Cram the PANCE Cardiology
Dilated Cardiomyopathy- PP: Tx:
dilation+impaired contraction of one/both Decrease mortality:
ventricles→ impaired systolic function ACE inhibitors “the -prils”:
Ventricles: baggy Lisinopril
Stretched out Captopril
Weak
Beta blockers:
E: most common type (90%) Carvedilol
Idiopathic (50%) Metoprolol
Alcohol
Cocaine Hydralazine+nitrate (isosorbide dinitrate)
Doxorubicin
Infection (coxsackie virus) Spironolactone
Vitamin B1
“Dilated starts with a D” “BASH the heart to make it beat harder”
*drinking (alcohol) Beta blockers
Dunno (idiopathic) Ace inhibitors
Deficiency (vitamin B1) Spironolactone
Doxorubicin Hydralazine+nitrate
Drugs (cocaine)
Disease (coxsackie virus) Lower sx:
Loop diuretics:
CM: Furosemide
left-sided HF: Digoxin
Dyspnea
Cough Low ejection fraction: implantable cardiac
Wheezing defibrillator (ICD)
Right sided HF:
Hepatomegaly
Jugular venous distention restrictive cardiomyopathy- PP: infiltrative
Peripheral edema disease→ stiffening of ventricles→ inability to fill
during diastole→ diastolic dysfunction
PE: S3 gallop
E: rare (1%)
DX: Amyloidosis
Echocardiogram: Hemochromatosis
Ventricular dilation Sarcoidosis
Thicken/stretched out ventricular walls “AMY HAS restrictive cardiomyopathy”
Decreased ejection fraction AMYloidosis
CXR: Hemochromatosis
Cardiomegaly Amyloidosis
Pleural effusion Sarcoidosis
EKG:
Arrhythmias CM:
Sinus tachycardias Right sided more common
Right-sided:
, Cram the PANCE Cardiology
Hepatomegaly Decreased venous return (standing/valsalva
Jugular venous distention maneuver)→ increased murmur intensity
Peripheral edema Increased venous return (squatting/leg raise)→
Kussmaul sign (increased jugular venous decreased murmur intensity
pressure breathing in Opposite of other murmurs
S4 on auscultation
Left-sided:
Dyspnea DX:
Cough Echocardiogram:
Wheezing Left ventricular wall 15+mm thickness (family
hx→13+mm thickness)
DX: EKG:
Echocardiogram: Repolarization
Normal/slightly thickened ventricles Left axis deviation
Diastolic dysfunction (decreased filling of Left ventricular Hypertrophy
ventricle)+normal ejection
Atrial dilation TX:
P:
Endomyocardial biopsy: 1st line: Beta blockers
Definitive Carvedilol
Apple-green birefringence on Metoprolol
staining→amyloidosis 2nd line: calcium channel blockers (Non-
Dihydropyridine):
TX: Diltiazem
Underlying cause Verapamil
“they Decrease Velocity of the heart by
decreasing AV node conduction”
Hypertrophic cardiomyopathy- PP: Diltiazem
autosomal dominant genetic disorder verapamil
Mutations in sarcomere genes:
Left-ventricle Hypertrophy (thickened left NP (refractory to P therapy):
ventricle) Septal myomectomy
Diastolic dysfunction Alcohol septal ablation
Outflow obstruction
Avoid:
CM: Digoxin
Dyspnea (most important) Niltrates
Angina Diuretics
Fatigue Exertion
Presyncope/syncope Dehydration
Sudden cardiac death Exacerbation of obstruction from increased
Asymptomatic contraction of heart+dehydration
PE:
Harsh systolic murmur best heard at left sternal heart failure (general)- PP:
border structure/functional disorder of heart→can’t fill
Dilated Cardiomyopathy- PP: Tx:
dilation+impaired contraction of one/both Decrease mortality:
ventricles→ impaired systolic function ACE inhibitors “the -prils”:
Ventricles: baggy Lisinopril
Stretched out Captopril
Weak
Beta blockers:
E: most common type (90%) Carvedilol
Idiopathic (50%) Metoprolol
Alcohol
Cocaine Hydralazine+nitrate (isosorbide dinitrate)
Doxorubicin
Infection (coxsackie virus) Spironolactone
Vitamin B1
“Dilated starts with a D” “BASH the heart to make it beat harder”
*drinking (alcohol) Beta blockers
Dunno (idiopathic) Ace inhibitors
Deficiency (vitamin B1) Spironolactone
Doxorubicin Hydralazine+nitrate
Drugs (cocaine)
Disease (coxsackie virus) Lower sx:
Loop diuretics:
CM: Furosemide
left-sided HF: Digoxin
Dyspnea
Cough Low ejection fraction: implantable cardiac
Wheezing defibrillator (ICD)
Right sided HF:
Hepatomegaly
Jugular venous distention restrictive cardiomyopathy- PP: infiltrative
Peripheral edema disease→ stiffening of ventricles→ inability to fill
during diastole→ diastolic dysfunction
PE: S3 gallop
E: rare (1%)
DX: Amyloidosis
Echocardiogram: Hemochromatosis
Ventricular dilation Sarcoidosis
Thicken/stretched out ventricular walls “AMY HAS restrictive cardiomyopathy”
Decreased ejection fraction AMYloidosis
CXR: Hemochromatosis
Cardiomegaly Amyloidosis
Pleural effusion Sarcoidosis
EKG:
Arrhythmias CM:
Sinus tachycardias Right sided more common
Right-sided:
, Cram the PANCE Cardiology
Hepatomegaly Decreased venous return (standing/valsalva
Jugular venous distention maneuver)→ increased murmur intensity
Peripheral edema Increased venous return (squatting/leg raise)→
Kussmaul sign (increased jugular venous decreased murmur intensity
pressure breathing in Opposite of other murmurs
S4 on auscultation
Left-sided:
Dyspnea DX:
Cough Echocardiogram:
Wheezing Left ventricular wall 15+mm thickness (family
hx→13+mm thickness)
DX: EKG:
Echocardiogram: Repolarization
Normal/slightly thickened ventricles Left axis deviation
Diastolic dysfunction (decreased filling of Left ventricular Hypertrophy
ventricle)+normal ejection
Atrial dilation TX:
P:
Endomyocardial biopsy: 1st line: Beta blockers
Definitive Carvedilol
Apple-green birefringence on Metoprolol
staining→amyloidosis 2nd line: calcium channel blockers (Non-
Dihydropyridine):
TX: Diltiazem
Underlying cause Verapamil
“they Decrease Velocity of the heart by
decreasing AV node conduction”
Hypertrophic cardiomyopathy- PP: Diltiazem
autosomal dominant genetic disorder verapamil
Mutations in sarcomere genes:
Left-ventricle Hypertrophy (thickened left NP (refractory to P therapy):
ventricle) Septal myomectomy
Diastolic dysfunction Alcohol septal ablation
Outflow obstruction
Avoid:
CM: Digoxin
Dyspnea (most important) Niltrates
Angina Diuretics
Fatigue Exertion
Presyncope/syncope Dehydration
Sudden cardiac death Exacerbation of obstruction from increased
Asymptomatic contraction of heart+dehydration
PE:
Harsh systolic murmur best heard at left sternal heart failure (general)- PP:
border structure/functional disorder of heart→can’t fill
