Step 3- Cardiology

zms2187's version from 2015-09-10 01:40

Section 1

Question Answer
Drugs to improve mortality post-MIasa, beta blockers, ACEi, statin
murmur of mitral stenosisdiastolic murmur at apex, opening snap no radiation.
Tx mitral stenosisHR control, balloon valvuloplasty or valve replacement
Tx mitral regurgif acute surgery always required. Otherwise replace valve if pt is symptomatic or if EF is <60%
blowing systolic murmur at apex radiating to axillaMR
MVP murmurmid-systolic click
What is parvus et tardussmall and slow carotid upstroke- common with severe AS
Drugs to avoid in aortic stenosisavoid overdiuresis and vasodilators like nitrates/ACEi
Physical exam for aortic regurghigh pitched diastolic murmur at L sternal border radiates toward apex. Wide pulse pressure
Tx aortic regurgAfterload reduction with hydral and ACEi. Replace valve if symptomatic or depressed EF
Associations with aortic regurgaortic root disease, dissection, syphilis, marfans, ankylosing spondy
Causes of diastolic heart failuremost common htn, others to consider sarcoid, amyloid, hemochromatosis, scleroderma, fibrosis (2/2 radiation)

Section 2

Question Answer
Causes of dilated CMhtn, ischemia, alcohol, tachycardia, chagas' disease (south america)
Causes of restrictive CMsarcoid, amyloid, hemochromatosis, cancer, glycogen storage disease (ekg w/low voltage, LVH on echo)
Tx hypertrophic CMbeta blockers, calcium channel blockers, or disopyramide. Avoid inotropes, excessive diuresis, and vasodilators.