Cardio Flashcards
What operation might a central vertical chest scar indicate?
Midline sternotomy -
CABG
Aortic valve replacement
Mitral valve replacement
Gold standard investigation for stable angina?
CT Coronary angiogram
What medication provides immediate symptomatic relief in angina?
GTN spray
What medication is used for long term symptom control in angina?
Beta blockers (bisoprolol)
CCBs eg amlodipine
What medication is used for secondary prevention in angina?
Statins
Aspirin
ACE inhibitors
Beta blockers
What surgical options are available for angina?
PCI
CABG
What are the criteria for a STEMI?
New st elevation or new left bundle branch block
Anterolateral MI artery?
LCA
Anterolateral MI ecg leads?
I, aVL, V3-V6
Anterior MI artery?
LAD
Anterior MI ecg leads?
V1-V4
Lateral MI artery?
Circumflex
Lateral MI ecg leads?
I, aVL, V5-V6
Inferior MI artery?
RCA
Inferior MI ECG leads?
II, III, aVF
Protein tested for cardiac muscle damage?
Troponin
STEMI tx options?
Primary PCI
Thrombolysis
Initial NSTEMI tx?
BATMAN
Beta blockers
Aspirin
Ticagrelor
Morphine
Anticoagulant (fondaparinux)
Nitrates (GTN)
Complications of MI?
DREAAD
Death
Rupture
Oedema
Arrhythmia
Aneurysm
Dressers syndrome
initial non pharma mgt of SVT?
valsalva
carotid sinus massage
main drug in tx of SVT?
adenoside
contraindications to adenosine?
asthma/copd
heart failure
heart block
severe hypotension
side effect of adenosine?
feeling of dying/doom
treatment if pharma mgt of SVT fails?
DC cardioversion
doses of adenosine in SVT?
initially 6mg, then 12 then 18
procedural tx of SVT?
radiofrequency ablation
what medications are used for pharma cardioversion in AF?
flecanide
amiodarone
5 most common causes of AF?
hypertension
ischaemic ht disease
mitral valve pathology
sepsis
thyrotoxicosis?
which rhythms are shockable?
v fib
v tach
which rhythms are non shockable?
PEA
asystole
4 types of pacemakers?
single chamber
dual chamber
biventricular (triple chamber)
implantable cardioverter defibs
indications for pacemaker? (5)
- symptomatic brady
- mobitz type 2 av block
- 3rd degree ht block
- severe ht failure
- hypertrophic obstructive cardiomyopathy (ICD)
what is dresslers syndrome?
2-6 weeks post MI
autoimmune reaction against antigenic proteins formed as the myocardium recovers
features of dresslers syndrome?
fever
pleuritic pain
pericardial effusion
raised ESR
management of dresslers syndrome?
NSAIDs
management of massive PE when hypotensive?
thrombolysis
provoked PE anticoag time?
3 months
unprovoked PE anticoag time?
6 months
secondary prevention medications post MI?
all patients:
dual antiplatelets (aspirin + other)
ACE inhibitor
Beta blocker
Statin
management of acute pericarditis?
NSAIDs and colchicine
presentation of acute pericarditis?
pleuritic chest pain L sided
relieved by sitting forward
saddle shaped widespread ST elevation
acute HF with respiratory failure not responding to treatment?
consider CPAP
causative organism of infective endocarditis in IVDU or acute presentation?
staph aureus
causative organism of infective endocarditis linked to dental procedure/poor dental hygiene?
strep viridans (mitis/sanguinis)
causative organism of infective endocarditis in patient post valve surgery/with indwelling lines?
staph epidermidis
causative organism of infective endocarditis linked to colorectal cancer?
streptococcus bovis (subtype gallolyticus)
non infective causes of IE?
SLE (libman-sacks)
malignancy - marantic endocarditis
culture negative causes of IE?
prior abx therapy
coxiella burnetii
bartonella
brucella
HACEK (haemophilus, actinobacillus, cardiobacterium, eikenella, kingella)
what is dresslers syndrome?
autoimmune pericarditis
pain worse on inspiration
raised ESR
low grade fever
4-6wks post MI
features of rheumatic fever?
recent strep infection
erythema marginatum
sydenhams chorea
polyarthritis
carditis and valvulitis (murmur)
subcut nodules
score used in suspected obstructive sleep apnoea?
epworth scale
most common CXR findings in PE?
normal
adenosine doses for narrow complex tachycardia?
6 -> 12 -> 18
cause of AV block post inferior MI?
occlusion of right coronary artery -> ischaemia of the AV node
new BP over 180/120 + retinal haemorrhage/papilloedema management?
admit for specialist assessment
initial non pharma management of SVT?
valsalva manoeuvre
carotid sinus massage
main drug in tx of SVT?
adenosine
contraindications to adenosine?
asthma
copd
HF
heart block
severe hypotension
if adenosine fails to resolve SVT?
DC cardioversion
prodedural tx of recurrent episodes of SVT?
radiofrequency ablation
secondary prevention after MI 6 As?
Aspirin
Another antiplatelet eg clopi or ticag
Atorvastatin
ACE-i
Atenolol
Aldosterone antagonist in those with clinical HF
inheritance of hypertrophic obstructive cardiomyopathy?
autosomal dominant
hypertension: already taking ACE-i, CCB, thiazide - what next?
add spiro if potassium in good range
most common ECG change in PE?
sinus tachycardia
NSTEMI with grace score >3%?
immediate coronary angiography (+/- PCI) if unstable, within 72h if stable
echocardiographic features in takotsubo cardiomyopathy?
apical ballooning of the myocardium ‘octopus pot’
murmur in aortic regurgitation?
diastolic
-»> also get head bobbing (de mussets sign)
score to assess whether PE pt can be discharged?
PESI score
abx that should be avoided in long QT?
erythromycin
which medication increases risk of gout?
thiazide diuretics eg bendro
-> dec uric acid excretion from kidneys
ECG features of hypokalaemia?
small or absent T waves
prolonged PR interval
ST depression
long QT
what is torsades de pointes?
polymorphic ventricular tachycardia associated with long QT interval
may deteriorate into Vfib
treatment of torsades de pointes?
mag sulf
ECG changes in brugada syndrome?
convex ST segment elevation >2mm in >1 of V1-V3 followed by a negative T wave
scoring system for infective endocarditis?
modified duke criteria
ECG changes in WPW syndrome?
short PR interval
wide QRS complexes with a slurred upstroke - ‘delta wave’
left axis deviation
management of WPW syndrome?
radiofrequency ablation of the accessory pathway
valve problem associated with collapsing pulse and wide pulse pressure?
aortic regurgitation
cardiac condition associated with marfans syndrome?
aortic regurg
mARfans
= AR
hypercalcaemia ECG abnormality?
SHORT QT
