Cardiology

Cardiomyopathy

Dilated Cardiomyopathy = Systolic Dysfunction = Low EF Etiology Ischemia Alcohol Postviral myocarditis Radiation Toxins → Doxorubicin Chagas disease Presentation SOB on exertion Edema Rales JVD Gallop Diagnosis Best initial → Echo Most accurate → Echo ECG → Nonspecific CXR → Nonspecific Treatment Symptom control Diuretics Digoxin ↓ Mortality ACEi/ARB Beta...

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Valvular Heart Disease

General Etiology Congenital Rheumatic fever → Mostly MS Aging → AS Hypertension → Regurgitation Ischemia → Regurgitation Presentation SOB CHF symptoms Murmur Expiration → ⬆︎ Left preload → ↑ Left murmurs Inspiration → ⬆︎ Right preload → ↑ Right murmurs Diagnosis Best initial → TTE More accurate → TEE Most accurate → Catheterization → Valve diameter, Pressure gradient...

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Acute Pulmonary Edema

Etiology Rapid fluid accumulation in lungs Presentation Acute SOB Rales JVD S3 gallop Edema Orthopnea Pink frothy sputum If sufficient time Ascites Organomegaly Diagnosis Best initial → ECG → To determine cardiac cause BNP → Normal excludes diagnosis CXR Vascular congestion Cephalization of flow Enlarged heart Pleural effusion Kerley B lines...

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CHF

Etiology Function loss Systolic dysfunction → ↓ EF Diastolic dysfunction → Normal EF Major causes Hypertension → Cardiomyopathy → Most common Valvular disease MI → Dilated cardiomyopathy Minor causes Alcohol Postviral myocarditis Radiation Adriamycin (Doxil) Chagas Hemochromatosis → Restrictive cardiomyopathy Thyroid disease Peripartum cardiomyopathy Thiamine deficiency Presentation LV failure → Lung symptoms → Dyspnea Left-sided...

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Acute Coronary Syndrome

Unstable Angina / NSTEMI / STEMI Presentation Angina pectoris Shortness of breath Cold sweat S4 gallop → Acute myocardial dysfunction Paredoxical S2 splitting → Delayed relaxation and delayed AV closure Diagnosis First infarction ECG Becomes positive → Immediately Stays positive → ST elevation progresses to Q-wave in about a week Findings ST...

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Coronary Artery Disease

hemoglobin c Risk Factors Major Diabetes → Worst Hypertension → Most common Hyperlipidemia ↑LDL is worst Tobacco → fastest correction benefit Family history of CAD M<55y F<65y Age M>45y F>55y Minor Physical inactivity Alcohol ↓Veggie intake Emotional stress ↑CT calcium score PET scan WRONG ↑Homocysteine Chlamydia ↑CRP Menstruating women never...

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