1,022
edits
Changes
Jump to navigation
Jump to search
Line 12:
Line 12: − + Line 33:
Line 33: + + + + + + − + − + − + − + + + − + + + + + + + + + + + + + + + + + + + + + + + − + − + − + − +
no edit summary
**H&P: palpitations, syncope
**H&P: palpitations, syncope
**DDx: Sinus tach, Afib, Aflutter, Vtach, Vfib, Vflutter, AVNRT, AVRT, WPW
**DDx: Sinus tach, Afib, Aflutter, Vtach, Vfib, Vflutter, AVNRT, AVRT, WPW
**Tx: Stable vs. Unstable. Synchronized cardioversion vs DCCV. Vagal maneuvers, atropine, beta blockers, amiodarone, digoxin, diltiazem. Rate control superior to rhythm control most of the time. Calculate a CHAD2S2VASc for Afib patients. Consider cardioablation vs. watchman. Always get a TEE/cardioversion for chronic Afib. The most effective AC is warfarin. Best AC is usually DOAC because of once daily oral dosing. LMWH is an alternative if they can't have a DOAC. Aflutter can be 2:1, 3:1, or 4:1 with fixed rates of 150, 100, and 75 respectively.
**Tx: Stable vs. Unstable. Synchronized cardioversion vs DCCV. Vagal maneuvers, atropine, beta blockers, amiodarone, digoxin, diltiazem. Rate control superior to rhythm control most of the time. Calculate a CHAD2S2VASc for Afib patients. Consider cardioablation vs. Watchman. Always get a TEE/cardioversion for chronic Afib. The most effective [[AC]] is warfarin. Best AC is usually DOAC because of once daily oral dosing. LMWH is an alternative if they can't have a DOAC. Aflutter can be 2:1, 3:1, or 4:1 with fixed rates of 150, 100, and 75 respectively. Do NOT shock sinus tach.
=Congestive Heart Failure=
=Congestive Heart Failure=
=Dyslipidemia=
=Dyslipidemia=
* Age 45-74, LDL > 190
* Age 45-74, LDL 70-190 ASCVD > 10%
* Age 45-74, LDL 70-190 ASCVD > 7.5%
* Age 45-74, Diabetes
* ACS = HD
* > 75 = MD
=Hypertension=
=Hypertension=
* Primary Hypertension
* Primary/Essential Hypertension
* Secondary Hypertension
** Dx: Rule out secondary causes, BP > 130/90 on two separate occasions.
** RAS, Hypo/Hyper(para)thyroidism, Conn syndrome, Cushing's syndrome, Pheochromocytoma
** DDx: Secondary HTN--RAS, Hypo/Hyper(para)thyroidism, Conn syndrome, Cushing's syndrome, Pheochromocytoma
* Hypertensive Crisis
** Tx: Can start with 1 or 2 agents depending on severity. First line: ACEI/ARB (good for kidney protection), (Non)Dihydropyridine CCB, Beta Blockers (cardiac selective, non-selective), Thiazide/Non-Thiazide Type Diuretics (second line)
* Hypertensive Urgency BP > 180
* Hypertensive Emergency BP > 180 + symptoms
=Pericardial Disease=
=Pericardial Disease=
* Pericarditis
* Pericarditis
* Cardiac Tamponade
* Cardiac Tamponade (Beck's triad)
=Valvular Heart Disease=
=Valvular Heart Disease=
{| class="wikitable sortable"
|+ Cardiac Murmur Descriptions and Maneuvers
|-
! Murmur !! Description !! Provocative Maneuvers
|-
| AR || Diastolic, M || Example
|-
| AS || Systolic, A || Example
|-
| MR || Systolic, A || Example
|-
| MS || Diastolic, Blowing, M || Example
|-
| MP || Systolic, Click, A || Example
|-
| TR || Systolic || Example
|-
| PDA || Continuous, Machine-like || Example
|}
* Maneuvers increase afterload (hand grip, standing), preload (passive leg raise, lying down), or both (vagal).
* Endocarditis: Janeway lesions, Osler nodes, Splinter hemorrhages
=Vascular Diseases=
=Vascular Diseases=
* Aortic Aneurism
* Aortic Aneurism: Different types of repair (open vs endovascular), when to intervene (> 5.5 cm or rapidly enlarging), one time screening abd US in ever smokers at age 50
* Aortic Dissection
* Aortic Dissection: Stanford classification: type B (post arch and descending aorta) is medically managed; type A (ascending or arch) is surgical emergency.
* Deep Venous Thrombosis
* Deep Venous Thrombosis: Virchow's triad
* Peripheral Arterial Disease
* Peripheral Arterial Disease: ABI
* Lymphedema
* Lymphedema
=Syncope=
=Syncope=