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37 Cards in this Set
- Front
- Back
subjects included in the RALES study
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NYHA class III-IV heart failure and ejection fraction 35% or below, serum potassium level 5.0 meq/L (5.0 mmol/L) or below, and creatinine level 2.5 mg/dL (221 µmol/L) or below
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trial showed reduced risk of death and of hospitalization in patients with mild systolic heart failure (NYHA class II) who were randomized to the aldosterone blocker eplerenone versus placebo
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Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure (EMPHASIS-HF)
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when to pick stress echo over exercise EKG?
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if with EKG abnormalities
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eponym for JVD with inspiration
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Kussmaul sign
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AF post MI, drug of choice
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amiodarone
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when does CABG have a survival benefit over medical therapy?
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left main disease, three-vessel disease with left ventricular systolic dysfunction, or multivessel disease with involvement of the proximal left anterior descending coronary artery
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which types of murmurs need echo?
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loud systolic murmur (≥3/6 in intensity) or any diastolic or continuous murmur
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when is transcatheter aoritic valve implantation indicated?
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if operative mortality is >50%
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name the infiltrative cardiomyopathies
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sarcoidosis, amyloidosis, hemochromatosis
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Transfer for primary PCI is a reasonable alternative to thrombolytic therapy in the setting of absolute contraindications to thrombolytic therapy or high-risk clinical features and if an acceptable time to transfer the patient to a PCI-capable hospital can be achieved
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(door to balloon time of 90 minutes or less)
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the recombinant form of the 32 amino acid human B-type natriuretic peptide, which is normally produced by the ventricular myocardium
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nesiritide (Natrecor)
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hip surgery patient with mech valve on warfarin, stopped 3 days before and no bridging given - what is the reasoning behind this recommendation?
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although annual risk of thromboembolic event is high, short term risk is low
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implication of murmur that increases with inspiration
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right sided murmur (Caravallo's sign)
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cardiac risk score for younger women
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Reynolds risk score
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first-line treatment for a hemodynamically stable VT
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IV antiarrhythmic s.a. amiodarone
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what is Ebstein anomaly
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a congenital heart defect in which the septal leaflet of the tricuspid valve is displaced towards the apex of the right ventricle of the heart.
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Nine risk factors strongly associated with acute MI in the INTERHEART study
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descending order: dyslipidemia, smoking, psychosocial stressors, diabetes mellitus, hypertension, obesity, alcohol consumption, physical inactivity, and diet low in fruits and vegetables
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six potentially lethal conditions (the “serious six”) of chest pain
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acute coronary syndrome, pericarditis with tamponade, pulmonary embolism, pneumothorax, aortic dissection, and esophageal rupture
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When is biventricular pacemaker for CRT indicated?
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left ventricular ejection fraction of 35% or below, New York Heart Association (NYHA) functional class III or IV heart failure, a QRS interval of 120 msec or greater, and on optimal heart failure medications
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AHA guidelines, for NSTEMI or UA treated medically, how long should clopidogrel be given?
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at least 1 month and ideally for up to 1 year.
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When is ranolazine contraindicated?
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prolonged QT
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complications of PCI
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hematoma formation at the arterial puncture site, pseudoaneurysm, arteriovenous fistula, cholesterol emboli syndrome, and retroperitoneal bleeding
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what to look for in PMH of patient with constrictive pericarditis?
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chest irradiation, connective tissue disease, kidney failure, malignancy, or tuberculosis
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strong evidence for constrictive pericarditis, vs restrictive
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ventricular interdependence and restrictive filling
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Indications for surgical intervention for mitral regurgitation include
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(1) left ventricular ejection fraction below 60%; (2) left ventricular end-systolic diameter greater than 40 mm; (3) severe pulmonary hypertension at rest (pulmonary artery systolic pressure >50 mm Hg) or during exercise (>60 mm Hg); or (4) new onset of atrial fibrillation.
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how is type B aortic dissection treated?
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Medical therapy of acute uncomplicated type B aortic dissection is preferred and is associated with a 30-day survival rate of greater than 90% (lower HR and BP)
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indications for AVR
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left ventricular ejection fraction is abnormal (<50%), response to exercise is abnormal (hypotensive or development of symptoms), rapid progression of stenosis or very severe stenosis (mean gradient >60 mm Hg) has occurred, or if other cardiac surgery is indicated and planned
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when is aortic valvuloplasty indicated?
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calcific aortic stenosis in patients with hemodynamic instability or decompensation, as a bridge to eventual aortic valve replacement
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contraindications to cilostazol
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heart failure or a left ventricular ejection fraction below 40%
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why is cilostazol contraindicated in heart failure?
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similar pharmacologic action to the inotropic drugs milrinone and inamrinone, which demonstrated increased mortality in heart failure patients with long-term use
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how is hypotension in HOCM patient treated?
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phenyephrine - severity of obstruction is more severe with small ventricular volumes, low afterload, and increased contractility
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diagnostic test to evaluate patient with sarcoidosis for myocardial involvement
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cardiac MRI, not endomyocardial biopsy
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TEE is the initial imaging test in these clinical situations
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detection of left atrial thrombus, evaluation of prosthetic mitral valve dysfunction, evaluation of suspected aortic dissection, and in patients with a moderate to high pretest probability of endocarditis
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positional symptoms of cyanosis and dyspnea that generally occur when the patient is sitting and resolve in the supine position
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platypnea-orthodeoxia
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causes of platypnea-orthodeoxia
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Right-to-left shunting across an atrial septal defect or patent foramen ovale causes cyanosis and dyspnea in the upright position due to deformation of the atrial septum and redirection of shunt flow
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normal hemogloobin level for a patient with cyanotic heart disease
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18 to 20 g/dL (180-200 g/L), with a hematocrit between 60% and 65
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how to Diagnose peripheral arterial disease in a patient with an uninterpretable ankle-brachial index
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get great toe pressuure measurement
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