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Internal Medicine EOR > Cardiovascular > Flashcards

Flashcards in Cardiovascular Deck (124)
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What is stable angina?

predictable, relieved by rest and/or nitroglycerine


What is unstable angina?

previously stable and predictable symptoms of angina that are more frequent, increasing or present at rest


What is prinzmetal variant angina?

coronary artery vasospasms causing transient ST-segment elevations, not associated with clot


What are premature beats?

-PVC: early wide bizarre QRS, no p wave seen
-PAC: abnormally shaped P wave
-PJC: narrow QRS complex, no p wave or inverted p wave


What is paroxysmal supraventricular tachycardia?

narrow, complex tachycardia, no discernible P waves


What is a-fib?

irregularly irregular rhythm with disorganized and irregular atrial activations and an absence of P wavws


What is a-flutter?

regular, sawtooth pattern, and narrow QRS complex


What is sick sinus syndrome?

-Brady-tachy: arrhythmia in which bradycardia alternates with tachycardia
-Sinus arrest: prolonged absence of sinus node activity (absent P waves) > 3 seconds


What is sinus arrhythmia?

normal, minimal variations in SA node's pacing rate in association with the phases of respiration
-heart rate frequently increases with inspiration, decreased with expiration


What is premature ventricular contractions (PVCs)?

early wide "bizarre" QRS, no p wave seen


What is ventricular tachycardia?

three or more consecutive VPBs, displaying a broad QRS complex tachyarrhythmia


What is ventricular fibrillation?

erratic rhythm with no discernable waves (P, QRS, or T waves)


What is torsades de pointes?

polymorphic ventricular tachycardia that appears to be twisting around a baseline


What is dilated cardiomyopathy?

MC type; an index event or process (MI) damages myocardium, wakening heart muscle a decreased ventricular contraction strength + dilation left ventricle; systolic heart failure


What are the characteristics of dilated cardiomyopathy?

-reduced contraction strength; large heart; caused by ischemia (CAD, MI, arrhythmia)
-PE: dyspnea, S3 gallop, rales, JVD
-Tx: no alcohol!!!; ACE-I, diuretic


What is hypertrophic obstructive (HOCM)?

hypertrophic portion of septum; LV outflow tract narrowed - worse with
-diastolic heart failure
-young athletes with positive family history sudden death of syncopal episode; inherited; SCREEN FAMILY


What is the PE of HOCM?

sustained PMI, bifid pulse, S4 gallop; high pitched mid-systolic murmur at LLSB increased with Valsalva and standing (less blood in the chamber); decreased with squatting


What is the tx of HOCM?

refrain from physical activity; BB or CCB; surgical or alcohol ablation of hypertrophied septum and defibrillator insertion


What is restrictive cardiomyopathy?

right heart failure; a history of infiltrative process; diastolic heart failure; still heart muscle
amyloidosis, sarcoidosis, hemochromatosis, scleroderma, fibrosis, cancer


What is the PE of restrictive cardiomyopathy?

pulmonary HTN; normal EF, normal heart size, large atria, normal LV wall, early diastolic filling


What is the tx of restrictive cardiomyopathy?

non-specific; diuretics, ACE-I, CCB


What are the MC cause of congestive heart failure?

CAD, HTN, MI, DM - LV remodeling = dilation, thinning, mitral valve incompetence, RV remodeling


What are the sx and signs of congestive heart failure?

sx: exertional dyspnea = rest, chronic nonproductive cough, fatigue, orthopnea, nocturnal dyspnea, nocturia
signs: Cheyne-stokes breathing, edema, rales, S4 (diastolic HF, preserved EF); S3 (systolic; reduced EF); JVC >8 cm, cyanosis, hepatomegaly, jaundice


What is the NY heart failure classification?

-Class 1: no limitation of physical activity
-Class 2: slight limitation physical activity; comfortable at rest
-Class 3: marked physical limitation; comfortable at rest
-Class 4: can't carry on physical activity; anginal syndrome at rest


How is congestive heart failure dx?

BNP, EKG, CXR (Kerley B lines); echo = gold (best to assess size and function of chambers)


What is the tx of congestive heart failure?

-Systolic: ACE-I + B-blocker + loop diuretic
-Diastolic: ACE-I + B-blocker or CCB


What is coronary vascular disease?

CAD is #1 killer in the USA and worldwide = Death rates decreased yearly since 1968 = MC cause of cardiovascular death and disability
-coronary artery disease can be due to either vasospastic disease (Prinzmetal angina) or atherosclerotic disease when a coronary artery narrows due to the build-up of atherosclerotic plaque - characterized by a type of chest pain called angina pectoris - it can be further divided into stable angina, unstable angina, and myocardial infarction


What are the risk factors of coronary vascular disease?

smoking, diabetes, dyslipidemia (increase LDL, decease HDL), hypertension, family hx, men >55, women >65


How is coronary vascular disease dx?

high-sensitivity, high CRP, lipids, triglycerides, carotid U/S


What is the tx of coronary vascular disease?

smoking cessation, lifestyle (BP, LDL/HDL, obesity)
-primary prevention = platelet inhibitors (aspirin, etc.) = cornerstone
-secondary prevention = aspirin, Beta-blockers, ACE-I/ARB, statins; nitro if symptomatic