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What is the cause of rheumatic heart disease
Cardiac disease secondary to rheumatic fever, resulting from Type A streptococcal infection
what complicationsare associated with rheumatic fever
- Heart failure
- Infective endocarditis
- Sudden cardiac death
What time frame should antibiotics be given to avoid rheumatic fever
- Within the first 2-3 weeks
- Caridac damage becomes evident some 30 years later
What is a temproary imbalance of O2 to the myocardium
What are the signs and symptoms of cardiac tampanod
- Chest pain
- Altered mental status or consciousness
MI is the most common cause of q
Looking for CASH as manifestations of poor perfusion in Arrhythmias
- C=Chest Pain
- A=altered mental status
- S=shortness of breath
What is the most common cause of MI
What is an accumiltion of fluid within the pericardial sac causing compression of the heart
Usually caused by trauma, will have rapid onset of manifistations of symptoms.
Infectious process or malignancy may take longer for fluid accumilation or compression
Most common causitive agent of endocarditis
Gram negative bacteria
These patients are at high risk for Endocarditis
- Prosthetic heart valve
- Aortic valve disease
- Mitral regurgitation
- Patent ductus arterious
- Ventricular septal defect
- coartation of the aorta
- Marfans syndrome
- Intravenous drug abuse
Patients who are at intermediate risk for endocarditis
- Mitral valve prolapse
- Pure mitral Stenosis
- Tricuspid valve diease
- pulmonary valve disease
- previous endocarditis
- Calcified aortic stenosis
Patients at LOW risk for endocarditis
- atrial septal defect
- arteriosclerotic plaque
- Coronar artery disease
- syphilitic aortic disease
- cardiac pacemakers
What is the most common arrythmia associated with cardiac death
What medications are used to manage MI
- O2 -2-4 L NC
- Nitroglycerin 1 sublingual dose Q 5 min x3
- Asprin 325 mg po chewed and swallowed
- Morphine 2-5mg slow IV
What are the symptoms of aortic stenosis
- S= Syncope, especially exertional
- A= Anginal chest pain
- D= Dyspnea
clinical findings of aortic stenosis
- Murmur: creshendo-decrescendo systolic murmur at the right upper sternal border
- murmur may radiate to the neck
- S4 possible
- lateral displacement of PMI
- Weak peripheral pulses with narrowed pulse pressure
- possible signs of congestive hr\eart failure
Most common cause of Mitral Stenosis
Rheumatic heart disease
Clinical findings of endocarditis
- New or recent changes in heart murmur
- septic emboli
- Clubbing of the digits
Symptoms of Pericarditis
- Chest Pain
- Increased chest pain with twisting of the thorax
- radiates to scapula
- typically relieved by sitting up and leaning forward
- may be accompanied by fevers, chills, and myalgias if due to an infectious process
What is the JNC-7 recommendation for pre hypertension
- Lifestyle modifications and other preventive measures
- Weight reduction and treatment
The most common primary diagnosis in america
Complications of Hypertension
- Worsening of hypertension
- Myocardial ischemia or infection
- Cerebrovascular accident
What medications do you give for anaphylactic shock
- Epinephrin 0.3-0.5 mg IM or SQ q3-5 min
- IM: 0.1mg dilute in 10ml of NSS q3-5 min
- Dyphenhydramine 25-50mg IM
- Albuterol via nebulizer tx
- H2 blockers (ranitidine, cimetidine)
is defined as any abnormality in the cardiac conduction system; results
in a change in pulse rate or rhythm. Basically, anything that is not normal
Heart failure, Arrhythmias (A-fib, Ventricular arrhythmias),
Infective endocarditis, and sudden cardiac death are complications of what?
. Early treatment of what, aids in prevention of Rheumatic
- Streptococcal pharyngitis
. Rheumatic fever develops how many weeks after the initial
patient presents with chest pain, dyspnea, shortness of breath, and an altered
mental status may have what cardiac condition?
is the most important ‘section’ of an EKG in relation to an arrhythmia?
usually results from thrombus formation in a coronary artery, initiated
by ulceration of an atherosclerotic plaque?
Trauma, Infectious process or malignancy, and Complication
of cardiothoracic surgery are causes of what condition?
are the three components of Cholesterol that make up ‘Total” Cholesterol
component of Total Cholesterol is considered a “negative risk factor”
for Coronary Artery Disease (CAD)?
- High-Density Lipoprotein (HDL)
What Total Cholesterol level is considered to be “High Risk”
AV Block (Complete Heart Block)
is also known as what?
- Nicotinic acid
Nicotinic acid may be considered in the treatment of what
condition, due to its cost (or) its ability to increase HDL levels?
- Heyperlipidemia (High Cholesterol)
has what effect on LDL? Niacin has what effect on HDL?
- Lowers ¯LDL by 20%
- Raises HDL by 20-40%
What medication class is contraindicated in pregnancy and
may cause potentially fatal rhabdomyolysis and renal failure (extremely rare)?
- HMG CoA Reductase Inhibitors AKA: “Statins
with exertion, anginal chest pain, and dyspnea are all symptoms of what?
What condition is almost always due to rheumatic heart
disease and usually accompanies mitral stenosis?
Janeway lesions and Osler’s nodes are associated with what condition?
- Endocarditis, dermatologic Involvement
Tender, pea-sized, erythematous nodules usually found in the
puld spaces of the fingers and toes are known as what?
What symptom favors Pericarditis vice AMI?
Duration of pain for several days
Sharp, stabbing pain for several days that starts anteriorly
and radiates to the scapula is symptomatic of what condition?
. Aortic Dissection is a tear in which layer,
through which blood accumulates within the aortic wall.
What is the primary difference between Hypertensive Urgency
- Urgency– no end-organ damage yet
- Emergency – some finding of end-organ damage
Hypertensive encephalopathy, Hypertensive nephropathy, Visual
changes, Neurologic impairment, and Cardiovascular insufficiency are symptoms
of what condition?
- Hypertensive Emergency / Crisis
encephalopathy: headache, confusion, irritability, and/or
- altered mental status
Hypertensive nephropathy: oliguria or anuria
Visual changes: blurred vision, diplopia
Neurologic impairment: numbness, tingling, weakness
Cardiovascular insufficiency: dyspnea, orthopnea, chest pain
Sulfa-containing agents, and Vaccines are all causative agents in what type of
What is “Shock state resulting from abnormal cardiac
function” resulting in reduction in cardiac output and inadequate en-organ
A patient presents with cool, clammy skin with “wet” lung
sounds. What type of shock are they experiencing?
is the most common cause of Cardiogenic Shock?