Buzz words: Cardiology Flashcards
Anacrotic pulse Breathlessness, syncope Angina on exertion Narrow pulse pressure, ejection systolic, radiating to carotids
Aortic stenosis
Pink frothy sputum Graham Steell murmur Post-MI Displaced, volume overloaded apex beat Pansystolic radiating to axilla
Mitral Regurgitation
Barlow syndrome
Mid-systolic click, late systolic murmur
Mitral Prolapse
Pulsating uvula, decrescendo diastolic IVDU Collapsing pulse: de Musset’s, Duroziez, Watson hammer pulse, Corrigan’s pulse, Quinky’s sign, Traube’s sign Displaced, volume-overloaded apex beat Early diastolic, heard in expiration and the lower sternal edge
Aortic Regurgitation
Large V waves in JVP
Pansystolic murmur at lower left sternal
edge
Tricuspid Regurgitation
Tapping apex beat
Loud first heart sound
Rumbling mid-diastolic murmur loudest at
apex
Mitral Stenosis
Muffled heart sounds
Lupus/malignancy
Pericardial Effusion
Positive valsalva manoeuvre + βB
Harsh ejection systolic murmur
HOCUM
Machine-like murmur
Bounding pulse, wide pulse pressure
Left subclavicular thrill
Patent Ductus Arteriosus
Dyspnoea, orthopnoea, PND
Fine inspiratory creps
↑BNP, (do stress echo if prev. MI)
Gold standard: transoesophageal echo
Cardiomegaly, bilateral pleural effusions,
alveolar oedema, kerley B lines and upper
lobe diversion
Heart Failure
IVDU Tricuspid murmur Petechiae, microvascular haematuria Janeway lesions, splinter haemorrhages Modified Duke Criteria
Infective Endocarditis
Irregularly irregular pulse
Absent P waves, absent A in JVP
Chaotic excitation
Old, palpitations, SOB, fatigue, syncope
Atrial Fibrillation
Narrow complex tachycardia
Look for 150bpm (ventricular) with a 2:1
block (atrial rate = 250-350bpm)
Saw-tooth appearance on ECG
Atrial Flutter
Broad complex
Previous MI
Ventricular Tachycardia
Pulseless, required cardioversion
Ventricular Fibrillation
Delta wave
Wolff-Parkinson White
Broad QRS
Uniform P waves with random QRS
Cannon A waves in JVP
Complete Heart Block
Collapse when running
Tearing pain to back
Connective tissue disorder
Dissected Aortic Aneurysm
Friction rub – walking on snow
Pericarditis
Male, post-MI
Worse lying down
Central, crushing chest pain
Radiating to jaw/left arm
MONA LISA
Myocardial Infarction
Sharp, pleuritic chest pain
Haemoptysis
OCP/long haul travel
Wells scoring system
Pulmonary Embolism
Anxiety, hypertension, weight loss
Phaeochromocytoma
Interscapular murmur
Decreased femoral pulses
Turner’s syndrome
Aortic Coarctation
HTN, polymyalgia, polyuria, polydipsia
↑Na, ↓K, normal renal function
↑ aldosterone, ↓ renin
Conn’s Syndrome
ANCA positive, histology diagnosis
Microaneurysms and MI
Polyarteritis Nodosa
ST depression and T wave inversion upon exertion Normal resting ECG Exertional chest pain, radiating to jaw Other CV risk factors e.g. smoking, fat
Stable Angina
Episodic, Gets worse, lasts longer
Unstable Angina
ST elevation, at rest, in cycles
Female, age 50
Vasospasmic, give CaCB
Prinzmetal/Variant Angina
ST depression on ECG, normal angiogram
Treat with nifedipine
Syndrome X
Occurs when lying down
Decubitus Angina
Occurs when lying down
Decubitus Angina
Severe, intermittent attacks in lower chest
Coxsackie B virus, fevers
Worse by rib cage movements, dyspnoea
Borneholme Disease
Pleuritic chest pain, low-grade fever and
pericarditis, few weeks post-MI
Dressler’s Syndrome
RHF, pulmonary hypertension
Large A waves in JVP
Cor Pulmonale
Pulmonary hypertension, HF, shunt reversal Harsh pansystolic murmur at left sternal edge Left parasternal heave Increased risk endocarditis
Ventricular Septal Defect
Wide, fixed split second heart sound
Ejection systolic murmur in 2nd/3rd IC
space
Atrial Septal Defect
Anterior (Lead and artery)
V1-V4
Left Anterior Descending
Inferior (lead and artery)
II, III & aVF
Right Coronary
Lateral
I, V5-6
Circumflex
Lateral
I, V5-6
Circumflex
Raised & fixed JVP
SVC Obstruction
Increased JVP on inspiration
cardiac tamponade/constrictive pericarditis
Large V waves (JVP)
tricuspid regurgitation
Absent A waves (JVP)
atrial fibrillation
Cannon A waves (JVP) (3)
Heart block, AV dissociation, ventricular arrhythmia
saw tooth pattern (ECG)
atrial flutter
ECG: Absent P wave
atrial fibrillation (also irregularly irregular rhythm)
ECG: bifid P wave
LA hypertrophy (eg- mitral stenosis)
ECG: Peaked P wave
RA hypertrophy (eg- pulmonary HTN, tricuspid stenosis)
ECG: Saddle Shaped ST elevation
Acute constrictive pericarditis
PE ECG
Sinus tachy
Atrial fib
RAD and RBBB
SI, QIII, TIII
ECG: SI, QIII, TIII
PE
ECG: Tall tented T waves Wide QRS (sine wave)
Hyperkalaemia
ECG: Flattened T waves
Prominent U waves
Hypokalaemia
Long QT interval
Hypocalcaemia
Long QT interval
Hypocalcaemia
SOB on exertion “Winter bronchitis” Wheeze Chronic productive cough Inv: post-bronchodilator Spirometry
COPD
Inv: post-bronchodilator Spirometry
COPD
Fever Chronic Cough Weight loss Asian Lowenstein Jensen Medium Red Ziehl-Nelson Stain “Acid fast bacilli” RIPE treatment
TB
Lowenstein Jensen Medium
TB
Red Ziehl-Nelson Stain
TB
“Acid fast bacilli”
TB
SE: orange tears
Rifampicin
SE: peripheral neuropathy
Isoniazid
SE: Red-green colour blind
Ethambutol
Steatorrhoea, diabetes Clubbing, Signet rings Recurrent Infections Bronchiectasis Sodium >60mmol
Cystic Fibrosis
Shipyard/power station worker
End-inspiratory crackles
Non-productive cough
Pleural effusion
Mesothelioma
Mouldy hay
Farmer’s lung (EAA)
Parakeets/Pigeons
Bird fanciers lung (EAA)
MI
Brady cardia
Inferior MI
Syncope, angina, dyspnoea
SAD triad of aortic stenosis
