NPLEX 2 cardiology
narrow pulse pressure vs wide pulse pressure - narrow - aortic stenosis
wide - aortic regurg
Heart blocks - 1st - long PR
2nd 1 - progressivly longer pr, then dropped
2nd 2 - randomly dropped, inconsistent ps
3rd - no relationship between p and QRS, but ps consistent
Emergent referral - MI, acute regurg, severe HTN, a-fib with rapid ventricular rate, pulmonary
edema, new onset heart faliure
causes of dialted cardiomyopathy - thiamine def, alcohol, myocarditis, cocaine, herion, peripartum
S3 and S4 sound - dialted cardiomyopathy
non specific st changes and q waves - dialted cardiomyopathy
missense mutation for HTCM - chromosome 14
double apical pulse, s4, harsh systolic murmur, angina with exercise, palpitations and dizziness with
valsalva - HTCM
ECG for HTCM - prominemnt q, short p-r interval
tx for HTCM - b-blockers
, gradually worsening SOB, exercise intoleracne and fatigue with low QRS voltage - RCM
ifxn with endocarditis - acute - staph aureus
subacute - strep viridans
sxs of endocarditis - regurg murmurs, splinter hemorrahages, janeways lesions, muscoal petechia,
roths spots (retinal hemmorage with pale center) oslers nodes (painful nodes on pads of fingers)
lab findings in endocarditis - Anemia, neutrophilic leukocytosis actuely, hematuria, proteinuria
pathology of myocarditis - coxsackie b infxn causing lymphocytic infiltration and dilation and
hypertrophy of all four chambers
auscultated rub during only inspiration and expiration - pleural rub, vs pericardial which is all the
time
chest pain, pericardial rub, arrhytmias and inc CK-MD and troponins - Myocarditis
chest pain, pericardial rub, pain better leaning forward, normal CK-MB - pericarditis
dx of myocarditis - endomyocardial bopsy
ECG and dx of pericarditis - PR-segment depression, echo for dx
tx for pericarditis - NSAIDs 7-14 days, colchicine for recurrent, prednisone
JONES criteria for rheumatic heart dz (2 major or 1 maj, 2 minor) - Major:
Carditis, polyarthritis (with swelling), chorea, subcut nodules, erythema marginatum