Unequal pulses or BPs in the arms; new murmur of aortic insufficiency; widened mediastinum
Name 4 criteria for thrombolytic therapy in the setting of an acute MI.
Clinical complaints are consistent w/ ischemic-type chest pain; ST-segment elevation more than 1mm in at least 2 anatomically contiguous leads; there are no contraindications to thrombolytic therapy; patient is < 75 years of age
What are 2 common causes of mortality in acute MI?
Myocardial pump failure (resulting in cardiogenic shock); ventricular arrhythmia (VT or VF)
What is accelerated idioventricular rhythm?
Wide-complex escape rhythm between 60-100 bpm that frequently accompanies reperfusion of the myocardium but causes no hemodynamic compromise
What medication is used to treat sinus bradycardia following acute MI?
What are 3 criteria used to define cardiogenic shock?
Hypotension w/ systolic arterial pressure < 80 mm Hg; markedly reduced cardiac index < 1.8 L/min/m2; elevated LV filling pressure (measured indirectly w/ a pulmonary capillary wedge pressure > 18 mm Hg)
What is the hallmark of treatment for pts w/ right ventricular infarction?
Volume replacement w/ saline or colloid solution to maintain adequate preload
What is the triad of Dressler syndrome?
Pericarditis; pleuritis; fever
Pts w/ established CAD should have an LDL cholesterol level < _____.
What 2 tests may be used to dx reinfarction in a patient w/ a recent MI?
New ECG findings; rapidly rising cardiac markers such as serum myoglobin or CK-MB
What are 3 symptoms of aortic valvular stenosis?
Late systolic murmur radiating to the carotid; paradoxical splitting of S2; diminished carotid upstroke
What are the 3 major treatment goals for pts w/ CHF?
Relief of sx; preventing disease progression; reduction in mortality risk
(T/F) Digoxin provides survival benefit for pts w/ CHF.
In CHF pts who cannot tolerate ACE inhibition (or in black pts in whom ACE inhibitors appear to confer less benefit, the use of _____ has been shown to decrease mortality.
Hydralazine /w nitrates
What is the most common valvular abnormality in adults?
Aortic stenosis in pts younger than 30 yrs is usually caused by _____.
Congenital bicuspid valve
What is the most common cause of aortic stenosis in pts 30-70 years of age?
In pts older than 70, the most common cause of aortic stenosis is _____.
Degenerative calcific stenosis
What are 3 physical findings a/w aortic stenosis?
Narrow pulse pressure; harsh late-peaking systolic murmur heard best at the right second intercostal space w/ radiation to the carotid arteries; delayed slow-rising carotid upstroke (pulsus parvus et tardus)
What are 2 characteristics of the EKG a/w atrial fibrillation?
Absence of discrete P waves; irregularly irregular ventricular response
Name the 2 most common causes of atrial fibrillation.
Hypertension; coronary atherosclerosis
Describe the "I SMART CHAP" mnemonic for causes of atrial fibrillation.