Cardio

Question 1

When do you surgically replace aortic valve for stenosis and regurg?

Answer 1

asymptomatic + EF <55%, BNP x2 ULN, aortic valve <0.6cm2 on echo

symptomatic <1cm2

AR: asymptomatic + EF <55%

Question 2

Austin flint murmur?

Answer 2

mitral stenosis caused by aortic regurgitation

The absence of an opening snap and loud S1 distinguishes the pure aortic regurgitation of an Austin flint murmur from that of mitral stenosis

Question 3

What are the complications of long standing mitral stenosis?

Answer 3

pulmonary hypertension

atrial fibrillation

Question 4

Indications for different scars
mini thoracotomy (only for valve), is antero lateral and posterolateral not for valve replacement?

Answer 4

mini thoracotomy: heart valve repair, to remove tumours from heart, AVSD surgery

thoracotomy: lungs and pleural space (lobectomy, bullectomy, diagnostically for open lung biopsy)

Question 5

What is Ebstein’s anamoly?

Answer 5

= the tricuspid valve is downwardly displaced into the right ventricle.

associated with tricuspid regurg - pansystolic
4th ICS but can be displaced

other differentials: mitral regurgitation

other signs: peripheral oedema, hepatic congestion
v wave
RHV

early: death, stroke, heart block, AF
late: valve degeneration, regurgitation

Question 6

Types of pacing?

Answer 6

pacing AVD:
AAI: atria
VVI: ventricle
DDD: dual chamber

ICD: cardio defib for VT/VF (ventricular arrythmias)

permanent pacemaker device, +/- implantable cardioverter defibrillator

Question 7

Complications of CABG and secondary prevention?

Answer 7

Bleeding during or after the surgery.
Blood clots that can cause heart attack, stroke, or lung problems.
Infection at the incision site.
Pneumonia.
Breathing problems.
Pancreatitis.
Kidney failure.
Abnormal heart rhythms.

stop smoking, control high blood pressure, improve cholesterol levels, begin exercising regularly, reduce weight if necessary, and reduce stress.
statins
aspirin

Question 8

Causes of clubbing

Answer 8

atrial myxoma
IE
CCHD

Question 9

Causes of collapsing pulse

Answer 9

aortic regurg
anaemia
pregnancy
thyrotoxicosis

Question 10

what is Graham steele murmur?

Answer 10

EDM murmur heard in mitral stenosis due to pulmonary hypertension

Question 11

Complications of valve replacement?

Answer 11

FIBAT