7 Cardiovascular Clinical Practice Cases Free Online FlashCards

What should be assessed before interpreting a cardiac rhythm tracing?

Assess airway, breathing, circulation, mental status, blood pressure, oxygen saturation, symptoms, and perfusion before interpreting the tracing.

How does pulselessness change rhythm management?

A pulseless patient requires cardiac-arrest management, not a pulse-based rhythm algorithm.

Which findings can signal hemodynamic instability?

Hypotension, shock, acute altered mental status, ischemic chest discomfort, or acute heart failure can signal instability.

How does electrical treatment differ for unstable tachycardia with a pulse versus pulseless VF or VT?

Unstable tachyarrhythmia with a pulse generally calls for synchronized cardioversion. Defibrillation is used for pulseless VF or pulseless VT.

What is an initial approach to stable, regular, narrow-complex tachycardia?

For stable, regular, narrow-complex tachycardia, try a vagal maneuver; adenosine may be used if the rhythm persists, following the applicable protocol.

What is the priority for unstable atrial fibrillation with rapid ventricular response?

Unstable atrial fibrillation with rapid ventricular response requires emergency support and immediate synchronized cardioversion; do not delay it for routine rate-control medication.

How is persistent symptomatic bradycardia escalated if atropine is ineffective?

For persistent bradycardia with cardiopulmonary compromise, atropine is used; if ineffective, proceed to transcutaneous pacing and/or dopamine or epinephrine infusion as indicated.

What is the priority when symptoms and ECG findings suggest STEMI?

ST-segment elevation in contiguous leads with compatible symptoms suggests STEMI, a time-critical acute coronary syndrome; activate emergency ACS and reperfusion pathways immediately.

What key cautions apply before nitroglycerin for suspected MI?

Check blood pressure and contraindications, including possible right-ventricular infarction or recent phosphodiesterase-5 inhibitor use. Nitroglycerin relief does not rule out MI or replace reperfusion.

What commonly guides antiplatelet therapy after ACS?

ACS antiplatelet plans commonly include aspirin plus a P2Y12 inhibitor, but the treatment strategy and bleeding risk affect the choice and duration.

What are key initial priorities for acute heart failure with pulmonary congestion?

Sit the patient upright, assess breathing and oxygenation, and seek urgent help. Give oxygen for hypoxemia; avoid reflexively giving a fluid bolus when pulmonary congestion is present.

Which medication classes form key guideline-directed therapy for HFrEF?

Guideline-directed therapy includes an angiotensin receptor–neprilysin inhibitor (or an ACE inhibitor/ARB when appropriate), an evidence-based beta-blocker, a mineralocorticoid receptor antagonist, and an SGLT2 inhibitor.