cardiac syncope

Question 1

Where do the coronaries branch off of

Answer 1

aortic root

Question 2

What does the acute marginal artery supply

Answer 2

RV to the apex

Question 3

What does the posterior descending artery supply

Answer 3

the dominant side of the heart

Question 4

What does the LAD feed

Answer 4

feeds anterior 2/3 of intraventricular septum

Question 5

Where is the circumflex artery located

Answer 5

around the AV groove to lateral aspect of LA, lateral wall

Question 6

Which leads are lateral

Answer 6

1
aVL
V5-V6

Question 7

Which leads are inferior

Answer 7

2
3
aVF

Question 8

Which leads are anterior / septal

Answer 8

V1-V4

Question 9

What is syncope usually caused by

Answer 9

vasovagal event

Question 10

When does syncope occur

Answer 10

interruption of cerebral flow for 10+ seconds
**usually from decreased CO

Question 11

What is the prodrome for syncope

Answer 11

sweating
light headedness
nausea
narrowing of vision

Question 12

What are the differentials for syncope

Answer 12

“PASS OUT”
Pressure
Arrhythmias
Seizures
Sugar
Output / O2
Unusual
TIA/CVA

Question 13

What is the rule of 15s

Answer 13

15% of PE, AAA, ruptured ectopic, SAH, and ACS all present with syncope

Question 14

What is the DDX for cardiac syncope

Answer 14

CHESS PIECES
CHF
HCT
ECG abnormality
SOB
SBP
Premature SCD
Ischemic heart disease
EF
Cardiomyopathy
Extertional syncope
Structural heart disease

Question 15

Which patient population is more likely to present with syncope in ACS

Answer 15

Elderly patient

Question 16

What are you at risk for with long QT

Answer 16

Torsades

Question 17

What is an example of a pre-excitation syndrome

Answer 17

WPW

Question 18

What is WPW

Answer 18

Abnormal conduction pathway along the bundle of Kent directly connecting the atria to ventricles, bypassing the AV node

Question 19

What are some symptoms of WPW

Answer 19

Palpitations
dizzy
syncope
sudden cardiac death
**commonly associated with afib

Question 20

What is the ECG triad with WPW

Answer 20

delta wave
short PR
Wibe QRS

Question 21

What is Brugada syndrome

Answer 21

depolarization issue associated with ion channels which can lead to ventricular strain

Question 22

What will be seen on ECG with brugada syndrome

Answer 22

RBBB with RSR
downsloping ST depression in V1 & V2

Question 23

How do you treat brugada syndrome

Answer 23

ICD implant

Question 24

What does HOCM look like on ECG

Answer 24

Dagger-like Q waves in lateral leads (1, aVL, V5-6)

Question 25

What is cardiac tamponade

Answer 25

Acute/chronic increase in fluid around the heart that can cause pressure on the heart = decrease CO= syncope

Question 26

What is Beck’s triad

Answer 26

Hypotension
muffled heart sounds
elevated JVP

Question 27

What are the classifications of PEs

Answer 27

Massive
Submassive w/ R. heart strain
Submassive w/o R. heart strain

Question 28

What is virchows triad

Answer 28

stasis
hyper coagulable
endothelial injury

Question 29

If a patient is at low risk for a PE, how do you work them up

Answer 29

Dimer

Question 30

If a patient is at high risk for a PE, how do you work them up

Answer 30

CTA

Question 31

What ECG finding are seen with PE

Answer 31

S wave in lead 1
Q waves in 3
Inverted T waves in 3

Question 32

What are some causes of pulmonary hypertension

Answer 32

HF
COPD
Vasculitis
Infection

Question 33

How will a patient present with severe pulmonary hypertension

Answer 33

SOB
CP
Effusion
Edema

Question 34

What is pulmonary arterial hypertension associated with

Answer 34

Occlusion/constriction of the capillary arterioles within the pulmonary vasculature

Question 35

What are the common causes of pulmonary arterial HTN

Answer 35

PE
ARDS
COPD
interstitial lung disease

Question 36

What is pulmonary venous hypertension associated with

Answer 36

left sided heart disease

Question 37

What are symptoms of as aortic dissection

Answer 37

tearing CP that radiates into back
murmur
syncope
JVD
pulsus paradoxus
pulse / neuro deficit