CARDIO Flashcards
MURMURS
AS
AR
MR
MS
TR
As - ES radiates to carotids, best heard at right parasternal area
AR - early diastolic, loudest on leaning forward . Soft S1
MR - pansystolic best heard at apex, radiates to Scilla
VSD - best heard left parasternal edge, accompanied by a thrill
MS - rumbling middiastolic, loudest over apex
TR - pansystolic - left 4th intercostal
Monitoring for AAA
Who’s more likely to die?
Is the prevalence increasing or decreasing?
> 4.5 cm - every 3 months
5.5cm - urgent referral to clinic for ?surgery
MEN
Decreasing
Contraindications to thrombolysis?
ABSOLUTE - bleeding, stroke <6 months, brain neoplasm, recent major trauma/surgery, previous ICH, dissection, GIB <1 month, non compressible punctures <1 month eg liver biopsy
RELATIVE - pregnancy, TIA <6 months, hepatic disease, anticoags, refractory hypertension, peptic ulcer, IE
Side effects amidst one
SKIN - grey skin
EYES - photophobia, blurring
THYROID - HYPER OR HYPO
HEART - arrhythmias, HYPOtension
BRAIN - PN, movement or sleep disorders
GASTRO
LUNGS - fibrosis, cough
Dukes criteria
For diagnosis IE
major: BCs, endocardium involved
Minor: fever, predisposition, vascular phenomena (JWL), immune (ON),
2 major or 1 major/3minor or all 5 minor
Management of HF
BB and CCB
Spirinolactone or eplerenone
Causes of LBBB
Cardiomyopathy
hypertension
Idiopathic fibrosis
MI
IHD
CHIMI
SOB, palpitations, dizziness,
Loud s1, pansystolic murmur at apex
Atrial myxoma
L>R
Benign cardiac tumour
Compression on mitral valve - obstructs
May have fever/weight loss
More common in females
Contraindications to exercise tolerance test
Heart failure
MI 7 days ago
Unstable angina
Electrolyte disturbance
AS
Pulmonary oedema
HUM - APE
What is treatment of MI for low risk and high risk bleeders that are not suitable for PCI
Low risk - ASA and ticagrelor
High risk - ASA and clopidogrel
Prasugrel is given as part of DAPT for those having PCI
DAPT for patients to have PCI if they have a history of stroke/TIA
Clopidogrel and ASA
Prasugrel contraindicated in stroke/TIA
Digoxin toxicity
BAD
VAN
Bradycardia/tachycardia
Anorexia
Diarrhoea
Visual disturbance
Abdo cramps
Nausea/vomiting
What test do we NOT use to diagnose stable angina
ETT
because a negative test doesnt exclude it
I hate the best imaging for dissection
TOE
Imaging if CTCA inconclusive for CAD
Stress echo
MR
