Emergency Medicine EOR Exam 2023

Dilated Cardiomyopathy: most common cause is ____. Others? - Answer alcohol; may also be idiopathic, myocarditis, or drugs (doxorubicin) -- 1 in 3 cases of heart failure are caused by dilated cardiomyopathy What PE and EKG changes are seen with dilated cardiomyopathy? - Answer PE: S3, JVD, crackles - possible mitral regurg EKG: nonspecific ST and T wave changes, LBBB Hypertrophic cardiomyopathy: is due to hypertrophy of the _____. PE reveals mitral regurgitation, a ____heart sound, and prominent left ventricular impulse. EKG reveals LVH - Answer cardiac septum; S4 Restrictive cardiomyopathy: often caused by a ____process, or post-radiation or post open-heart surgery. What is the most common first symptom? - Answer --infiltrative process - amyloidosis, sarcoidosis, and hemochromatosis -- changes in myocardium --most common first symptom is exertion intolerance and fluid retention, signs of right heart failure Atrial fibrillation - regularly irregular - the most common sustained arrhythmia in adults - what three treatments are used? - Answer 1. rate control w BB, CCB, or digoxin 2. Anticoagulation w heparin & warfarin 3. rhythm control w amiodarone or cardioversion Atrial flutter - sawtooth pattern in II, III, aVF - what three treatments are used? - Answer 1. cardioversion if no contraindications 2. acute rate control tx w BB, CCB - amiodarone, sotalol, quinidine, or procainamide 3. If site of reentrant is known, catheter ablation Multifocal atrial tachycardia - noted in patients with COPD or severe systemic illness - EKG shows multiple shaped P waves and differing PR intervals. ____are agents of choice? - Answer CCB