Cardiology EM Terms & Definitions for Medical Students

High pitched diastolic blowing murmur. 3rd ICS on left.

Aortic Regurgitation

Systolic crescendo-decrescendo murmur. Radiates to carotid

Aortic Stenosis

Low pitched diastolic rumble. Opening snap. Radiates to axilla

Mitral Stenosis

High pitched Holosystolic Murmur

Mitral Regurgitation

most common cause Acute Bacterial Endocarditis?

Staph Aureus (sudden onset)

Most common cause Subacute Bacterial Endocarditis?

Strep Viridians. (gradual onset)

Dukes Criteria

Diagnostic criteria for endocarditis

Major Criteria (dukes)

Two positive blood cultures or echocardiographic evidence.

Minor Criteria (dukes)

Includes fever, immunologic signs (roth, osler, janeway), and risk factors.

Osler Nodes

Tender nodules on fingers associated with endocarditis.

Janeway Lesions

Painless hemorrhagic lesions on palms and soles.

Roth Spots

Exudative retinal lesions indicative of endocarditis.

Stable Angina

Predictable chest pain triggered by exertion.

Unstable Angina

Chest pain at rest or worsening pattern.

Unstable Angina EKG

Negative or inverted T waves.

Unstable Angina Labs

negative troponins

Beck's Triad

Signs of cardiac tamponade: JVD, hypotension, muffled sounds.

Pulsus Paradoxus

Drop in blood pressure during inspiration >12mmHg.

Kussmaul Sign

Increased venous pressure during inspiration.

CHA2DS2-VASc Score

CHF history, HTN, Age >75(2), Diabetes, Stroke Hx(2) Vascular disease hx, Age 65-74, Sex Female

Ventricular Tachycardia

Rapid heart rate, can lead to sudden cardiac death. QRS >.12s (widening) Rate >100 bpm

Torsades de Pointes

Polymorphic VT associated with long QT syndrome.

Premature Ventricular Contractions (PVC)

Early heartbeats originating from ventricles. run of 3+ PVC= Vtach

Sgarbossa's Criteria

Criteria for diagnosing STEMI in known Left Bundle Branch Blocks.

Concordance

ST-T moving same direction as QRS complex.

STEMI

ST elevation myocardial infarction, requires immediate intervention. + elevated troponins

PAC

Premature atrial contraction; early heartbeat from atria.

NSTEMI

Non-ST elevation myocardial infarction;

NSTEMI ECG

non-specific. No ST elevation (ST segment depression, T wave inversion)

NSTEMI Labs

LOW troponins (<0.5ng/dL)

Prinzmetal Angina

Coronary vasospasm without high-grade stenosis.

STEMI on EKG, but no blockages found in PCI

Systolic HF

Heart failure with reduced ejection fraction (<40%).

Diastolic HF

Heart failure with preserved ejection fraction (>50%).

CHF Causes

CAD and hypertension are most prevalent causes.

Cardinal Symptoms of CHF

Dyspnea on exertion, orthopnea, peripheral edema.

Left-Sided HF Symptoms

Dyspnea, orthopnea, fatigue, pulmonary rales.

Right-Sided HF Symptoms

Peripheral edema, JVD, RUQ discomfort.

Acute HF Management

LMNOP: Lasix, Morphine, Nitrates, Oxygen, Position.

Hypertensive Urgency

Marked hypertension without end-organ damage. SBP >180-220 / DBP >120

Hypertensive Emergency

Marked hypertension WITH end-organ damage. SBP >180-220 / DBP >120

Heart, brain, kidney, retina, HTN encephalopathy, nephropathy, retinopathy.

Orthostatic Hypotension

Drop in BP >20 mmHg from sitting to standing

Peripheral Arterial Disease

MCC is atherosclerosis; causes limb ischemia.

ABI Scale

Ankle-brachial index; assesses PAD severity.

ABI value 1.0-1.4

normal

ABI value 0.9-1.0

allowable ABI value

ABI value 0.8-0.9

Mild PAD- tx RF

ABI value 0.5-0.8

Moderate PAD refer vascular

ABI value <0.5 Severe PAD- refer

Buerger's Disease

Inflammatory disease linked to tobacco use.

Raynaud's Disease

Vasospastic disorder causing color changes in fingers.

Venous Insufficiency

Inadequate venous return; causes varicose veins.

Venous Ulcers

Chronic wounds due to venous insufficiency. MC medial malleolus

Chronic Arterial Insufficiency

Causes painful ulcers and weak pulses.

S3 Gallop

Heart sound indicating heart failure.

Carotid Massage

Diagnostic maneuver for carotid sensitivity.

Asystole

Absence of heartbeats for over 3 seconds.

MCC of Aortic Stenosis

degenerative heart disease.

Paradoxical Splitting of S2

Abnormal heart sound during expiration.

heard in HCM (opposite MR/VSD)

ECG Findings in Mitral Stenosis

Notched P-waves and right axis deviation. Left atrial enlargement

Which is more common

AAA vs TAA :AAA > TAA

Cardarelli's Sign

Tracheal pulsation indicating aortic arch aneurysm.

Aortic Dissection

Tear in the aorta's inner layer.

Debakey & Standford Classifications

Systems for classifying aortic dissections.

Class 1- Na+ blockers

Antiarrhythmics that block sodium channels.

Class 1A antiarrhythmic meds

Disopyramide, Procainamide, Quinidine

Class 1B antiarrhythmic

Lidocaine

Class 1C antiarrhythmic meds

Propafenone, Flecainide

Class 2 antiarrhythmic meds

Propranolol, Metoprolol, Acebutolol

Class 3- Antiarrhytmics

K+ channel blockers (rhythm control)

Class 3 antiarrhythmic meds

Amiodarone, Dofetilide, Sotalol

Class 4 - Antiarrhythmics

Ca+ channel blockers (rate control)

Class 4 antiarrhythmic

Verapamil, Diltiazem

miscellaneous antiarrhythmic

Adenosine, Digitalis, Magnesium Sulfate

First generation beta blockers that are non-selective

1st gen: Non-selective- N-Z -olol

CI

asthma :Contraindication for non-selective beta blockers.

Second generation beta blockers that are cardio-selective.

2nd gen: Cardio-selective- A-M olol

CCBs- DHPS (CYP 3A4 substrates)

Calcium channel blockers that are dihydropyridines.

dihydropyridine calcium channel blockers (DHPs)

Amlodipine, Nifedipine, Nicardipine

Adverse effects of ACE-inhibitors.

AE: hyperkalemia, cough, angioedema, HoTN

alpha-1 adrenergic blocker

Prazosin, terazosin, doxazosin, tamsulosin

Adverse effects of alpha-1 adrenergic blockers.

AE: HoTN, dizziness

central sympatholytic antihypertensives

Clonidine, Guanfacine

Adverse effects of clonidine.

withdrawal reaction &, orthostatic HoTN

1st Class Antiarrhythmics

Na+ channel blockade (rhythm control)

3rd generation BB

Carvedilol, Labetalol