Cardiovascular Disease

Coronary Artery Disease (CAD)

Chest pain (angina), dyspnea; Leading cause of MI; risk factors: HTN, smoking

Myocardial Infarction (MI)

Crushing chest pain, diaphoresis, nausea; Elevated troponins; STEMI vs NSTEMI

Stable Angina

Exertional chest pain relieved by rest; Due to fixed atherosclerotic plaques

Unstable Angina

Chest pain at rest or minimal exertion; Pre-infarction syndrome; urgent evaluation needed

Variant (Prinzmetal) angina

Chest pain at rest, transient ST elevation; Due to coronary artery spasm

Heart Failure (HF)

Dyspnea, orthopnea, edema, fatigue; Systolic vs diastolic; LVEF key measurement

Left-Sided Heart Failure

Pulmonary congestion, crackles, SOB; Causes: MI, HTN, valvular disease

Right-Sided Heart Failure

Peripheral edema, JVD, hepatomegaly; Often secondary to left HF or lung disease

Cardiomyopathy, dilated

CHF symptoms, systolic dysfunction; Most common type; causes: idiopathic, viral

Cardiomyopathy, hypertrophic

Dyspnea, syncope, sudden death risk; Genetic; asymmetric septal hypertrophy

Cardiomyopathy, restrictive

Fatigue, exercise intolerance; Infiltrative diseases like amyloidosis

Valvular aortic stenosis

Crescendo-decrescendo systolic murmur, syncope; Often calcific degeneration in elderly

Mitral regurgitation

Holosystolic murmur, fatigue, pulmonary edema; Due to leaflet prolapse, ischemic damage

Mitral Stenosis

Diastolic murmur, opening snap, hemoptysis; Usually rheumatic heart disease

Aortic Regurgitation

Early diastolic murmur, bounding pulses; Causes: bicuspid valve, endocarditis

Tricuspid Regurgitation

Holosystolic murmur increased with inspiration; Common in right HF, carcinoid syndrome

Pulmonary Stenosis

Systolic murmur, right ventricular hypertrophy; Usually congenital

Endocarditis

Fever, new murmur, petechiae; Staph aureus common; risk: prosthetic valves

Pericarditis

Sharp chest pain improved by leaning forward; Pericardial friction rub; ECG: diffuse ST elevation

Pericardial Tamponade

Hypotension, muffled heart sounds, JVD (Beck’s triad); Emergency: fluid in pericardial sac compresses heart

Atrial Fibrillation

Irregularly irregular pulse, palpitations; Risk of stroke; anticoagulation important

Atrial Flutter

Rapid regular atrial rhythm; sawtooth on ECG; Can progress to AFib

Ventricular Tachycardia

Palpitations, syncope; can lead to VFib

Ventricular Fibrillation

Sudden collapse, no pulse; Medical emergency; defibrillation needed

Bradycardia

Fatigue, dizziness, syncope; Heart rate <60 bpm; may require pacemaker

Sick Sinus Syndrome

Alternating bradycardia and tachycardia; Dysfunction of SA node

Atrioventricular Block

Syncope, dizziness, bradycardia; 1st, 2nd, 3rd degree blocks; 3rd degree often needs pacemaker

Wolff-Parkinson-White (WPW) syndrome

Palpitations, tachycardia; accessory pathway causes pre-excitation on ECG

Long QT Syndrome

Syncope, sudden death; Risk of torsades de pointes; congenital or acquired

Pulmonary Embolism

Sudden dyspnea, pleuritic chest pain, hemoptysis; Often due to DVT; can cause right heart strain

Deep Vein Thrombosis (DVT)

Leg swelling, pain, redness; Risk factor for pulmonary embolism

Hypertension

Often asymptomatic, headache, visual changes; Major risk for CAD, stroke, heart failure

Malignant Hypertension

Severe headache, visual disturbances, renal failure; Hypertensive emergency with organ damage

Coarctation of the aorta

Hypertension in upper limbs, weak femoral pulses; congenital narrowing of aorta

Patent Ductus Arteriosus (PDA)

Continuous “machine-like” murmur; Left-to-right shunt between aorta and pulmonary artery

Tetralogy of Fallot

Cyanosis, “tet spells,” murmur; Congenital; 4 defects including VSD and pulmonary stenosis

Atrial Septal Defect

Often asymptomatic, fixed split S2; Left-to-right shunt; risk of paradoxical embolism

Ventricular Septal Defect (VSD)

Heart failure signs in infancy; Left-to-right shunt causing volume overload

Infected Endocarditis

Fever, new murmur, septic emboli; Often on damaged valves; staph or strep common

Myocarditis

Chest pain, heart failure, arrhythmias; Viral causes common; can mimic MI

Cardiac Tamponade

Hypotension, muffled heart sounds, JVD; Emergency; pericardial fluid compresses heart

Rheumatic Heart Disease

Migratory arthritis, carditis, valvular damage; Post-strep infection; mitral valve most affected

Endocardial Fibroelastosis

Heart failure in infants; Thickened endocardium; congenital or viral

Congestive Heart Failure

Dyspnea, orthopnea, edema; Systolic vs diastolic; BNP elevated

Pulmonary Hypertension

Dyspnea, fatigue, syncope; Leads to right heart failure

Aortic Aneurism

Often asymptomatic, back pain if large; Risk of rupture; abdominal aortic most common

Peripheral Artery Disease (PAD)

Claudication, weak pulses; Atherosclerosis of limb arteries

Takotsubo cardiomyopathy

Chest pain, ECG changes, transient LV dysfunction; “Broken heart syndrome”; stress-induced

Myxoma

Cardiac tumor causing emboli, obstruction; Most common primary heart tumor

Arrhythmogenic right ventricular cardiomyopathy

Ventricular arrhythmias, sudden death risk; Fibrofatty replacement of RV myocardium