pathology smd

ischemic chest pain location

right side, jaw, epigastrium, back

chest pain severity due to cad

fc1: no symp w daily activities.

fc4: symptoms at rest

warfarin- anti k drug

prevent thrombosis in af

Heparin

Acute coronary syndrome

nitrates

dilate veins, reduce preload for cad

b1 receptors

reduce heart rate and contractility

calcium channel blockers

htn

statins

reduce cholesterol

ace inhibitors

reduce bp and afterload. htn, hf

digoxin

slow hr in fast af

central cyanosis

r-l shunts, tof, long l-r shunts, impaired pulm funct.

peripheral cyanosis

extremities, severe hf, circ shock, raynauds

bp measurement

both arms one leg, arm at heart level, 5 min rest

atrial pulse

patency, heart rhythm, pumping heart-bp

s1

mv, tv closure

s2

av, pv closure

s3

syst hf, vol overload

s4

dias hf

opening snap

ms

early syst click

as

mid to late syst click

mv prolapse

dias murmurs

ar, pr, ms, ts

syst murmurs

as, ps, asd, mr, tr, vsd

continuous murmur

pda, arterio venous fistula

sensitivity

pt w disease, + test

specificity

pt wo disease, - test

what is this?

posteroanterior chest radiograph. B.lateral chest radiograph

what is this?

RA enlargement

what is this?

La enlargement

what is this?

rv enlargement. 

what is this?

lv enlargement

what is this?

cephalization of pulm vessels. first sign of congestive hf, phtn

what is this?

alveolar pulm edema

what is this?

active hyperemia in asd

lvh- st dep, prominent r

rvh- t inv, 

what is this?

lvh

what is this?

rvh

flat st depression

subendocardial infarction

st elevation

earliest sign of mi

what is this?

st elevation w pericarditis

what is this?

ischemia

what is this?

injury acute isch subendo

what is this?

injury acute isch transm

what is this?

acute inferior mi

what is this?

old antero-septal mi

what is this?

old inf infraction

what is this?

hyperkalemia

what is this?

hypokalemia

myocardial o2 consumption 

hr, syst bp, contractility

mechanism of arrhythmias

disturbance of impulse formation and propagation

what is this?

multifocal pvc

what is this?

sinus tachycardia

what is this?

af

what is this?

psvt

what is this?

psvt sudden onset

3 pvcs

vent tachycaria

what is this?

vf

what is this?

sinus bradycardia

what is this?

sinus arrhythmia

what is this?

1 deg av block

what is this?

2 deg. mobitz type 1

what is this?

2 deg. mobitz type 2

what is this?

3 deg complete av block

what is this?

3 deg w vent escape rhythm

supply

hr, blood o2, coronary perfusion

demand

hr, contractility, afterload (bp)

consequences of myocardial isch

acute reversible isch, chronic sev isch, necrosis, electrical instability

what is this?

acute demand. exercise w cad

what is this?

acute supply. thrombus or spasm

clinical syndromes of ihd

angina pect, mi, arrhythmia, heart failure

what is this?

thrombus in unstable angina

unstable angina clues

crescendo angina, rest angina, onset angina

most common cause of deaths after mi

electrical- arrhythmia, v tach, v fib, av blocks

tx arrhythmia

vf: defib w dc shock

vt: anti arrhythmia or dc shock

ruptures

pap musc- mr

septal - vsd

free wall - pericardial tamponade

what is this?

normal ao

what is this?

severe acute ar

tsv inc, fsv red, lvedp inc

what is this?

chronic compensated ar

edv inc, sv inc, lvedp normal

what is this?

decomp ar

esv inc, ef red, sv red

what is this?

normal mv

what is this?

ms

lap inc, pv p inc, phtn

mva and mg depend on

sv and dias filling time (hr)

complication of ms

thrombus, a fib, systemic embolism

what is this?

normal mv

what is this?

acute mr

lap inc, ef inc

what is this?

chronic comp mr

lap dec, ef inc

what is this?

chronic decomp mr

lap inc, ef dec

htn

140/90

masked htn

daytime 140/90, nighttime 120/70

pressure overload hypertrophy

lvh leads to lv dias dysf, la dilation, and a fib

hhd

htn present, concentric and symm lvh

hocm

htn absent, asymm lvh

pulm htm causes

1: arterial htn (l-r shunts)

2: left heart disease

3: lung disease (hypoxia, cor pulm)

4: chronci throboembolic phtn

5: multifactor

rv pressure overload

high PAP leads to RVH, syst failure, dilation

cor pulmonale

pulm disease, sev ph, rv syst failure, tr

hocm

lvh, dias dysf, la dilation, mr

hcm symp and signs

dyspnea, syncope, angina, s4

dcm

lv rv dilation, syst dysf (low ef), 2 mr, isch cmp

eisenmenger’s syndrome

l-r shunt leads to sev phtn, r-l shunt, cyanosis

tof

vsd, overriding ao, ps, rvh