Cardiology

• Defects in cardiac sodium or potassium channels
• Macrolides (erythromycin)
• Antimalarials (chloroquine, mephaquine)
• Haloperidol
• Risperidone
• Methadone
• Protease inhibitors
• Antiarrythmics (class IA)
• K+ channel blockers

Magnesium

• Wolff-Parkinson-White syndrome
• TX: Procainamide and Amiodarone

Borrelia burgdoferi = complete heart block

Increase in blood volume and atrial pressure = activation

• MOA:
• vascular relaxation
• constricts efferent arteriole and dilates afferent arteriole = increased diuresis.

• Hypertension
• bradycardia
• respiratory depression

INcreased ICP constricts arterioles -> cerebral ischemia -> sympathetic hypertension(restore blood flow to brain) -> reflex bradycardia -> increased pressure on brainstem -> depressed respirations

• Infantile type coarctation of the aorta.
• Preductal

PGE synthesis and low O2 tension

• Septal defects
• PDA
• pulmonary artery stenosis

• Calicification in the media of the arteries, esp radial or ulnar.
• Benign, no blood flow obstruction, and intima not involved.

• Rheumatic fever
• Antigenic similaritiy between bacterial antigens and normal "self" antigens in the heart and CNS lead to anti-self antibodies.
• myocarditis -> mitral/aortic insufficiency

GROSS: Hyperemic border; central yellow brown softening

Risk for free wall rupture, tamponade, papillary muscle rupture, interventricular septal rupture; due to macrophages degrading important structural components.

• Alcohol
• wet beriberi
• Coxsackie B viure myocarditis
• chronic cocaine use
• Chagas disease
• Doxorubicin
• Hemochromatosis
• peripartum cardiomyopathy

Osler's nodes- tender raised lesions on finger or toe pads

Janeway Lesions- small painless erythematous lesions on palm or sole

• Joints (migratory polyarthtritis)
• O pancarditis
• Nodules subcutaneous
• Erythema marginatum
• Sydenham's Chorea

Wegeners granulomatosis

TX: Cyclophosphamide and corticosteroids

• Microscopic polyangiitis:
• ~ Wegeners without the granulomas
• Affects small vessels

• Churg-Strauss syndrome:
• granulomatous vasculitis with eosinophilia
• Present with asthma, sinusitis, skin lesions, and peripheral neuropathy

Acute, self limiting necrotizing vasculitis in infants/children. Associated with asian ethnicity.

changes in lips/oral mucosa, lymphadenitis, desquamative skin rash. May develop coronary aneurysms.

Benign capillary skin papules found in AIDS patients. Caused by Bartonella henselae infections.

• Diuretics(thiazide)
• ACE inhibitors
• angiotensin II receptor blockers
• calcium channel blockers

increase cGMP -> smooth mucle relaxation -> afterload reduction

• FOR:
• severe hypertension(also pregnancy with methyldopa)
• CHF

• S/E: compensatory tachycardia
• increase renin release

Dopamine D1 receptor agonist

relaxes renal vascular smooth muscle

K+ channel opener

• Hyperpolarizes and relaxes vascular smooth muscle.
• Can cause hyperglycemia

• Nifedipine
• Amlodipine
• Felodipine
• Nicardipine
• Nisoldipine

• Pindolol
• acebutolol

• MOA:
• inhbits Na/K ATPase
• stimulates vagus nerve -> decreased conduction at AV node and depression of SA node