Cardiovascular Medicine Exam Prep: Cardiac Care, Heart Failure, Hypertension & Arrhythmias for Physician Assistants

Prepare for your physician assistant certification with this focused summary of the most critical concepts in cardiovascular medicine from A Comprehensive Review for the Certification and Recertification Examinations for Physician Assistants by Claire Babcock O'Connell and Thea Cogan-Drew. This guide covers cardiac care principles, common and emergency pathologies, key diagnostics, and management strategies—vital for exam and clinical success.

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Cardiac Care Principles & Shock

• Shock: Recognize hypovolemic, cardiogenic, obstructive, and distributive types. Key features: hypotension, altered mental status, tachycardia, cool extremities. Treat underlying cause, use IV fluids, and consider life support.
• Orthostasis/Postural Hypotension: Sudden blood pressure drop on standing; manage with medication review and underlying condition treatment.

Major Cardiac Pathologies

• Hypertension (HTN): Primary (essential) HTN is multifactorial; secondary HTN has identifiable causes. Hypertensive emergencies require urgent BP control.
• Heart Failure (HF): Results from fluid retention, congestion, and reduced cardiac output. Treated with ACE inhibitors, beta-blockers, diuretics, and lifestyle changes.
• Atherosclerosis & Ischemic Heart Disease: Atherosclerosis causes arterial plaque buildup and increased cardiovascular risk. Ischemic heart disease results from reduced blood flow to the myocardium; management may include lifestyle modification, medications, and surgical interventions.
• Acute Coronary Syndromes (ACS): Includes unstable angina (UA), NSTEMI, and STEMI. Diagnosis uses ECG and cardiac biomarkers. Management: aspirin, oxygen, nitroglycerin, reperfusion (for STEMI).
• Congenital & Valvular Heart Disease: Congenital defects (cyanotic or non-cyanotic) may require surgical repair. Valvular disease (aortic/mitral stenosis or insufficiency) is assessed by echocardiography and may need surgery.

Arrhythmias, Cardiomyopathies, and Pericardial Disorders

• Arrhythmias: Abnormal heart rhythms; can be treated with medications, cardioversion, or ablation.
• Cardiomyopathies: Dilated (most common; weak heart muscle), hypertrophic, and restrictive types, each with unique management strategies.
• Pericardial Disorders: Pericarditis (inflammation) and pericardial effusion (fluid accumulation) cause chest pain and require prompt evaluation.
• Infective Endocarditis (IE): Infection of the heart’s lining, diagnosed with Duke criteria, managed with IV antibiotics.
• Rheumatic Heart Disease: Follows streptococcal infection; treated with antibiotics and anti-inflammatories.

Peripheral Vascular Disorders

• Peripheral Arterial Disease (PAD): Atherosclerotic disease of extremity arteries, causes claudication and poor wound healing.
• Deep Vein Thrombosis (DVT): Thrombus in deep veins, risk for pulmonary embolism. Managed with anticoagulation therapy.

Glossary of Key Terms

• ACS: Acute Coronary Syndromes
• CABG: Coronary Artery Bypass Graft
• CHF: Congestive Heart Failure
• ECG: Electrocardiogram, crucial for cardiac event diagnosis
• MI: Myocardial Infarction (heart attack)
• PAD: Peripheral Arterial Disease
• STEMI: ST-Segment Elevation Myocardial Infarction
• UA: Unstable Angina

Conclusion: Exam Success in Cardiovascular Medicine

For exam success, master the diagnosis, management, and distinguishing features of common and emergency cardiovascular conditions. Focus on shock, heart failure, arrhythmias, ischemic heart disease, and vascular pathologies, as these are frequently tested and critical for safe clinical practice.

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