Term
| Premature ventricular contraction etiology |
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Definition
| Ectopic beeats from ventricular foci. Associated with hypoxia, electolyte abnormalities, and hyperthyroidism |
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Term
| Premature ventricular treatment |
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Definition
| Treat underlying cause, b-blockers if symptomatic |
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Term
| Ventricular tachycardia etiology |
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Definition
| Associated with CAD and MI |
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Term
| Ventricular tachycaria ECG |
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Definition
| Three consecutive PCV, wide QRS complexes, AV dissociation |
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Term
| Ventricular tachycaria treatment |
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Definition
| Cardioversion, amiodarone, lidocaine, procainamide |
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Term
| Ventricular fibrillation etiology |
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Definition
| Associated with CAD and MI |
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Term
| Ventricular fibrillation signs |
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Definition
| Syncope, hypotension, pulselessness; totally erratic tracing |
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Term
| What are the ECG manifestation of hyperkalemia |
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Definition
| Peak T waves --> widerning of PR interval --> widening of QRS, sinusoidal wave pattern --> ventricular fib |
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Term
| How do you distinguish LBBB and RBBB based on ECG results |
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Definition
| WiLLiaM MaRRoW - W pattern of QRS in V1-V2 and M pattern of QRS in V3-V6 for LBBB. Reverse for RBBB |
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Term
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Definition
| Anticoagulate, B-blocker, Calcium channel blocker (cardiovert if <48 hrs, TEE shows no clot or six weeks of warfarin), digoxin |
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Term
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Definition
| Pulmonary disease, ischemia, rheumatic heart disease, anemia/atrial myxoma, thyrotoxicosis, ethanol, sepsis |
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Term
| Multifocal atrial tachycardia etiology |
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Definition
| Multiple atrial pacemakers or reentrant pathways, COPD, hypoxemia |
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Term
| Multifocal atrial tachycardia treatment |
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Definition
| Treat underlying disorders, verapamil/B-blockers for rate control and pacemaker suppression |
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Term
| Atrioventricular nodal reentry tachycardia findings and treatment |
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Definition
| Rate of 150-250, with P wave often buried in QRS; carotid massage, valsalva or adenosone. Cardioversion for hemodynamically unstable |
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Term
| Paroxysmal atrial tachycardia etiology |
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Definition
| Non-nodal ectopic pacemaker, leading to palpitations, sob, angina, syncope |
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Term
| Paroxysmal atrial tachycardia ECG findings |
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Definition
| Rate > 100, p wave with an unusual axis before QRS complex |
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Term
| Paroxysmal atrial tachycardia diagnosis |
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Definition
| Adenosine can be used to turn off ventricular response and observe underlying atrial activity |
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Term
| Presentation of PE on ECG |
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Definition
| Sinus tachycardia, S1Q3T3 |
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Term
| How do ventricular hypertrophies present on ECG? |
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Definition
| LVH = amplitude of R wave in aVL + amplitude of S wave in V3 >24. RVG is diagnosed by right-axis deviation and R wave in V1 >7mm |
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Term
| What are the diagnostic criteria for dilated cardiomyopathy |
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Definition
| Left ventricular dilatation and systolic dysfunction (low EF), diagnosed by echo. ECG may show ST-T changes, low voltage QRS, sinus tach. LBBB common. CXR enlarged |
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Term
| How will dilated cardiomyopathy present on history and PE? |
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Definition
| Gradual development of CHF symptoms. Cardiomegaly and S3, mitral/tricuspid regurgitation |
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Term
| What are common causes of dilated cardiomyopathy |
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Definition
| Alcohol, beriberi, coxsackie (B), Chagas, cocaine, doxorubicin |
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Term
| What is the treatment of dilated cardiomyopathy |
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Definition
| Stop all alcohol use, treat symptoms of CHF (diuretics, ACEIs, B-blockers). Consider anti-coagulatio and implantable cardiac defibrillator (last one if EF <35%) |
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Term
| What is most common cause of hypertrophic cardiomyopathy? Other causes? |
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Definition
| Idiopathic hypertrophic subaortic stenosis (congenital) occurs in 50% of patients; hypertension and AS other known causes |
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Term
| How will hypertrophic cardiomyopathy present on history and PE? |
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Definition
| Syncope after exertion, dyspnea, palpitations, chest pain. Arrhythmia and increase left atrial pressure = bad prognosis. Mitral regurg, sustained apical impulse, S4 and systolic ejection murmur on exam. Obstruction worsened with Valsalva, vasodilators, dehydration (increases contractility but decreases filling) |
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Term
| What is the treatment of hypertrophic cardiomyopathy |
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Definition
| B-blockers initially, followed by calcium channel blockers. Surgery for IHSS (dual-chamber pacing, partial excision). Avoid intense athletic activity |
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Term
| What are the common causes of restrictive cardiomyopathy |
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Definition
| Infiltrative disease (sarcoidosis, hemochromatosis, amyloidosis) or scarring/fibrosis (radiation/doxorubicin) |
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Term
| How does restrictive cardiomyopathy present on history and PE? |
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Definition
| Decreased elasticitiy impairs systolic filling without significant systolic dysfunction. Left and right heart failure occur, leading to JVD and peripheral edema |
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Term
| How does one diagnose and treat restrictive cardiomyopathy |
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Definition
| Diagnosis by biopsy, treat by correcting underlying cause and improve CHF symptoms (sodium restriction, diuretics) |
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Term
| What defines hypertensive urgency? |
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Definition
| BP > 180/130 that is asymptomatic/moderately symtpomatic (headache, chest pain, syncope) |
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Term
| What defines hypertensive emergency? |
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Definition
| Any BP, but signs or symptoms of end-organ damage (renal failure or hematuria, altered mental status or evidence of neurologic disease, intracranial hemorrhage, ophthalmologic findings, papilledema, vascular changes, unstable angina/MI, pulmonary edema) |
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Term
| How is malignant hypertension defined? |
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Definition
| Progressive renal failure and/or encephalopathy with papilledema |
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Term
| What is the most appropriate antihypertensive for diabetes? CHF? Systolic htn? MI? Osteoporosis? BPH? |
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Definition
| ACEIs; ß-blockers, ACEIs, diuertics; diuretics, ß-blockers without intrinsic sympathomimetic activity, ACEIs; thiazide; alpha-antagonists |
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Term
| What are the major side effects of thiazides |
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Definition
| hyper GLUC - hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia |
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Term
| What are the common causes of secondary htn? |
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Definition
| Cushing's syndrome, hyperaldosteronism, aortic coarction, pheochromocytoma, stenosis of renal arteries |
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Term
| What are the physical signs of pericarditis? |
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Definition
| Friction rub, elevated JVP, and pulsus paradoxus (bp falls >10 mmHg on inspiration); often positional |
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Term
| What are the diagnostic signs of pericarditis? |
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Definition
| ECG = PR-segment depression in precordial leads, low voltage and diffuse ST-segment elevation. Pericardial thickening on echo. |
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