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EKG ID
CardiacMurmurs
PhysicalSigns
Anti-arrhythmics
100
200
300
400
500
EKG ID Physicalsigns
Anti-arrhythmics
Cardiacmurmurs
100
200
300
400
500
100
200
100
200
300300
400400
500500
What is a normal ECG?
What is anterior wall MI?
What is ventricular tachycardia?
What is Wolf-Parkinson-White
Syndrome (WPW) ?
What is atrial flutter?
With a slow carotid upstroke,
this murmur is best heard in the 2nd L ICS and occurs in mid-systole, though a late-peaking
one may indicate worse disease
What is aortic stenosis?
Best heard at the apex and with
the patients in left lateral decubitus, it is holo-diastolic
and low-pitched—rare now with reduction in RHD cases
What is mitral stenosis?
A blowing, decrescendo, diastolic murmur, it is associated
with many conditions such as Marfan syndrome and ankylosing spondylitis
What is aortic regurgitation?
Named after a 19th century American MD, this diastolic murmur is best heard in the
apex; it suggests severe AR and is thought to be related to early
closure of the mitral valve
What is Austin Flint murmur?
In AS, the murmur may radiate to the apical area mimicking
MR presumed to be due to high frequency vibrations from a
calcific aortic valve to the apex
What is Gallavardin phenomenon?
This finding is defined by a greater than 10 mm Hg
inspiratory decline in systolic arterial pressure
What is pulsus paradoxus?
Inspiratory rise in jugular venous pressure commonly seen in cardiac tamponade
What is Kussmaul’s sign?
Performed by attempting to forcibly exhale while keeping
the mouth and nose closed, this maneuver can terminate supraventricular tachycardias
What is Valsalva maneuver?
Increase in the intensity of tricuspid regurgitation murmur
during inspiration
What is Carvallo’s sign?
Systolic and diastolic two-phase murmur that can be
heard over the femoral artery in severe aortic regurgitation
What is Duroziez’s sign or murmur?
Class Ia antiarrhythmic agent known to cause “cinchonism”
What is Quinidine?
Class II antiarrhythmic agents known to improve survival in
CAD and HF patients
What are beta blockers?
Class III antiarrhythmic agent with a half life of 45days
What is amiodarone?
A very effective pure class III antiarrhytmic agent for the
conversion of atrial flutter; it may however prolong the QT interval and promote torsades
What is Dofetilide(or Ibutilide)?
Class Ia antiarrhythmic agent often used to treat atrial fibrillation in the
setting of WPW
What is procainamide(Pronestyl)?
ACS 911
Images in Cardiology
BloodMarkers
Heart Failure
200
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1000
ACS 911Blood
markersHeartFailure
Images inCardiology
200
400
600
800
1000
200
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600600
800800
10001000
According to the TIMI score, the minimum patient
age that merits 1 point indicating high risk
What is 65 years?
Killip class consistent with (+) rales, S3, JVD but no acute pulmonary edema
What is Killip class II?
Among patients who receive DES, the minimum duration (in months) of aspirin therapy 162-325 mg/d before switching to
75-162 mg/d indefinitely
What is 3 months?
While recommended PCI DTB time is <90 minutes, this is the maximum Door-to-Needle time
(in minutes) to treat STEMI patients with fibrinolytics in
non-PCI hospitals
What is 30 minutes?
Regardless of reperfusion therapy, STEMI patients should
take clopidogrel 75 mg/d in addition to aspirin for at least
this this number of days
What is 14 days?
What is infective endocarditis
(Janeway lesions)?
What is aortic dissection(widened mediastinum)?
What is infective endocarditis (splinter
hemorrhage)?
What is a prosthetic (metallic) mitral valve?
What is hypothermia (Osborne waves)?
These biomarkers are highly sensitive and specific for acute
myocardial injury and offer equivalent, robust prognostic
information; make sure to note kidney function
What are troponins I and T?
This biologically active hormone from the ventricles is
secreted in response to LV wall stress; its clinical use is accepted in HF and emerging
in ACS
What is BNP?
Synthesized by the liver, this readily available acute phase reactant is an independent but
non-specific marker of inflammation, and mediator of
endothelial function
What is CRP?
This molecule is present in IDL, VLDL, LDL and chylomicrons;
thus, it represents the total burden of lipoprotein particles
that are most atherogenic
What is ApoB-100?
Made by the hypothalamus and stored in the post. pituitary,
excess of this hormone leads to worse HF and blockade of its receptor (i.e. tolvaptan) results
in relief of acute symptoms
What is arginine vasopressin?
In the DIG trial, although this drug did not reduce mortality of
patients with systolic HF, it reduced the rate of readmissions
What is Digoxin?
As shown by the RALES trial, this drug improved mortality in patients with stage II-IV HF and
low EF (<30%)
What is spironolactone (Aldactone)?
In the A-HEFT trial, African American HF patients responded better to this combination therapy
What are hydralazine and isosorbide dinitrate
(BiDil)?
In the COMET trial, this closely related drug proved to be
superior to metoprolol in the treatment of HF patients
What is carvedilol (Coreg)?
In the CHARM trial, the addition of this class of drugs to ACE-I
therapy proved to be superior to ACE therapy alone in systolic
HF patients
What are ARBs? (Angiotensin receptor
blockers)
Late breaking Trials
This recently published trial (NEJM) showed that patients with normal LDL levels and high CRP were at higher risk for death and would benefit from statin therapy as primary prevention for CVD
What is the JUPITER trial?(The Justification for the Use of statins in Primary Prevention: an
Intervention Trial Evaluating Rosuvastatin)
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