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Cardio Word Assoc
Cardio Word Association Board Review
| Question | Answer |
|---|---|
| DOE, PND, edema. Echo w/ LVH or RVH, hypokinesis | CHF |
| S3 | CHF, dilagted cardiomyopathy |
| High output heart failure | Pregnancy, thyrotoxicosis, anemia, beriberi, paget’s disease |
| Low output heart failure | Ischemic heart disease, HTN, dilated CM, valve disease, arrhythmia |
| Heart failure after URI | Myocarditis |
| Young athlete with syncope during athletic event or practice. No physical exam abnormalities | Hypertrophic CM or fatal arrhythmia. Get EKG or Echo |
| Alcoholic with DOE, heart failure | Primary dilated CM |
| Alcoholic with palpitations, arrhythmia | Atrial fibrillation (Holiday heart) |
| Irregular irregular | Atrial fibrillation; (if > 48 or chronic – anticoagulate) |
| Atrial fibrillation or prosthetic valve | Warfarin (2 – 3 for Afib; 2.5 – 3.5 for valve); Tx Warfarin OD is vitamin K |
| Hx angina but no acute sx. EKG no acute changes. | Do Exercise stress test |
| Crushing CP, dyspnea, palpitations, radiation to neck or left arm | Angina (if lasts minutes), AMI if lasts > 30 minutes. Acute Ischemia – ST elevation; Injury – T wave depression; Infarct – Q wave |
| Constant, sharp CP worse lying down, better sitting up and leaning forward | Pericarditis |
| pulsus paradoxus | Pericardial effusion/tamponade, pericarditis, asthma attack, tension PTX, SVC obstruction |
| Electrical alternans, narrow pulse pressure, pulsus paradoxus | Pericardial effusion/tamponade |
| JVD, Hypotension, muffled heart sounds | Pericardial effusion/tamponade (Beck’s triad) |
| Pericarditis post open heart surgery | Dressler’s syndrome. Tx w/ ASA |
| Sudden onset ripping, tearing chest pain, diminished pulses | Aortic dissection |
| Flank pain, hypotension, pulsatile abdominal mass | AAA |
| EKG changes, N, V, yellow-green visual disturbances | Digoxin toxicity (Hypokalemia will make worse) |
| Hx CHF on diuretic & digoxin | Suspect dig toxicity (hypokalemia from diuretic = dig toxicity) |
| Grossly elevated blood pressure esp. w/ signs of EOD | Malignant or Urgent HTN |
| HTN Tx w/ meds, cough or angioedema | ACEI is cause |
| DM & HTN | ACEI is best choice |
| Heart failure, LVH | ACEI (improves survival, prevents development of heart failure Sx) |
| Post MI | Beta-blockers |
| Tx of HTN w/ alpha-blocker | SE is postural Hypotension |
| HTN not responsive to basic meds | Think secondary HTN most likely Renal artery stenosis (infrarenal artery). |
| Mechanical valve or prosthesis & Dental, GU, GI, or ortho procedure prophylaxis | Bacterial endocarditis (strep. Viridians) prevention |
| IVDA w/ new murmur | Bacterial endocarditis (strep. Viridians) |
| Elderly w/ systolic murmur | Aortic stenosis (due to calcifications – age related (or bicuspid valve - congenital) |
| Diamond shaped, blowing systolic murmur. May have angina, syncope, CHF | Aortic stenosis |
| Lateral displaced PMI, Canon “a” waves, Quincke’s pulse, Corrigan’s pulse, Austin flint murmur, deMusset’s sign, water | Aortic Regurgitation/Insufficiency: Quincke’s pulse (subungual capillar pulsation), Corrigan (rapid rise and fall), Austin filnt (low pitch middiastolic murmur at apex) |
| Diastolic murmur best heart at apex without radiation | Mitral stenosis (ARMS are BAD) |
| Systolic ejection murmur heard best at base with radiation to left clavicle | Pulmonary stenosis |
| Female or Post MI, systolic murmur best @ apex preceded by click without radiation | Mitral valve prolapse |
| Systolic murmur heard best at apex with radiation to left axilla (apical systolic) | Mitral regurgitation |
| New murmur after MI (esp. if apical systolic) | Mitral regurgitation (caused by papillary muscle rupture) |
| Murmur & Hx rheumatic heart disease | Mitral stenosis |
| Continuous harsh, machine-like murmur | PDA |
| Cyanotic infant with systolic thrill @ LSB, systolic ejection murmur +/- click | Tetralogy of falot |
| Holosystolic murmur @ LSB, may have ventricular hypertrophy | VSD |
| Infant w/ dyspnea, difficulty feeding. Holosystolic murmur @ LSB, 3rd ICS. LVH & RVH | VSD |
| Peds w/ leg pain after physical activity, abnormal heart sounds, unequal UE & LE pulses, rib notching | Coarctation of aorta |
| Short PR, wide QRS, Delta wave | Wolf-parkinson-white; avoid Digoxin, |
| Young female (<30yo), palpitations, long arms & fingers, pectus excavatum, ectopic lentis, flexible joints | Marfan’s Syndrome – MVP, Aortic regurgitation, Aortic dissection, Aortic root dilatation, ectopic lentis |
| LE rubor, no hair, brittle nails, pallor on elevation, calf or LE pain esp. with walking short distances relieved with rest or at PM | Arterial insufficiency/PAD, Intermittent claudication (ABI best choice, ateriogram gold standard) |
| Claudication with rest pain, (ABI < 0.4) | Tx is arterial bypass |
| LE pain after long periods of standing. Dilated, tortuous, veins | Varicose veins. Tx w/ compression stockings |
| Trendelenberg test of extremities | Tests for veinous insufficiency. |
| Blue extremities worse w/ cold exposure, improves w/ warming | Acrocyanosis |
Created by:
smaxsmith
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