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nsmallwood
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1st sign of CHF in newborns
hepatomegaly
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sxs of CHF
- hepatomegaly
- FTT
- tachycardia
- tachypnea
- recurrent pulmonary infxns
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initial treatment for CHF
lasix and digoxin
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what are causes of R to L shunts
- tetrology of Fallot
- transposition
- truncus arteriosus
- tricuspid atresia
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ways to make sure pt has pulmonary blood flow in R to L shunts
- PGE-1
- Balloon atrial septostomy
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when do large VSDs usually cause sxs
after 4-6 wks of life
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MC reason for early repair of VSD
FTT
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contraindication for asd/vsd repair
PVR > 8 woods units not reversible with vasodilators
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timing of repair for VSDs
- shunt > 2.5- 1 year
- shunt 2-2.5- 5 yrs
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timing of ASD repairs
1-2yrs
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morphological abnormality of tetrology
ant displacement of infundibular septum
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medical tx of tetrology
b blocker
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timing of repair in tetrology
3-6mo
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timing of repair in transposition
- no vsd then 1-2 weeks
- vsd 1-2 mo
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tricuspid atresia need what procedure
Fontan
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manifestation of vascular rings
recurrent pulmonary/trachea infxns and dysphagia
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indications for CABG
- left main or equivalent
- 3 vessel
- 2 vessel + EF < 50% or extensive ischemia
- 1 or 2 vessel with large area of viable myocardium and high risk or unstable angina/arrhythmias/ongoing ischemia depsite max med therapy
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tx of vsr or papillary mm rupture post MI
- IABP
- VSR-patch
- papillary mm- replace valve
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indications for surgery in asx AS
valve area <0.6 cm2
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indications for repair in asx AR
- ef < 50
- LV dilatation (LVED>70mm)or
- Aortic root dilatation >4.5
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usually the first procedure in MS
balloon commissurotomy
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MS is at high risk for
mural thrombi and subsequent cerebral embolization
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MCC of MR
myxomatous degeneration
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indications for repairing asx MR
- EF,60 or
- LV dilatation
- Pulm HTN
- A fib
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criteria for endocarditis
- major- + blood cxs, + ECHO
- Minor
- - new or changing murmur
- - vascular sxs
- -progressive CHF
- -Fever
- -predisposing RFs
- -immune signs
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MC site for endocarditis
Aortic valve
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MC IVDA organism
pseudomonas
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abx for endocarditis
- vanc
- gent
- + rifampin if prosthetic valve
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tx for periprocedureral endocarditis proph
1st gen ceph starting 1 day prior to procedure
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initial treatment of acute heart failure
- Lasix
- morphine
- nitrate
- oxygen
- position in sitting position
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ideal clinical parameters in acute heart failure
- MAP > 60
- CI 2.2
- SVR < 800
- wedge 15-20
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when are AICDs considered in CHF
EF < 30-35%
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MC for nontraumatic intimal tear
ascending
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what is the anatomic cutoff of type A and B
innominate cutoff
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spinal cord ischemia seen in repair of aneurysms secondary to
ligation of intercostal arteries and/or artery of adamkiewicz
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MCC of ascending thoracic aortic aneurysms
cystic medial necrosis
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indication for repair of ascending TAA
- sxs
- increases in size > 0.5cm/yr
- >5.5cm
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MCC of descending aortic aneurysms
atherosclerosis
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indications for repair of descending TAA
- sxs
- increase in size > 0.5 cm/yr
- >6.5 cm
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RFs for rupture of aneurysms
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Key maneuver in MAZE procedure
pulmonary vein isolation
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branches of internal mammary
musculophrenic and sup epigastric
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first sign of cardiac tamponade on echo
right atrial diastolic compression
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MC primary malignant tumor of heart
angiosarcoma
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MC pediatric cardiac tumor
rhabdomyoma
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what should you avoid in HOCM
inotropes
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indications for reexploration with mediastinal bleeding
- >500cc over 1st hour
- >250cc/h over 4 hrs
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