Cardiology master sheet
| Name | Symptoms/signs | ECG/X-ray | Diagnostic studies | treatment |
| Infectious Myocarditis (follows URI) genetic predisposition | -Heart failure -dyspnea, chest pain, arrhythmias -pericardial friction rub -pleuritic pain – gallop rhythm | -ST elevation -ventricular ectopy -cardiomegaly | – high WBC, ESR, CRP – endo-myocardial biopsy | -ACEI, BB, NSAID -AVOID DIGOXIN -Fulminant myocarditis = IABP OR LAVD |
| Non-Infectious Myocarditis (caused by drugs like chemo) | Same | Same | BNP | Same |
| Dilated Cardiomyopathy (thinning of muscle) | -gradual HF -rales, elevated JVP, cardiomegaly, S3 gallop, edema , ascites | -sinus tach, LBBB -cardiomegaly -PE – A and V arrhythmias | -BNP -cardiac MRI | -ACEI, ARB, BB, aldosterone antagonists, diuretics -digoxin second line -CPAP improve LV func. AICD/Pacemaker |
| Stress Cardiomyopathy (occurs after catecholamine discharge ie: tako tsubo) | -mostly in post meno -angina -dyspnea -arrhythmias | -ST elevation – T wave inversion | – LV abnormal movement with echo | – ASA -BB -ACEI |
| Hypertrophic Cardiomyopathy (athletes who die suddenly) genetic | -LV diastolic raised – Dyspnea – chest pain – syncope – S4 systolic murmur | -LV wall > 1.5 cm -LVH involving septum -Ventricular arrhythmias poss V-fib then death A FIB possible | -BB -CCB -diuretics -excision of septum -AICD | |
| Restrictive Cardiomyopathy (amyloidosis) | -angina, syncope, stroke amyloidosis- thick tongue, hepatomegaly | -low volt= small QRS -favors right sided failure | -endo-myocardial biopsy -BNP elevated | -treat amyloidosis with chemo -diuretics -BB -Avoid digoxin -PULMONARY HTN |
| Acute Inflammatory Pericarditis (due to infectious or systemic diseases) | -pleuritic AND supine chest pain -fever -pericardial rub -dyspnea | -ST elevation IN EVERY LEAD -CXR: could be enlarged – maybe PE -PR depression | -ESR elevation – CRP elevation -high WBC | -ASA -NSAID -Colchicine |
| Pericardial Effusion/ Tamponade | -tachy -elevated JVP -pleuritic or no pain -dyspnea/ cough -pericardial friction rub -hypotension | -CXR: globular/water bottle -small QRS | X ray- echo | -pericardiocentesis |
| Constrictive Pericarditis (causes post-surgery, connective tissue disease) | -no change of JVP (Kussmaul sign) -dyspnea, fatigue -edema, ascites | -A fib – favors right sided failure | -CXR: maybe enlarged -thick pericardium -cardiac catherization | -NSAID -Diuresis -pericardiectomy |
| Pulmonary Hypertension | -Mean pressure > or = 25 mm Hg -elevated JVP -exertional dyspnea, CP, fatigue -later: syncope, ascites, edema | -RVH, RAH | -sildenafil/Viagra -anticoagulation -lung transplant | |
| Coronary artery disease | Metabolic syndrome -abdominal obesity -positive fam history | -high sensitive CRP – TRIGLYCERIDE HIGH -HDL low -fasting glucose high | -ARB -ACEI -Smoking cessation -lowering BP -Lowering LDL -statins -antiplatelet | |
| Chronic stable angina pectoris (atherosclerotic HD) | -chest pain brought on by stress relieved with rest -short duration -BP elevation -gallop rhythm/ systolic murmur | -ST depression due to ischemia -LVH | -stress testing raising treadmill every 3 min (Bruce protocol) -PET -EBCT | -nitroglycerin -BB, CCB, platelet inhibitor rest |
| Acute Coronary syndrome without ST elevation | -angina -elderly, women, diabetic show no symptoms | -ST depression and flattening | -CK-MB -troponin I -troponin T -myoglobin | -ASA -Glycoprotein inhibitor -Anticoagulants -nitroglycerine -BB, CCB, statin |
| Acute Coronary syndrome with ST elevation (common at rest and in morning) | -syncope -stroke -angina -diaphoresis -weakness, cough, wheezing, vomiting -tachycardia -cyanosis -JVD -s4 GALLOP | -ST- elevation -peak T wave -LBBB -aortic dissection | -troponin I -troponin T -CK-MB | -primary PCI -fibrinolytic therapy -ASA -NTG -BB, nitrates, ACEI, ARB -NO CCB CAN CAUSE DEATH |
