-
Amiodarone
- class III antiarrhythmic agent
- Used to treat hypertension, atrial fibrillation
- Caution: amiodarone-induced hypothyroidism
- AEs: lung fibrosis, liver toxicity
-
amiodarone-induced hypothyroidism
- Must measure TSH
- symptoms: difficulty concentrating, fatigue, dry skin, weight change
-
Hydralazine
side effects
- Salt retention
- reflex tachycardia
- lupus-like syndrome
-
Metoprolol
side effects
- impotence
- bradycardia
- AV node blockade
-
Verapamil
side effects
- constipation
- dizziness
- flushing
-
Enalapril
side effects
- hyperkalemia
- cough
- decreased GFR
- rash
- angioedema
-
Digoxin
side effects
- nausea/vomiting
- diarrhea
- blurry yellow vision
- arrhythmias
-
STEMI (inferior)
management
- reperfusion (thrombolysis or percutaneous angioplasty)
- antiplatelet therapy
- morphine
- heparin
- nitrates - not indicated in aortic stenosis, recent phosphodiesterase inhibitor use, or right ventricular infarction
- beta-blockers
-
RIght ventricular infarct
- presentation: clear lung fields, jugular venous distention, hypotension
- RV stroke volume decreases, cardiac output is impaired.
- Tx: IV fluid resuscitation to increase RV stroke volume, enhance LV filling
-
CHADS2 score
anticoagulation in atrial fibrillation
- C: congestive heart failure (1 point)
- H: hypertension (1 point)
- A: age >75 (1 point)
- D: diabetes mellitus (1 point)
- S2: prior stroke or TIA (2 points)
- Score: 0 - low stroke risk (no anticoagulation or aspirin)
- Score: 1 - intermediate (anticoagulation or aspirin)
- Score: 2-6 - high (anticoagulation)
-
anticoagulants
- Warfarin
- dabigatran
- rivaroxaban
- apixaban
-
S3
- inflow from the left atrium strikes blood that is already in the left ventricle
- normal in younger individuals, athletes
- sign of left ventricular failure
- Tx: iv diuretics (in symptomatic patient)
- symptoms: shortness of breath, hypertension, low saturations
-
DASH diet
- high in fruits and vegetables, low in saturated and total fats
- reduces systolic blood pressures by 8-14mmHg
- **Most effective lifestyle intervention for reducing blood pressure in non-obese patients
- Obese patients: weight loss
-
Also drops systolic blood pressure...
lifestyle
- weight loss: reduce BMI <25
- Dietary sodium: <3g/day
- Exercise: 30min/day for 5 or 6 days/week
- Alcohol intake: <2 for men, 1 for women
-
recent URI followed by sudden heart failure
dilated cardiomyopathy, most likely 2/2 acute viral myocarditis
-
dilated cardiomyopathy
etiology
diagnosis
- toxic
- metabolic
- infectious: viral or idiopathic (common following coxsackievirus B, parvovirus B19, hHV 6, adenovirus, enterovirus)
- diagnosis: echocardiogram shows dilated ventricles with diffuse hypokinesis resulting in a low ejection fraction
-
latex allergy
pre-existing atopic dermatitis increase the risk of latex allergy
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