cardiac.txt

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Author:
nsmallwood
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125603
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cardiac.txt
Updated:
2012-01-01 23:17:21
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cardiac
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  1. 1st sign of CHF in newborns
    hepatomegaly
  2. sxs of CHF
    • hepatomegaly
    • FTT
    • tachycardia
    • tachypnea
    • recurrent pulmonary infxns
  3. initial treatment for CHF
    lasix and digoxin
  4. what are causes of R to L shunts
    • tetrology of Fallot
    • transposition
    • truncus arteriosus
    • tricuspid atresia
  5. ways to make sure pt has pulmonary blood flow in R to L shunts
    • PGE-1
    • Balloon atrial septostomy
  6. when do large VSDs usually cause sxs
    after 4-6 wks of life
  7. MC reason for early repair of VSD
    FTT
  8. contraindication for asd/vsd repair
    PVR > 8 woods units not reversible with vasodilators
  9. timing of repair for VSDs
    • shunt > 2.5- 1 year
    • shunt 2-2.5- 5 yrs
  10. timing of ASD repairs
    1-2yrs
  11. morphological abnormality of tetrology
    ant displacement of infundibular septum
  12. medical tx of tetrology
    b blocker
  13. timing of repair in tetrology
    3-6mo
  14. timing of repair in transposition
    • no vsd then 1-2 weeks
    • vsd 1-2 mo
  15. tricuspid atresia need what procedure
    Fontan
  16. manifestation of vascular rings
    recurrent pulmonary/trachea infxns and dysphagia
  17. MCC of death in US
    CAD
  18. 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
  19. tx of vsr or papillary mm rupture post MI
    • IABP
    • VSR-patch
    • papillary mm- replace valve
  20. MC valve lesion
    AS
  21. indications for surgery in asx AS
    valve area <0.6 cm2
  22. indications for repair in asx AR
    • ef < 50
    • LV dilatation (LVED>70mm)or
    • Aortic root dilatation >4.5
  23. usually the first procedure in MS
    balloon commissurotomy
  24. MS is at high risk for
    mural thrombi and subsequent cerebral embolization
  25. MCC of MR
    myxomatous degeneration
  26. indications for repairing asx MR
    • EF,60 or
    • LV dilatation
    • Pulm HTN
    • A fib
  27. criteria for endocarditis
    • major- + blood cxs, + ECHO
    • Minor
    • - new or changing murmur
    • - vascular sxs
    • -progressive CHF
    • -Fever
    • -predisposing RFs
    • -immune signs
  28. MC site for endocarditis
    Aortic valve
  29. MC IVDA organism
    pseudomonas
  30. abx for endocarditis
    • vanc
    • gent
    • + rifampin if prosthetic valve
  31. tx for periprocedureral endocarditis proph
    1st gen ceph starting 1 day prior to procedure
  32. initial treatment of acute heart failure
    • Lasix
    • morphine
    • nitrate
    • oxygen
    • position in sitting position
  33. ideal clinical parameters in acute heart failure
    • MAP > 60
    • CI 2.2
    • SVR < 800
    • wedge 15-20
  34. when are AICDs considered in CHF
    EF < 30-35%
  35. MC for nontraumatic intimal tear
    ascending
  36. what is the anatomic cutoff of type A and B
    innominate cutoff
  37. spinal cord ischemia seen in repair of aneurysms secondary to
    ligation of intercostal arteries and/or artery of adamkiewicz
  38. MCC of ascending thoracic aortic aneurysms
    cystic medial necrosis
  39. indication for repair of ascending TAA
    • sxs
    • increases in size > 0.5cm/yr
    • >5.5cm
  40. MCC of descending aortic aneurysms
    atherosclerosis
  41. indications for repair of descending TAA
    • sxs
    • increase in size > 0.5 cm/yr
    • >6.5 cm
  42. RFs for rupture of aneurysms
    • women
    • smoking
    • HTN
  43. Key maneuver in MAZE procedure
    pulmonary vein isolation
  44. branches of internal mammary
    musculophrenic and sup epigastric
  45. first sign of cardiac tamponade on echo
    right atrial diastolic compression
  46. MC primary malignant tumor of heart
    angiosarcoma
  47. MC pediatric cardiac tumor
    rhabdomyoma
  48. what should you avoid in HOCM
    inotropes
  49. indications for reexploration with mediastinal bleeding
    • >500cc over 1st hour
    • >250cc/h over 4 hrs

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