This is With Host... Your EKG ID Cardiac Murmurs.

This

is

With

Host...

Your

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

400

600

800

1000

ACS 911Blood

markersHeartFailure

Images inCardiology

200

400

600

800

1000

200

400

200

400

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)

Thank you for playing