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4th Year > Cardio > Flashcards

Cardio Flashcards

1
Q

hello everyone (JY), these flashcards are going to cover..

A 
the management of:
arrhythmia 
heart failure
MI 
murmurs
angina

in the bare minimum possible detail bc honestly I can hardly read let alone learn cardio <3

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2
Q

treatment for torsades de points

A

IV magnesium sulphate

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3
Q

treatment for pulseless VT/VF

A

immediate defibrillation

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4
Q

treatment for sustained VT in a conscious but deteriorating patient

A

synchronised direct current cardio version

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5
Q

treatment for sustained VT in a stable patient

A

IV amiodarone

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6
Q

rate control treatment for AF

A

beta blocker or rate limiting CCB (verapamil)

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7
Q

rhythm control drugs for AF

A

beta blocker
flecainide
amioderone

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8
Q

when do you use rhythm control as well as rate control in AF

A

if coexistent heart failure or

first onset of AF or

reversible cause to the AF

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9
Q

how do you treat acute AF in an unstable patient

A

emergency cardio version

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10
Q

how do you treat AF in a stable patient

A

rate +/- rhythm control

electrical or drug cardio version (drugs = felcainaide/amioderone)

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11
Q

when would you use electrical cardio version in a stable patient with AF

A

if they’ve been anti coagulated for at least 3 weeks

or

if the AF has been present for <48 hours (if its been there longer theres more likely to be clots in the atria which would be released by cardio version can cause a stroke)

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12
Q

treatment for paroxysmal SVT

A

1st line - vagal stimulation

2nd line - IV adenosine

if patient unstable - direct cardio version

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13
Q

what are vagal stimulation techniques

A

valsalva manoeuvre
immersing in cold water
carotid sinus massage

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14
Q

treatment for recurrent atrial flutter

A

catheter ablation

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15
Q

treatment for bradycardia in a patient with signs of shock

A

atropine

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16
Q

how does adenosine work

A

causes transient heart block - blocks SA node to terminate SVT

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17
Q

side effects of adenosine

A

flushing
chest pain
bronchospasm

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18
Q

how does hypothermia present on ECG

A

bradycardia + J waves

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19
Q

1st line treatment for chronic heart failure

A

ACEi and beta blocker

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20
Q

2nd line treatment for chronic heart failure

A

aldosterone antagonist (spironolactone)

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21
Q

3rd line treatment for chronic heart failure

A

needs to be initiated by a cardiologist - indicated if ejection systolic fraction <35%

ivabradine
digoxin
savubitril-valsartan

others

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22
Q

what vaccines should you offer people with heart failure

A

annual flu vaccine

one off pneumococcal vaccine

23
Q

how does an MI present

A

u know the usual signs lol

central crushing chest pain
radiating to jaw/arm
feeling of impending doom
etc

24
Q

what are the ECG indications for thrombolysis or PCI in MI

A

ST elevation >2mm in two or more consecutive chest leads

ST elevation of >1mm in >2 consecutive inferior leads

25
Q

how do you manage a STEMI

A

MONAT

morphine
oxygen 
nitrates
aspirin 
tricagrelor
26
Q

timings for giving PCI/fibrinolysis

A

PCI within 120 mins

if can’t give PCI in 120 mind give fibrinolysis within 12 hours

27
Q

what are some common post-MI conditions

A 
left ventricular free wall rupture
pericarditis (Dressler syndrome)
left ventricular aneurysm 
ventricular septal defect 
acute mitral regurgitation
28
Q

how does left ventricular free wall rupture present

A

1-2 weeks after MI

patients present with acute heart failure secondary to tamponade

  • treat with pericardiocentesis)
29
Q

how can post-MI pericarditis present

A

commonly in first 48 hours

OR

2-6 weeks later as Dressler’s syndrome

30
Q

when is a 3rd heart sound normal

A

in people <30

if >30 then its abnormal - can indicate heart failure

31
Q

what causes a loud second heart sound

A

pulmonary hypertension

32
Q

how do you treat an NSTEMI

A 
beta blockers
aspirin 
ticagrelor 
morphine 
anticoagulant 
nitrites

(BATMAN) can add in oxygen if stats are dropping

33
Q

what is the first heart sound

A

closing of the tricuspid and mitral valves (after filling, getting ready for systole)

contraction happens between S1 and S2

34
Q

what is the second heart sound

A

aortic and pulmonary valves closing after ventricular contraction

35
Q

what extra heart sound is always abnormal

A

4th heart sound

comes before S1

indicates hypertrophic ventricle

36
Q

systolic murmurs

A

MRS ASS

mitral regurgitation

aortic stenosis

37
Q

diastolic murmurs - rarer

A

mitral stenosis

aortic regurgitation

38
Q

what does mitral stenosis do to the heart

A

causes left atrial hypertrophy

much harder to get block through the valve so atria becomes thickkk

39
Q

what does aortic stenosis do to the heart

A

causes left ventricular hypertrophy

40
Q

what does mitral regurgitation do to the heart

A

causes left atrial dilation

  • back flow of blood into left atria stretches it out
  • presents as a bifid P wave on ECG (p mitrale)
41
Q

what does aortic regurgitation do to the heart

A

causes left ventricular dilatation

42
Q

what causes mitral stenosis

A

rheumatic heart disease

infective endocarditis

43
Q

what does mitral stenosis sound like

A

mid-diastolic low pitched rumbling murmur

can present with malar flush

44
Q

what does mitral regurgitation sound like

A

high pitched whistling murmur

45
Q

how do tell what a murmur is going to sound like

A

stenosis - low pitched, blood moving slowly trying to get through stiff valve

regurgitation - high pitched, blood moving at high velocity backwards through the valve

46
Q

where does mitral regurgitation radiate to

A

left axilla

47
Q

where does aortic regurgitation radiate to

A

carotids

48
Q

stable vs unstable angina

A

stable - on exertion - relieved by rest or GTN

unstable - at rest

49
Q

gold standard investigation for angina

A

CT coronary angiogram

50
Q

management of angina for immediate symptomatic relief

A

GTN spray

51
Q

treatment for long term symptomatic relief for angina

A

beta blockers

CCBs

52
Q

secondary prevention of angina/CVD

A

Aspirin - 75mg OD
atorvastatin 80mg OD
ACEi
beta blocker

53
Q

surgical intervention for angina

A

PCI with coronary angioplasty

CABG is severe stenosis

4th Year (25 decks)

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