PCCN 2024 Cardiovascular review Questions and Answers

PCCN 2024 Cardiovascular review Questions and Answers S3 heart sound is an indication of _________? Other causes of S3? - Correct Answer ️️ -Ventricular gallop Auscultated in fluid overload when preload is elevated. Other causes: - cardiomyopathy - ventricular septal defect (VSD) - mitral or tricuspid regurgitation When is S3 sound normal? - Correct Answer ️️ -Normal in kids, high cardiac output, 3rd trimester of pregnancy S4 heart sound is an indication of _____? Other causes of S4? - Correct Answer ️️ - Auscultated during ischemia (increased resistance to ventricular filling) Other causes: - HTN - pulmonary stenosis - CAD - aortic stenosis - LV hypertrophy Split S1 causes? - Correct Answer ️️ -Mitral valve closes before tricuspid valve Causes: RBBB, PVCs, ventricular pacing Split S2 causes? - Correct Answer ️️ -Aortic closes before pulmonic valve Causes: overfilled right ventricle. atrial septal defect (ASD) What is the most sensitive and specific cardiac marker? When does it elevate? Peak? Return to normal? - Correct Answer ️️ -Troponin I (or T) Elevates in 3-6 hrs Peaks in 14-20 hrs Normal in 1-2 wks >0.4 mcg/L is elevated Chest pain assessment: OLD CART - Correct Answer ️️ -Onset? Location? Duration? Characteristics? Associated s/s? Relieving factors? Treatment? Stable angina: Definition? Cause? Treatment? - Correct Answer ️️ -- exertional, stops when exertion stops - may have fixed vessel stenosis with demand ischemia - treat with SL nitro Unstable angina: Difference from stable? What is it a sign/precursor of? Treatment? - Correct Answer ️️ -- increasing frequency, time, duration - sign of MI (10-20% have MI) - antiplatelet therapy Variant (Prinzmetal's) angina: Cause? When does it occur? Assessment? Treatment? - Correct Answer ️️ -- Sudden pain caused by coronary artery vasospasm - occurs at rest or when sleeping - get 12 lead EKG with and without symptoms. Will see changes with pain and symptoms - Treat with nitro and calcium channel blockers to relieve spasm Non-ST elevation ACS: Cause? s/s? Hallmark sign? 12 lead EKG results? Labs? Treatment? - Correct Answer ️️ -- PARTIAL OCCLUSION of coronary artery - pain/s/s at rest and last > 20 min - Hallmark sign: pain with increased frequency, heaviness, or pressure - 12 lead EKG: ST depression or T wave inversion (ischemia). 8 or more leads with ST depression/T wave inversion & ST elevation in aVR = proxim