Cardiology Vocab Flashcards

Terms Definitions
tachy
fast
arrhythmic
rythmos; rhythym
y?
filling of RA
pericardial knock
constrictive pericarditis
arteriosclerosis
hardening of the arteries
"sawtooth" P waves
Atrial Flutter
angina at rest
unstable angina
 
 
 
Acute Infectious Endocarditis
 
 
 
Staph Aureus
Necrotizing, ulcerative, invasive valvular infections
Death in days to weeks
Occurs in previously healthy heart
ventricular fibrillation
extremely rapid, ineffective heartbeat
What surrounds lipid core?
fibrous cap
Statins
HMG CoA reductase inhibitors
Decrease LDL (18-55%)
Increase HDL (5-15%)
TG unchanged

SEs: GI distress, constipation, decrease absorption of other drugs

Best for decreasing LDL and coronary mortaility--partially 2/2 other antiflammatory effects
Target-Organ Damage
Kidney
Chronic Kidney Disease
prophylaxis
avoid stress/emotional triggers, treat existing HTN and high LDLs. DRUGS: long acting nitrates, beta-blockers (to decrease HR/contractility and tissue O2 demand), calcium channel blockers (to dec. HR/contract and dilate coronaries), antiplatelet agents (ASA to prevent coronary thrombosis), coronary revascularization procedures (CABG, percutaneous transluminal coronary angioplasty-PTCA)
ACE Inhibitors
Prevents inactivation of vasodilator.
Use for: HTN, CHF, diabetic renal disease
murmur that improves with handgripping
HOCM
How do you treat aspirin toxicity?
NaHCO3
valvulotome
instrument used to cut diseased valves
diastolic
blood pressure when heart is relaxed
Familial cardiomyopathies
Dilated -- systolic hf

Hypertrophyic - diastolic hf
Location of angina
Difficult to pinpoint
Usually substernal (can be nose to navel)

Radiates frequently to left arm and specifically to right arm
Renin cascade
Renin converts angiotensinogen to angiotensin I
Angiontensin Converting Enzyme coverts it to Angiotensin II
Angiotensin II causes adrenal secretion of aldosterone, increased constractility, and systemic vasoconstriction
Aldosterone increases sodium retention in kidney
localizations of STEMI
inferior, anteroseptal, anterior, lateral, posterior
Name the triad; stasis, hypercoagulability, endothelial damage.
Virchow's triad
MS almost always results from_________
rheumatic fever
other causes
RF (usually accompanied by MS)
"Banana" shaped LV on Echo.
Hypertrophic Cardiomyopathy
clopidogrel is what kind of drug
anti-plt
anastomosis
communication between blood vessels by means of collateral channels, esp. when usual routes are obstructed.
Define stenosis.
Causes obstruction to forward flow causing an increased pressure in the ventricle
CXR
 What assists in the detection of cardiomegaly, pulmonary vascular congestion, aortic disease (aneurysm, coarctation)?
what regulates arteriole diameter?
autonomics, circulating vasoactive hormones, and local metabolites
What is a rhythm strip?
An EKG printout
Coronary spasm
Acute, usually transient occlusion of blood vessel
Can occur in normal vessels, usually in atherosclerotic ones
Prevalence of HTN
increases with?
Age
Black race
Less education
Male gender before middle age, female after
ACE inhibitors as antiypertensives
Inhibit angiotensin conversion, decrease TPR, aldosterone
SE: cough (bradykinin effect), renal failure
Drugs: catopril, lisopril
Volume overloads on LV
Aortic regurgitation, mitral regurgitation, patent ductus, systemic arteriovenous fistula
atrial flutter
regular rhythm with ventricular rate of 125-150 and atrial rate of 250-300; treat with cardioversion if unstable OR digitalis, verapamil, betablockers
GERD differentiating features
acid reflux, relief with antacids
Which electrolyte imbalance can cause Torsades de pointe?
Potassium. Hypokalemia
systolic heart murmurs:
TR, PS, MR, and AS
Class I antiarrhythmics
Na channel blockers
1A: Quinidine
1B: Lidocaine
1C: Flecainide, Encainide
elevations in both CK-MB and trop
acute MI
two cardiovascular conditions associated with hoarseness
mitral stenosis, aortic aneurysm
An S3 gallop.
What is the differentiating histological feature between polyarteritis nodosa and microscopic polyangiitis (leukocytoclastic vasculitis)?
What drug can cause cholesterol gallstones?
Bile acid resins
How do you monitor the levels of coumadin?
PT/INR
Echocardiography
 
*digital or stress
What type of imaging detects congenital, valves, HF, and detects perfusion abnormalities –  CHD?
Describe Sick Sinus Syndrome...
Any sinoatrial node problem...sinus bradycardia, sinus pauses / blocks / sinus arrest, and tach-brady syndrome. These patients usually do not need eletrophysiologic testing.
What are factors that determine stroke volume?
preload, afterload, contractility
What is Automaticity?
Pacemaker cell's capability to self depolarize. The cell with the fastes rate of discharge becomes the hearts pacemaker.
CAD risk factors
Major non-modifiable : age, male, FH
Major modifable: HTN, cigarettes, hypercholesteremia
Other: Low HDL, diabetes, obesity, metabolic syndrome, sedentary lifestyle, gout, inflammation (CRP)
General causes of myocardial ischemia
Decreased myocardial oxygen supply
Increased myocardial oxygen demand
aortic regurgitation pathogenesis
valve insufficiency leads to volume overload of left ventricle with compensating Frank-Starling; dilation, overstretching and decreased contraction force; if acute, can have large LEVEDP because ventricle is not adapted; acute pulmonary edema can occur; lower systolic blood pressure is due to regurgitation of blood out of aorta and decreased SVR; there's increased systolic pressure and widened pulse
Common murmur that does not imply pathology
Flow murmur
what causes ventricular dilation?
spiraling increase in circulatory fluid volume
what determines pulse pressure (Psystolic - Pdiastolic)
SV and arterial compliance
female pt with few CAD risk factors, angina at rest, CP sx's cluster in middle of the night, h/o migraines
Prinzmetal's
what kind of infarction benefits most from thrombolysis
anterior infarction
Tx for MVP
only when sx's: endocarditis prophy, Bblocker for CP, antiarrhythmics for arrhythmias
Which cardiac disease presents with the same clinical triad as aortic stenosis (angina, syncope, dyspnea)?
HOCM (IHSS)
Most specific marker of an MI (gold standard).
Troponin I
What are the complications as a result of stress test?
Angina, MI
men >35
 
Women >45
Routine testing for the USPSTF for dyslipidemias occurs at what age for men and women?
Mechanism, Origin and Rate of Atrial tachycardia?
Reentry, Atria, 150-240
What is Dromotropy?
Pertains to the autonomic control of the rate of nervous impulse conduction.
What is a triplet?
A group of three repetitive PVC's.
What causes the a wave to be absent?
asystole
a-fib
Paroxysmal nocturnal dyspenea physiology
Patient awakens short of breath several hours after going to bed

Fluid reabsorbed from edematous legs increases blood volume
sudden cardiac death
is a complication of ACS; most commonly ventricular fibrillation or tachycardia
high-risk features of UA/NSTEMI
repetitive or prolonged chest pain (>10min)
elevated biomarkers
persistent ECG changes
hemodynamic instability (SBP<90)
sustained ventricular tachycardia
syncope
LV EF <40%
diabetes
chronic kidney disease
prior PTCA or CABG
An agent that reverses the effects of heparin.
Protamine Sulfate
what are kerly b lines
water in the interlobular septa
Cardiac drug working on voltage-gated calcium channel
Calcium channel blocker
Beta agonist
Jervell and Lange-Nielsen syndrome
long QT syndrome, autosomal recessive, associated with hearing loss
duroziez sign
heart trill or murmur heard over the femoral arteries --> aortic insufficiency
False. Only supraventricular arrhythmias.
What drugs are contraindicated in conjunction with digoxin use?
How is mitral valve prolapse diagnosed?
Most pts are asymptomatic Symptoms typically include: palpitations, syncope, CP
What is the pathogenesis of infective card?
Endocardial surface injuryThrombus formationBacteremiaBacterial adherence
What is a cardiac cath?
Invasive testing to assess pt hemodynamics and perform coronary angiography
What do you do with a patient having an MI that developes hypotension and Type II second degree AV block and is not responsive to atropine?
Temporary Pacing!
What are EKG findings of hypokalemia?
Progressive Pattern • Diffuse Flattening of the T wave (c possible diffuse ST segment depression or T wave inversion) • Appearance of the U wave • Torsades de Pontes
What are Beta₁ Receptors?
They are primarily located in the heart, increase the HR and contrctility
How does the ventricular syncytium contract?
The ventricular syncytium contracts from the inferior to the superior, expelling blood from the ventricles into the aorta and pulmonary arteries.
What impact does free radicals have on arteries?
Leads to vasoconstriction
Differentiating musculoskeletal pain from other chest pain
Reproduce pain by pressing on chest wall
cardiac Vs. pulmonary dyspnea
cardiac is more sudden, not associated with sputum production, without history of pulmonary disease, no lung disease evidence on x-ray, cardiomegaly seen on x-ray

pulmonary dyspnea is the contrary
What is the target LDL in a patient with diabetes?
< 70
how does stress affect heart?
limbic system interprets stressor and tells vasomotor center to send inc'd symp activity down spinal cord which affects a1 receptors in skel muscl arterioles/veins causing vasoconstriction. this increases TPR while venous constriction moves stored blood to heart. the inc'd symp tone to heart's b1 recepotrs cause inc'd contractility. SO, inc'd CO and inc'd TPR all lead to HTN.
What is an Aschoff nodule?
Aschoff's bodies or nodules are reactive histiocytes, characteristic lesion of acute rheumatic fever
contraindications to the use of warfarin
TCP, surgery or trauma, EtOH
What is the most common benign tumor of the heart in adults? Kids?
Atrial myxoma. Rhabdomyoma.
GPIIb-IIIa receptor activation.
What is the hallmark of treatment for acute coronary syndrome patients experiencing unstable angina?
what is the attack of ARF
After Group A pharyngitis: 3% epidemic, 0.3% endemic 10% chronic recurrence with repeated Group A strep infections
What is a stress test?
Measures the efficiency of the heart during a dynamic exercise stress period
Total cholesterol and HDL
What cholesterol tests do not need to be fasting?
what is the typical CO for a 70 kg individual?
5 L/min
Explain Negative and Positive Deflection
Negative is the impulses that travel away from the lead.
Positive is the impulses that travel toward the lead.
What is an Accelerated Junctional Rhythm?
Results from increased automaticity in the AV junction, causing the AV junction to discharge faster than its intrinsic rate.
What 3 Factors does stroke volume depend on?
preload, Cadiac contractility and afterload.
What is seen on EKG in coarctation of aort?
L axis deviation
Vasoconstriction of neurohumoral response pros and cons
Pro -- maintains BP for perfusion of essential organs
Cons -- decreased stroke volume, increases cardiac energy expenditure
Furosemide and ethacrynic acid
Inhibit the reabsorption of Na and Cl not only in proximal and distal tubules but also in the loop of Henle
What effect does digoxin have?
A positive inotropic agent that: 1. inc's contractile force and 2. inc's parasympathetic tone to heart
when to use thrombolytic therapy?
STEMI only. contraindicated in NSTEMI and unstable angina (UA)
Chronic angina therapies (nitrates/PDE5-inhibitors+BB/CCB's to vasodilate + reduce CO) along with ANTI-PLATELET / ANTI-THROMBIN THERAPY. This spectrum ranges from aspirin and clopidogrel (mild) to heparin/LMWH (strong) and IIb/IIIa receptor blockers (stro
What is the newest set of thrombolytic therapies and what makes them better?
What is the pathologic giveaway for acute rheumatic carditis?
Aschoff bodies - inflammatory infiltrates of mononuclear cells, mainly histiocyes.
Like nitrates they increase cGMP. Inc contractility in the heart. Dilate SMC where they have specific activity, so bronchioles dilated in some PDE-I's. Remember Sildenafil dilates blood vessels in the penis.
Why does nitrate tolerance occur?
What is the treatment for mitral stenosis?
Asymptomatic pts do not require therapySymptoms of mild dyspnea and orthopnea can be treated with diuretics aloneA-fib and other arrhythmias must be controlledAnticoagulation to a target INR of 2.5-3.5Balloon valvotomy or complete valve replacement
Yes
 
*It will NOT work during exercise
Will myocardium that is ischemic work during rest?
compare and contrast the Na+/Ca2+ exchanger and the Sarcolemmal Ca2+ pump
- both push Ca2+ from intracellular to the extracellular environment- Na+/Ca2+ exchanger is a high capacity, low affinity transporter, which means that it can transmit LOTS of Ca2+ when the concentration is high- sarcolemmal Ca2+ pump is a low capacity / high affinity pump, which means that it transmits a lot less Ca2+, but that it works well even at low [Ca2+]i
How do you analyze the QRS complex?
The QRS complex represents ventricular depolarization. Answer these questions:
Do all of the QRS complexes look alike?
What is the QRS duration? Remember, anything longer than 0.12 sec (3 small boxes) is abnormal.
What is the underlying cause for angina?
Mismatch btwn bl supply and demand
aortic stenosis Vs. aortic valve sclerosis
both have systolic murmur but in aortic valve sclerosis carotids don’t have delayed upstroke
no hypertrohpy in ECG
no excursion of valve leaflets in ecochardiography
no hemodynamically significant aortic valve gradient
how is angina similar to intermittent claudication?
both involve inadequate arterial flow due to atherosclerosis, result when O2 demand exceeds O2 supply
When is exercise treadmill test positive
when >2mm ST segment depressions OR when drop >10mmHg in SBP
what tx is contraindicated in aortic dissection?
intra-aortic balloon pump, which will inflate in diastole
Thrombolytics (blood thinners)- inflammation of pericardium + blood thinner can lead to a rupture of blood in the pericardium leading to tamponade.
If a patient is positive for a delta wave on EKG, what drugs could lead to life-threatening conditions if administered?
What is the treatment of MVP?
Most pts only need to observe standard endocarditis prophylaxisB-blockers help relieve symptoms of palpitationsLow dose ASA (81 mg) recommended for pts with redundant leaflets to reduce risk of CVA
Mechanism, Origin and Rate of WPW or Concealed accessory AV connection?
Reentry, Circuit includes accessory AV connection, atria, AV node, His-Purkinje system, ventricle;...Rate = 150-220 usually (+/- 30)
What are some findings upon physical exam of a patient with aortic regurgitation?
• wide pulse pressure • physical findings of Marfan's • displaced PMI (due to left ventricular hypertrophy) with palpable S3 and S4 • possible pulmonary congestion • diastolic "blowing" murmur along left sternal border • high pitched decrescendo diastolic murmur heard best by sitting up and leaning forward
What are the rules of interpretation for Idioventricle rhythm?
Rate: 15-40
Rhythm: Irregular in a single ventricular escape complex. Vantricular escape rhythms are usually regular unless pacemakers site is low in the ventricular conductive system.
Pacemaker Site: Ventricle
P waves: none
PRI: none
QRS: greater than 0.12 sec and bizarre in morphology
Sensitivity of stress tests
Sen - 70 Spec - 85
w/ thallium
Sen - 90 Spec- 95
how does heart failure from CAD cause both SF and DF?
SF from dec'd contractility from chronic myocardial ischemia and DF from fibrosis of destroyed myocardium
what if pt is intolerant of one statin?
try another statin in different dosing
Nitrates because they reduce preload upon which those patients depend to sustain their cardiac output.
How does nitric oxide act in the vasculature?
When does toponin I rise after an MI?
After 4 hours and elevated 7-10 days.
What are characteristics of a junctional rhythm on EKG?
• negative P wave in lead II that occur immediately before the QRS, immediately after the QRS, or hidden within the QRS. • Short PR interval <0.10 sec • A QRS complex that is identical or very similar to normally conducted beats
What is the Lown grading system for premature beats?
Grade 0: No premature beats
Grade 1: &lt;30 per hour
Grade 2: &gt;30 per hour
Grade 3: Multifocal
Grade 4: Repetitive PVC
Grade 5: R on T phenomenon
what sn show up with heart exam?
heave or lift palpable on chest, 3rd and/or 4th heart sounds
How do you reverse Dig toxicity?
1. stop drug, 2. give K, 3. Lidocaine and phenytoin, 4. if acute OD use Digibind
What kind of shunting in a tetralogy of Fallot is more serious? What are the symptoms when the dz gets to this point? What can a child with this and an acute spell of paroxysmal hypoxia (and RVOT spasms) do to relieve this?
Right to left. Cyanosis that worsens with exercise and clubbing. Children can squat, it kinks their aorta increasing PVR and forcing more blood flow to the lungs.
When is a MRI of the heart indicated?
When it is necessary to examine the size and thickness of the chambers of the heart, and determine the extent of damage caused by a heart attack or progressive heart disease
What are the 2 steotypes of ppl that have mitral regurg?
Young, thin woman with scoliosis and pectus excavatum small AP diameter. Puts mechanical constraints on heart so that RH has to work harder to pump

Iler male with prior hx of MI. Disrupts how MV moves
V-tach consists of at least 3 consecutive PVC's (wide QRS, no P) at a rate of over 110bpm and potentially life-threatening. AIVR is anything below that and is a benign finding. "Sustained" is anything lasting over 30s.
What is the rate of patients with VF having primary VF? What is the rate of resuscitation of patients experiencing sudden cardiac death? What properties of the VF dictate survival rate?
Is the highest P at the end of systole?
No, it is slighly before the dicrotic notch
What lead is best to evaluate for atrial enlargement?
• V1: in LAE, Biphasic P wave in V1 c terminal (negative) component increased in amplitude (>1mm) and duration (>1mm) • in RAE, Biphasic P wave in V1 with increased amplitude and duration of initial component.
Apolipoproteins
Lipoproteins contain specific _________ that interact with specific cell membrane recptors thereby “identifying” the phospholipid to the cell.
Stage 2 HTN
>=160 >=100
disease from Marfans and SLE?
MVP
HDL-C
What lipoprotein has a cardioprotective role facilitating the transfer of Cholesterol from atherogenic lipoproteins and peripheral tissues to be metabolized by the liver?
Artifact
Activity recorded in an electrocardiogram caused by extraneous activty such as patient movement, loose lead, or electrical interefence
cardiomyopathy that is from amyloidosis and hemochromotosis?
Restrictive Cardiomyopathy
PND
Sudden episodes of labored breathing that awaken the patient from sleep is referred to as:
 
a. P and D
b. PCP
c. PND
d. O and P
exogenous pathway
Which pathway transports dietary lipids to the periphery and liver?
Primary dyslipidemia
What type of dyslipidemia comes from inherited disorders, genetically based derangement of synthesis or cell receptor?
Glucocorticoids
What family of steroid derivatives regulates carbohydrate, protein, and lipid metabolism and stabilizes capillary membranes?
Ventricular tachycaria treatment
Cardioversion, amiodarone, lidocaine, procainamide
Name a Platelet GP IIb/IIIa Antagonist
eptifibatid_(Integrilin)...tirofiban_(Aggrastat)
WAP
What arrhythmia occurs when the pacemaker is from a different site every beat and under 100bpm?
cardiomyopathy that is mainly genetic? 2 characteristics
Hypertrophic CardiomyopathyIncreased Diastolic PressuresSAM
systole
The contraction phase of the cardiac cycle is:
 
a. diastole
b. endocardium
c. systole
d. tachycardia
digoxin
The antiarrhythmic agent used to treat congestive heart failure and arrhythmias, like atrial fibrillation, is:
 
a. digoxin
b. doxepin
c. doxycycline
d. Doxidan
four compensatory mechanism for increasing CO
frank-starlin mechanismSNSventricular hypertrophyventricular dilatation
Cholesterol & TG
 Hydrophilic and hydrophobic portions of phospholipid allow __________and ______to be dissolved in plasma as a lipoprotein.
liver
What is the primary organ responsible for regulating the steady-state concentration of LDL?
saturated
Higher degress of ____ fats in diets lead to harmful alteration in blood lipids.
Chylomicrons
What are the largest of the lipoproteins?
A fib etiology
Pulmonary disease, ischemia, rheumatic heart disease, anemia/atrial myxoma, thyrotoxicosis, ethanol, sepsis
Fibrinolytics should be given within how many hours after the onset of pain?
6 hours.
Which Cardiac Meds prolong survival Post MI?
Beta-blockers./.Carvedilol./.ACE inhib./.ARBs./.ASA
Which is better Valve Replacement or Repair?
Repair
decrease
If there is systolic dysfunction in HF, what will the SV do?
Aneurysm
Local dilations in a blood vessel wall
this disease is secondary to right ventricle dilation
Tricuspid Regurgitation
12
How many leads are in a standard electrocardiogram?
 
a. 9
b. 11
c. 12
d. 13
CABG
Which of the following is a surgical procedure used to restore blood flow to an area of the heart when an artery is occluded by atherosclerosis?
 
a. echocardiogram
b. pacemaker implantation
c. AV node ablation
d. CABG
hydrochlorothiazide
Which of the following is a diuretic that is often combined with antihypertensive medications?
 
a. ibuprofin
b. acetylsalicylic acid
c. lovastatin
d. hydrochlorothiazide
sinoatrial node
Which node is considered the dominant pacemaker?
 
a. atrioventricular node
b. coronary node
c. sentinel node
d. sinoatrial node
Treatment for Unstable Angina
Antithrombotics: Heparin, or LMWH and/or Plavix
the Intestines
What is the primary means of cholesterol elimination?
LDL
What is the most atherogenic of the lipoproteins?
Paroxysmal atrial tachycardia etiology
Non-nodal ectopic pacemaker, leading to palpitations, sob, angina, syncope
Which MI is more likely to have primary or secondary Type I block (usually temporary)
Inferior
V fib.
WPW in the presence of A-flutter/fib has a high risk of leading to what?
Sinus Tachycardia
Which arrhythmia is caused by rapid beating of the SA node of 100-180 bpm and can cause a "racing heart"?
Regular
Are the P-P and R-R intervals regular or irregular in 3rd Degree Av block?
Risk of PE is a concern with what disease?
DVT
which disease has pulsus paradoxus? other Sx?
Cardiac tamponadeBecks: distant heart sound, hypotension, JVD
myocardial infarction
Which of the following is the medical term for a heart attack?
 
a. diphtheritic myocorditis
b. myocardial hamartoma
c. myocardial infarction
d. septal myomectomy
LA Places' Law formula
T= (P * R) / M
LDL or VLDL
Apolipoprotein B is a marker for what?
Ventricular tachycaria ECG
Three consecutive PCV, wide QRS complexes, AV dissociation
When is S3 normal?
Children and usually in pregnant women. Abnormal over the age of 40.
Junctional Arrhythmias
What type of arrhythmias have none or inverted P waves?
Tachycardia
Heart rate of more then 90 beats per minute
Percutaneous Transluminal Coronary Angioplasty (PTCA)
Procedure that improvese blood flow through a coronary artey by pressing the plaque against the wall of the artery with a ballon on a catheter, allowing for more blood flow
what factors affect ventricular performance
SNS, + & - inotropic drug
Unsaturated fats
What type of fats are liquid at room temp?
More dangerous
Is a smaller sized LDL more or less dangerous than a large one?
What is the most appropriate antihypertensive for diabetes? CHF? Systolic htn? MI? Osteoporosis? BPH?
ACEIs; ß-blockers, ACEIs, diuertics; diuretics, ß-blockers without intrinsic sympathomimetic activity, ACEIs; thiazide; alpha-antagonists
AV High-grade block is usually seen with:
Anterior MI (usually infraHisian)
pacing
 
 
*DO NOT USE anti-arrhythmic drugs!! - do not want to stop the site that IS working
What is the treatment for Ventricular escape rhythms/beats?
Stage B
Which stage of HF is someone in if they have structural heart damage, but no S&S?
Name the major Framingham criteria for CHF.
PND, JVD, rales, cardiomegaly, Pulmonary Edema, S3, Increased CVP, and hepatojugular reflex. Note these are all CENTRAL (Lungs, heart, neck veins)
Bile acids, Androgens & Estrogens, Progestins, Glucocorticoids, Mineralcorticoids
Steroids derived from cholesterol in animals is divided into what 5 families?
What defines hypertensive emergency?
Any BP, but signs or symptoms of end-organ damage (renal failure or hematuria, altered mental status or evidence of neurologic disease, intracranial hemorrhage, ophthalmologic findings, papilledema, vascular changes, unstable angina/MI, pulmonary edema)
Which MI is more likely to have a new bundle branch block or high grade AV block?
Anterior MI
Atropine
 
*increase SA firing would increase number of dropped vent beats & decrease CO more
Which drug should you avoid in Second Degree Type II AV block?
Atropine
 
*INcreases the HR
What drug would you give to a person with sinus bradycardia if they become symptomatic?
Lt Sided HF
What type of HF presents c signs of hypoperfusion of body tissue and pulmonary vascular congestion?
When would you use digoxin in HF?
Pts with clear cut systolic dysfunction or Aflutter or Afib w/ RVR
homocysteine level test for what?
- vitamin B12 deficiency or folic acid deficiency. -inherited disease (homocystinuria) that causes a deficiency of one of several enzymes needed to convert food to energy. unexplained blood clots
What causes painless ST segment changes on stress testing.
Silent Myocardial Ischemia and it is caused by inadequate perfusion.
3 weeks before
 
 
*and for 4 weeks after
How long must soneone be on anticoagulants before you can cardiovert them?
Occasional unifocal PVC's and PAC's need no TX. When would you treat PVC's/PAC's and how?
Use a BB when they interfere with ADL
What are the physical signs of pericarditis?
Friction rub, elevated JVP, and pulsus paradoxus (bp falls >10 mmHg on inspiration); often positional
How do you treat STABLE VT?
Lidocaine bolus of 1.0 - 1.5 mg/kg followed by 2 - 4 mg/min infusion....... Amiodrone 150 mg infused over 5 minutes followed by a constant infusion of 1.0 mg/min for 6 hours.
Yes... it is a high risk factor
Would a pt with a previous Stroke need to be on coumadin?
What is the most common EKG change seen with abberations of sodium (hypo and hyper)
None. At Sodium levels compatible with life, no EKG changes usually occur.
How do ventricular hypertrophies present on ECG?
LVH = amplitude of R wave in aVL + amplitude of S wave in V3 >24. RVG is diagnosed by right-axis deviation and R wave in V1 >7mm
3rd degree and advanced 2nd degree with bradycardia symptoms
What types of AV block are indications for Pacing?
With regard to the prognosis of CAD what is most closely related to Longevity?
LV function (this is the most powerful risk stratification parameter in all of cardiology)..... Severity of the angina ....Exercise capacity: the duration of exercise on a stress test (measured in METs) is highly predictive of prognosis. Note that none of these parameters requies coronary angiograpy.
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