Cardio Flashcards
Secondary ACS prevention?
Aspirin, clopidogrel, B blocker, ACEi, statin
Adenosine SE?
Chest pain
Bronchospasm - avoid in asthmatics
Transient flushes
What rhythms are shockable?
VF and Pulseless VT
BBlocker + Verapamil =
VerapaKILL
Complete heart block
Type A and B aortic dissection?
A = ascending aorta (2/3 of cases) - surgical management B = descending aorta - conservative management
CXR aortic dissection?
Widened mediastinum
Top 2 causes of sudden cardiac death?
- Hypertrophic cardiomyopathy
2. Arrythmogenic right ventricular cardiomyopathy
What is ARVC?
Right ventricular myocardium replaced by fatty tissue.
Presents with palpitations, syncope and sudden cardiac death.
Epsilon on ECG.
ARVC management?
Solatol
Catheter ablation to prevent Vtach
Implantable cardioverter-defibrillator
Naxos disease
ARVC, palmoplantar keratosis, wooly hair
Atrial myxoma
Most common primary cardiac tumour.
75% in left atrium.
Mid-diastolic murmur = tumour plop
BBlocker SE?
Bronchospasm Fatigue Cold peripheries Sleep disturbance - nightmares Erectile dysfunction
Bivalirudin
Reversible direct thrombin inhibitor used as an anticoagulant in ACS
Brugada Syndrome?
Can cause sudden cardiac death. Inherited. Convex ST elevation in V1-V3 with a negative T wave. Partial RBBB. Manage with implantable cardioverter.
What is the first cardiac enzyme to rise?
Myoglobin
Why is CK-MB useful?
To look for re- infarction as returns to normal after 2-3 days
What type of valvular defect is most common after infective endocarditis?
Aortic regurgitation
Aortic regurgitation presentation?
Early diastolic murmur Collapsing pulse Wide pulse pressure Quincke's sign De Musset sign
How does pericarditis present?
Pleuritic chest pain, relieved by sitting forward.
Tachypnoea and tachycardia
ECG changes in pericarditis?
Saddle shaped ST elevation.
PR depression.
Pericarditis treatment?
NSAIDs and colchicine
Beck’s Triad?
- Muffled heart sounds
- Raised JVP
- Hypotension
= CARDIAC TAMPONADE
Cardiac tamponade treatment?
Pericardiocentesis
Cardiac tamponade ECG finding?
Electric alternans
How does a posterior MI present on ECG?
Tall R waves in V1-V2
Takotsubo cardiomyopathy?
Stress induced.
Eg. pt finds out family member dies, develops chest pain and features of HF.
Transient, apical ballooning of myocardium.
Supportive treatment
Sudden dyspnoea and pleuritic chest pain. Calf pain/swelling.
COCP user.
Malignancy
PE
Tearing chest pain radiating through to back
Dissecting aortic aneurysm
Boerhaaves Syndrome
Spontaneous rupture of oesophagus due to repeated vomiting. Sudden onset severe chest pain. CT contrast swallow.
CHF management?
- ACE + B blocker
- Spironolactone or epleroenone
- Ivabradine/sacubitril-valsartan/digoxin
Also offer annual flu and one of pneumococcal
Class of drug of clopidogrel?
Thienopyridines.
Antagonist of P2Y12 ADP receptor, inhibiting activation of platelets.
Coarctation of the aorta?
congenital narrowing of the descending aorta
Presentation of coarctation of the aorta?
Radio femoral delay
Mid systolic murmur over back
Apical click from aortic valve
Notching of inferior border of ribs
Kussmauls sign
Increased JVP on inspiration
V Tach management
Amiodarone
Lidocaine
What drug is avoided in VT
Verapamil
Pulsus paradoxus
Drop in BP on inspiration
What drug is the commonest cause of drug-induced angiooedma?
ACEi
Rheumatic Fever
Immunological reaction to recent (2-6 weeks ago) strep infection
Features of RF
Erythema marginatum Syndenhams chorea Polyarthritis Carditis and valvulitis Subcutaneous nodules
Statin + clarithromycin =
myopathy
What is the action of statins
HMG-CoA reductase inhibitors
Broad complex tachycardia =
V tach
Where are inhaled foreign objects most likely to be found?
Right main bronchus
Nitrates SE
Hypotension
Tachycardia
Headaches
Flushing
Warfarin + Fluconazole =
Monitor INR
Pharmacological options for orthostatic hypertension?
Fludrocortisone and midodrine
Sinus bradycardia management?
500 micrograms IV atropine
