hypotension decreases afferent firing

aortic body chemoreceptor stimilated by O2

109

carotid sinus baroreceptor

carotid body chemoreceptor

via CN9 to solitary nucleus of medulla

increased pressure/massage increases afferent firing, increases AV node refractory period --> slower HR

O2

110

Cushing reaction

HT, bradycardia, respiratory depression

increased ICP increased CO2 and decreases pH --> symp --> HT

stretch --> peripheral baroreceptor --> slow HR

111

central chemoreceptor

respond to CO2 and pH of brain ICF

no direct O2 effect

112

skeletal muscle autoregulation

lactate, adenosine, K, H, CO2

113

tricuspid atresia

needs ASD and VSD to live

has hypoplastic RV too

114

tet spells

TOF cyanosis

squatting increases SVR, decreases R to L shunt

115

left to right shunts

present later in childhood

116

ASD

ostium secundum more common, isolated

ostium primum with other cardiac

not a patent foramen ovale

117

PDA leads to

RVH, LVH, HF
late cyanosis on lower extremities

118

Eisenmenger syndrome

late cyanosis, clubbing, polycythemia from PA hypertension/RVH flipping shunt

119

location of coarctation of aorta

near ductus arteriosus = juxtaductal

120

diabetic mother's baby heart

transposition of great vessels

121

Williams syndrome heart

supravalcular AS

122

DiGeorge heart

truncus arteriosus
TOF

123

Rubella heart

PDA, PAS, septal defect

124

FAS heart

VSD, PDA, ASD, TOF

125

fibromuscular dysplasia

10% of HT cause
RA has string of beads appearance
young women

126

Monkeberg medial calcific sclerosis

calcified elastic lamina of medium sized arteries
stiff without obstruction of blood flow
pipestem x-ray
no intima involvement

127

atherosclerosis locations

AA > CAD > popliteal > carotid

128

unequal BP in arms

aortic dissection

129

ST depression

stable angina
or unstable angina
or NSTEMI (subendocardial

130

transient ST elevation

Prinzmetal/variant angina

trigger by tobacco, cocaine, triptans

give CCB, nitrates

131

complication 1-3 days after MI

fibrinous pericarditis
-friction rub

132

complication 3-14 days after MI

wall rupture, causes MR or VAD
LV pseudoaneurysm (low CO, thrombus, arrhythmia)

133

MI diagnosis

134

complication 2 wks to months after MI

true ventricular aneurysm
-outward bulge when contract, fibrosis

135

dilated cardiomyopathy has

S3
systolic regurgitant murmur
90% of cardiomyopathies

136

hypertrophic cardiomyopathy occurrence

70% familial AD from B-myosin heavy chain
in Friedrich's ataxia
ventricular arrhythmia death in young athlete
S4
systolic murmur
MR

137

hypertrophic cardiomyopathy treatment

B-blocker or nonDHP CCB
ICD if needed
stop athletics

138

spironolactone and HF

decreases mortality

139

hemosiderin laden macrophages in lungs

left HF causing pulmonary edema via venous congestion

140

SIRS

>2 of:
fever/low T
HR - first sign!
RR
WBC up/down

141

nonbacterial endocarditis

culture negative endocarditis

cancer, hypercoagulable, lupus

Coxiella, Bartonella, HACEK

142

widespread ST elevation
PR depression

acute pericarditis

143

cause acute pericarditis

uremia
coxsackie
cancer
STEMI/Dressler
SLE, RA
radiation

144

JVP increases with inspiration

constrictive pericarditis
restrictive cardiomyopathy
RA/RV tumor

"Kussmaul sign"

145

Bacillary angiomatosis

neutrophilic infiltrate
in AIDS from Bartonella

146

Kaposi sarcoma

lymphocytic infiltrate
skin, mouth, GI, respiratory
HHV8 and HIV

147

chronic postmastectomy lymphedema causes

angiosarcoma

148

hepatic angiosarcoma

vinyl chloride
arsenic

149

pulseless disease
night sweats
arthritis, myalgias
skin nodules
visual distubance

Takayasu arteritis -
narrowed aortic arch and great vessels

150

vasculitis with Raynaud

thromboangitis obliterans

151

pANCA

microscopic polyangiitis
Churg-Strauss

152

renal microaneursyms
melena
neurological damage

polyarteritis nodosa

153

AS leads to

microangiopathic hemolytic anemia
syncope with exercise
concentric LV hypertrophy

154

louder with squatting and expiration

MR

155

mets to heart

breast
lung
melanoma
lymphoma

get pericardium effusion