cardiovascular

miscellaneous

Acute chest pain. Aggravated by movement and/or breathing. Physical exam reveals tenderness to palpation. Likely diagnosis?

• Costochondritis
M: Treatment? (1)
• Analgesics (e.g. NSAIDs, acetaminophen) along with reassurance that it should resolve within a few weeks

chest pain

Acute chest pain. Incited by exertion/stress. Relieved with rest. Likely diagnosis?

• Stable Angina
M: First-line treatment? (+2 Others?)
• Beta-blockers. Other options include nondihydropyridine CCBs or nitrates.

Acute chest pain. Not relieved with rest or nitroglycerin. EKG reveals ST-depressions. Labs show negative cardiac enzymes. Likely diagnosis?

• Unstable Angina
M: Initial treatment? (5)
• MONA BASH: Nitrate, antiplatelets, beta-blocker, statin, and heparin
• Optional: Morphine if severe pain, oxygen if SaO2 less than 90, lasix if pulmonary edema without hypovolemia
M: Definitive treatment within 24-72 hours?
• Reperfusion (e.g. percutaneous coronary intervention)

Acute chest pain. Episodic and often occurs suddenly at night. Resolves spontaneously after several minutes. Likely diagnosis?

• Vasospastic (Prinzmetal) Angina
A: Risk factors? (3)
• Risk factors include cigarettes, cocaine, and triptans.
P: Mechanism?
• Intrinsic hypercontractility of coronary artery smooth muscles that leads to vasospasms
D: Possible finding on an EKG? (1)
• ST segment elevation
M: Treatment to abort an episode? (1)
• Nitroglycerin
M: Treatment for prophylaxis? (1)
• Calcium channel blockers (CCBs)

Acute chest pain. EKG reveals ST-depressions. Labs show elevated cardiac enzymes. Likely diagnosis?

• Non-ST Elevation Myocardial Infarction (NSTEMI)
• Subendocardial infarction
• 

Acute chest pain. EKG reveals ST-elevations. Labs show elevated cardiac enzymes. Likely diagnosis?

• ST Elevation Myocardial Infarction (STEMI
• Transmural infarction
• 

heart failure

Shortness of breath. Aggravated by laying flat. Sometimes wake up at night gasping for air. Exam reveals wheezes and bibasilar crackles. Likely diagnosis?

• Acute Decompensated Heart Failure (ADHF)
C: Common findings on physical examination?
• Physical examination can reveal bibasilar crackles and/or wheezes on auscultation, peripheral edema, jugular venous distention, S3 or S4 heart sounds
M: Treatment?
• LMNOP: Lasix (furosemide), morphine, nitroglycerin, oxygen supplementation, positioning (sitting upright)

arrhythmias

Palpitations. EKG reveals “early P waves that differ in morphology from normal sinus P waves”. Likely diagnosis?

• Premature Atrial Complexes
•