Transcript high CRP

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EKG ID
Cardiac
Murmurs
Physical
Signs
Antiarrhythmics
EKG ID
Cardiac
murmurs
Physical
signs
Antiarrhythmics
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100
100
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200
200
200
200
300
300
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300
400
400
400
400
500
500
500
500
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 midsystole, 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?
th
19
Named after a
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 twophase 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
Blood
Markers
Heart
Failure
ACS 911
Images in
Cardiology
Blood
markers
Heart
Failure
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200
200
200
400
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400
400
600
600
600
600
800
800
800
800
1000
1000
1000
1000
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 162325 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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