CMN 574 Exam (Cardiac)– Questions & Accurate
Solutions
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Terms in this set (81)
Musculoskeletal CP Usually more localized and pt can point to it
Made worse with movement/deep inspiration
Often reproducible
*Examen for rash associated with zoster
X-rays if hx of trauma
Tx: Rest, anti-inflammatories, ice/heat
,Pericarditis Sharp Chest Pain: Usually felt behind the breastbone
or on the left side; it often feels stabbing and can
radiate to the left shoulder or neck.
Positional Discomfort: Pain typically worsens when
lying flat or breathing deeply and improves when
sitting up and leaning forward.
Fever: Often a low-grade fever, especially if the
cause is a viral or bacterial infection.
Shortness of Breath: Particularly noticeable when
lying down (orthopnoea) or if fluid has built up
around the heart.
Heart Palpitations: A sensation of a racing, fluttering,
or pounding heartbeat.
Tx: Reduce inflammation and pain through first-line
therapy with high-dose aspirin or NSAIDs (such as
ibuprofen) combined with colchicine. Patients must
strictly restrict physical activity until symptoms
resolve and inflammatory markers, such as C-
reactive protein (CRP), normalize. If standard
treatments are ineffective or contraindicated,
second-line options include low-dose
corticosteroids like prednisone, though these are
tapered slowly to avoid flare-ups. For difficult-to-
treat recurrent cases, newer interleukin-1 (IL-1)
blockers (e.g., rilonacept) are now preferred over
long-term steroids. In rare, severe complications,
procedures such as pericardiocentesis to drain fluid
or a pericardiectomy to remove the heart sac may
be necessary.
Gastrointestinal CP (always ask about OTC pain meds)
Substernal, burning pain, nocturnal cough, flatus,
belching, dysphagia
Esophageal spasm -> squeezing or pressure
Epigastric pain radiating to back -->Pelvic Ulcer
disease, pancreatitits
Usually recurrent, worsened by meals/supine
Relieved by antacids, PPI, H2 blockers
Tx: PPIs, ABX for H. pylori, Diet, Elevate HOB
, Psychogenic CP Precordial CP
constant or intermittent heaviness unrelated to meals
or activity
Screening Questions
1. In past 6 mos, any spell/attack where suddenly felt
anxious, frightened, uneasy?
2. In past 6 mos, suddenly heart race, felt faint, or
couldn't breathe?
*Yes to either is positive screen. No makes panic
disorder unlikely
Mitral Valve Prolapse Usually asymptomatic but can have non-specific CP,
dyspnea, palpitations
Inc risk in healthy females, thin collagen disease
(Marfan's, Ehlers-Danlos Syndrome)
Pansystolic or late systole with single to multiple mid-
systolic click
Skeletal changes such as pectus excavatum or
scoliosis
Diagnosis confirmed by echo, ambulatory ECG
(palpitations)
Tx: Low dose BB, mitral valve repair
ACRONYM:
PEEP-EM
PECTUS EXCAVATUM
ECHOCARDIOGRAM
ECG (Ambulatory/Palpitations)
Pansystolic
EHLER'S DANLOS SYNDROME
Marfan's
Solutions
Save
Terms in this set (81)
Musculoskeletal CP Usually more localized and pt can point to it
Made worse with movement/deep inspiration
Often reproducible
*Examen for rash associated with zoster
X-rays if hx of trauma
Tx: Rest, anti-inflammatories, ice/heat
,Pericarditis Sharp Chest Pain: Usually felt behind the breastbone
or on the left side; it often feels stabbing and can
radiate to the left shoulder or neck.
Positional Discomfort: Pain typically worsens when
lying flat or breathing deeply and improves when
sitting up and leaning forward.
Fever: Often a low-grade fever, especially if the
cause is a viral or bacterial infection.
Shortness of Breath: Particularly noticeable when
lying down (orthopnoea) or if fluid has built up
around the heart.
Heart Palpitations: A sensation of a racing, fluttering,
or pounding heartbeat.
Tx: Reduce inflammation and pain through first-line
therapy with high-dose aspirin or NSAIDs (such as
ibuprofen) combined with colchicine. Patients must
strictly restrict physical activity until symptoms
resolve and inflammatory markers, such as C-
reactive protein (CRP), normalize. If standard
treatments are ineffective or contraindicated,
second-line options include low-dose
corticosteroids like prednisone, though these are
tapered slowly to avoid flare-ups. For difficult-to-
treat recurrent cases, newer interleukin-1 (IL-1)
blockers (e.g., rilonacept) are now preferred over
long-term steroids. In rare, severe complications,
procedures such as pericardiocentesis to drain fluid
or a pericardiectomy to remove the heart sac may
be necessary.
Gastrointestinal CP (always ask about OTC pain meds)
Substernal, burning pain, nocturnal cough, flatus,
belching, dysphagia
Esophageal spasm -> squeezing or pressure
Epigastric pain radiating to back -->Pelvic Ulcer
disease, pancreatitits
Usually recurrent, worsened by meals/supine
Relieved by antacids, PPI, H2 blockers
Tx: PPIs, ABX for H. pylori, Diet, Elevate HOB
, Psychogenic CP Precordial CP
constant or intermittent heaviness unrelated to meals
or activity
Screening Questions
1. In past 6 mos, any spell/attack where suddenly felt
anxious, frightened, uneasy?
2. In past 6 mos, suddenly heart race, felt faint, or
couldn't breathe?
*Yes to either is positive screen. No makes panic
disorder unlikely
Mitral Valve Prolapse Usually asymptomatic but can have non-specific CP,
dyspnea, palpitations
Inc risk in healthy females, thin collagen disease
(Marfan's, Ehlers-Danlos Syndrome)
Pansystolic or late systole with single to multiple mid-
systolic click
Skeletal changes such as pectus excavatum or
scoliosis
Diagnosis confirmed by echo, ambulatory ECG
(palpitations)
Tx: Low dose BB, mitral valve repair
ACRONYM:
PEEP-EM
PECTUS EXCAVATUM
ECHOCARDIOGRAM
ECG (Ambulatory/Palpitations)
Pansystolic
EHLER'S DANLOS SYNDROME
Marfan's
