Term
|
Definition
| Fast glucose > 100, HDL < 40 / 50 (men women), Triglyceride > 150, waist circumference > 40 / 35 inches (men/women), BP > 130/85 |
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Term
| Contraindications to dobutamine stress test |
|
Definition
| severe baseline HTN and h/o arrhythmias |
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|
Term
| Contraindications to adenosine stress test |
|
Definition
| bronchospastic airway disease and theophylline use |
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Term
|
Definition
| Asymptomatic patient at moderately high risk (10-20% Framingham 10 year risk) of CAD or young persons with a strong FH of premature CAD |
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|
Term
|
Definition
| DM, atherosclerosis, prior stroke |
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|
Term
| Typical chest pain (all three components) |
|
Definition
| Substernal CP or discomfort, provoked by exertion or emotional stress, relieved by rest / NTG |
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Term
|
Definition
| 2 out of 3 components of typical CP |
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Term
|
Definition
| No components of typical CP |
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|
Term
| Criteria for high pretest probability of CAD |
|
Definition
| Men over 40 with typical CP, women over 60 with typical CP |
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|
Term
| Criteria for low probability of CAD |
|
Definition
| Men under 40 with non-anginal CP, women under 60 with non-anginal CP and under 50 with atypical CP. |
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Term
| Contraindications to nitrate tx |
|
Definition
| Severe, symptomatic AS, hypertrophic CM |
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Term
|
Definition
| CAPRIE found plavix superior to aspirin in anginal pts in reducing stroke, MI, or vascular death. CHARISMA found the benefit to be insignificant. |
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Term
|
Definition
| < 100, <70 if very high risk |
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Term
|
Definition
| Left main, >70% of LAD and Cx, triple vessel, or double vessel withincluding sig. LAD and EF < 50% or ischemia on non-invasive testing. |
|
|
Term
|
Definition
| Decompensated HF, 2nd degree HB, bradycardia, SBP < 90 |
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|
Term
| Names of GP IIb / IIa inhibitors |
|
Definition
| abciximab, eptifibatide, tirofiban |
|
|
Term
| Indication of successful thrombolytic tx |
|
Definition
| >50% reduction in ST-elevation 60 minutes after thrombolytic administration |
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|
Term
| Glucose control in diabetics with ACS |
|
Definition
| <150 in initial days and <110 for rest of hospitalization |
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|
Term
| Indications for cardiac biopsy |
|
Definition
| New onset HF, associated with LV dilatation and new ventricular arrhythmias, 2nd or 3rd degree AV block, failure to respond to tx in 1-2 weeks, concern for a specific cause, routine surveillance s/p OHT |
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|
Term
| ACE / ARB contraindications |
|
Definition
| hypovolemia, renal failure, hyperkalemia (hydralazine and imdur can be used with renal failure or hyperkalemia) |
|
|
Term
| Spironolactone increase survival in NYHA class... |
|
Definition
|
|
Term
| CMR in restrictive cardiomyopathy |
|
Definition
| high-intensity areas represent sarcoid, low-intensity areas represent hemochromatosis |
|
|
Term
| Differences between restrictive CM and constrictive pericarditis |
|
Definition
| Constrictive pericarditis shows respiratory variation in ventricular filling, respiratory variation in ventricular septal wall motion. Cardiac MR shows pericardial thickening and pericarditis in constrictive pericarditis. Constrictive pericarditis has a slight elevation in BNP if no recent irritations while restrictive cardiomyopathy has a larger BNP elevation. |
|
|
Term
| Murmur of hypertrophic CM / left ventricular outflow obstruction |
|
Definition
| Midsystolic harsh murmur loudest at lower left sternal border or between border and cardiac apex, increased by Valsalva, diminished by squatting. |
|
|
Term
| Medical tx for hypertrophic cardiomyopathy |
|
Definition
Symptomatic with preserved LVF: BB, verapamil
Symptomatic with LV dysfunction: standard HF treatment
Avoid digoxin and vasodilators which cause LVOO |
|
|
Term
| Risk factors for sudden death in hypertrophic CM |
|
Definition
| Prior cardiac arrest, sustained VT, family history of sudden death |
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|
Term
| When should CCB and adenosine not be used? |
|
Definition
| VT. Wide-complex tachycardias are VT until proven to be SVT with aberrancy or accessory-pathway mediated tachycardia. Also contraindicated with WPW AND pre-excited aFib. Adenosine should also not be used with severe bronchospastic dz. |
|
|
Term
| Class IC anti-arrhymics and usage indications |
|
Definition
Flecainide (life threatening arrhythmias, SVT, PAF, AFL) and Propafenone (life threatening arrhythmias, PAF, PAFL, PSVT).
Use BOTH with BB / CCB (nondihydropyridine) / digoxin to avoid organizing afib to aflutter. Not used in CAD. |
|
|
Term
|
Definition
| No survival advantage to rhythm control in pts older than 70 years. Less appropriate for younger pts. |
|
|
Term
|
Definition
| Usually benign, with LBBB and tall monophasic R waves, triggered by exercise and stress. |
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|
Term
|
Definition
|
|
Term
| Brugada syndrome ECG finding |
|
Definition
| J-point elevation V1-3 - tx is ICD |
|
|
Term
| Criteria for intervention in chronic MR |
|
Definition
| Repair better than replacement. Intervene if symptomatic, EF < 60 or end-systolic vent. dimension > 40mm |
|
|
Term
| Criteria for intervention in chronic AR |
|
Definition
| Replace valve +/- if symptomatic, EF < 50, end-systolic vent. < 55mm or end-diastolic < 70mm or abnormal response to exercise. |
|
|
Term
| Criteria for intervention in mitral stenosis |
|
Definition
| BAV if minimal mitral REGURGE and no atrial clot, else mitral replacement if symptomatic or abnormal response to exercise (NYHA III-IV) |
|
|
Term
| Criteria for intervention in AS |
|
Definition
| Symptomatic (syncope, angina, HF) or EF < 50%. |
|
|
Term
| Causes of tricuspid valve disease |
|
Definition
| Pulmonary HTN, endocarditis, injury following pacer placement, CARCINOID dz, mediastinal irradiation, trauma. |
|
|
Term
| Indication for operating on coarctation |
|
Definition
| Systolic gradient of coarctation is > 30mm Hg |
|
|
Term
| Indication for operating on pulmonary stenosis |
|
Definition
| When peak systolic gradient is >50mm Hg, RVH, or pt is symptomatic |
|
|
Term
|
Definition
| Pts fully anti-coagulated on heparin, pulmonary HTN |
|
|
Term
| Treatment for chronic stable angina |
|
Definition
| ASA, BB, long acting nitrate, statin. ACE/ARB if EF < 35% |
|
|
Term
|
Definition
| Age > 65, 3 or more CAD risk factors (FH, HTN, tob, DM, HL), ASA use, 2 anginal events in 24h, known CAD w/>50% stenoisis, ST segment deviation, positive CE |
|
|
Term
| Initial medications for STEMI |
|
Definition
| ASA, analgesics, BB, nitrates, O2, ACE, heparin, clopidogrel, GP IIb/IIIa |
|
|
Term
| Cardiac resynchronization therapy (bi-v pacing) improves... |
|
Definition
| Functional status and survival in HF patients with ventricular dyssynchrony and NYHA III/IV |
|
|
Term
| Treatment philosophies with restrictive cardiomyopathy |
|
Definition
| Lower intercavitary pressure - loop diruetics for dyspnea, BB and non-dihydropyridine CCB, then ACE/ARB. Possible PPM for bradycardia. |
|
|
Term
|
Definition
|
|
Term
| Treatment for pericarditis |
|
Definition
| ASA, NSAIDs, colchicine. If all fails, steroids (except with infectious causes). Colchicine for recurrent pericarditis |
|
|
Term
| Mechanical ventilation in tamponade is... |
|
Definition
|
|
Term
| Only CCB indicated to not be harmful in HF |
|
Definition
|
|
Term
| Exercise vs nuclear stress test |
|
Definition
| Exercise with normal ECG, nuclear for abnormal ECG. |
|
|
Term
|
Definition
| Selective aldosterone blocker approved for HTN and LV dysfunction post-MI. Alternative for spironolactone in NYHA III/IV HF |
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