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Flashcards in Dyspnea Deck (13)
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1
Q

**Medications for Dyspnea **

  • Anti-platelet effect (block TX)
  • CAD, hypercholesterolemia
  • Vasodilation, reverse remodeling of LVH
A
  • Aspirin - anti-platelet effect (block TX)
  • Atorvastatin - CAD, hypercholesterolemia
  • Ramipril - vasodilation, reverse remodeling of LVH
2
Q

Causes of Dyspnea

  • Pulmonary
  • Neuro/MSK
  • Hematologic
  • Toxic/Metabolic
  • Cardiac
  • Upper airway
A
  • Pulmonary
    • COPD or asthma
    • Infection
    • Pneumothorax
    • Contusion, hemorrhage
  • Neuro/MSK
    • ALS, myasthenia gravis
    • Rib fracture
    • Chest or spine deformity
  • Hematologic
    • Anemia
    • Pulmonary embolism
  • Toxic/Metabolic
    • Metabolic acidosis
    • Poisonings (CO, salicylate)
  • Cardiac
    • Heart failure
    • MI
    • Arrhythmia
    • Valvular disorder
    • Cardiac tamponade
  • **Upper airway **
    • Angioedema
    • Anaphylaxis
    • Pharyngeal infections
    • Deep neck infections
    • Foreign body
3
Q

**Causes of Heart Failure **

  • Preserved EF
  • Reduced EF
  • Pulmonary/Vascular
  • High output failure
  • Other primary cardiac causes
A
  • Preserved EF
    • HTN
    • Aging
    • Restrictive CM
    • Infiltrative
  • Reduced EF
    • CAD/MI
    • HTN
    • Toxins
    • Viral
    • Idiopathic
  • Pulmonary/Vascular
    • Cor pulmonale
    • AV malformation
  • High output failure
    • Anemia
    • Thyrotoxicosis
  • **Other primary cardiac causes **
    • Congenital lesions
    • Valvular disease
    • Arrhythmias
    • Idiopathic
4
Q

Causes of Atrial Fibrillation

A
  • Advancing age
  • **CV causes & risk factors **
    • HTN
    • CAD
    • Rheumatic heart disease
    • Non-rheumatic valvular heart disease
    • Cardiomyopathy
  • **Other causes **
    • Thyrotoxicosis
    • Obstructive sleep apnea
    • Alcohol
    • Acute stressors
5
Q

Goals of Treatment: Atrial Fibrillation

A
  • Control rate
  • Convert to sinus rhythm
  • Prevent stroke
  • Improve symptoms
  • Prevent/improve CHF
6
Q

New Medications

  • Rate control of atrial fibrillation, anti-HTN
  • Oral anticoagulant
  • Treatment of peripheral or pulmonary edema
A
  • Diltiazem - rate control of atrial fibrillation, anti-HTN
  • Warfarin - oral anticoagulant
  • Furosemide - treatment of peripheral or pulmonary edema
7
Q

3 Cardinal Features of Severe Aortic Stenosis

A
  • Congestive heart failure
  • Syncope
  • Anginal/exertional chest pain
8
Q

Preferred treatment for severe aortic stenosis

A

Valvuloplasty (surgical replacement)

9
Q

Clinical Features of PE

A
  • Dyspnea, sudden onset
  • Hemoptysis
  • Wheezes
  • Fever
10
Q

What are the 3 major scoring systems for PE?

A
  • Wells
  • Geneva
  • PERC rule
11
Q

Which of the following medications is most likely to provide immediate symptom relief of dyspnea?

  • IV Nitroprusside
  • IV Furosemide
  • IV Hydrochlorothiazide
  • IV Digitalis
  • IV Hydralazine
  • IV Captopril
A

IV Furosemide

  • Heart Failure
    • Excessive salt & water retention
    • Inappropriate volume expansion of vascular & extravascular space
  • Powerful loop diuretic
  • Excretion of 25% of filtered Na+ load through inhibition of Na+/2Cl-/K+ co-transporter (thick ascending limb of LOH)
  • Impairs generation of hypertonic interstitium
12
Q

What is the mechanism of action of diltiazem?

What is the most likely major benefit of diltiazem in a patient with atrial fibrillation?

A
  • Selective blockade of L-type cardiac Ca2+ channels
  • Decrease in HR
13
Q

Orthostatic hypotension is a common side effect of ______ and ______.

May be a sign of __________.

A

ß-blockers, vasodilators

hypovolemia