Cardio Flashcards
cardiac tamponade pulse abnormality
In cardiac tamponade, there will be an abnormally large drop in BP during inspiration, known as pulsus paradoxus
Upon cardiovascular examination, it is notable that his radial pulse disappears during inspiration.
Aortic regurgitation is associated with which syndrome?
Aortic regurgitation is associated with Marfan syndrome
Electrical alternans is suggestive of
Electrical alternans is suggestive of cardiac tamponade
Aortic stenosis management
Aortic stenosis management: AVR if symptomatic, otherwise cut-off is gradient of 40 mmHg
NSTEMI (managed conservatively) antiplatelet choice
NSTEMI (managed conservatively) antiplatelet choice
aspirin, plus either:
ticagrelor, if not high bleeding risk
clopidogrel, if high bleeding risk
Use rhythm control to treat AF if
Use rhythm control to treat AF if there is coexistent heart failure, first onset AF or an obvious reversible cause
Electrical cardioversion is synchronised to which part of the ECG
Electrical cardioversion is synchronised to the R waves
Quincke’s sign (nailbed pulsation) is a clinical sign of
Quincke’s sign (nailbed pulsation) is a clinical sign of aortic regurgitation
All TIA patients should have which procedure
All TIA patients should have an urgent carotid doppler unless they are not a candidate for carotid endarterectomy
In mitral stenosis,…indicates the leaflets still have some mobility
In mitral stenosis, an opening snap indicates the leaflets still have some mobility
passmed typical cardiac tamponade presentation
Consider cardiac tamponade in elevated JVP, persistent hypotension and tachycardia despite fluid resuscitation in a patient with chest wall trauma
On the cardiology ward round, a 56-year-old man is seen three days post-myocardial infarction. He complains of worsening dizziness when mobilising. An ECG is performed, which shows a heart rate of 43 beats per minute, and features consistent with third-degree heart block.
What blood vessel was most likely to have been affected by his myocardial infarction?
Right coronary artery:
AV block can occur following an inferior MI
right coronary artery supplies AV node
angina pectoris drug management
summary: BB or CCB prvention and GTN for symptomatic relief
cause of a third heart sound
young patients- normal–> rapid ventricular filling
older patients: can indicate heart failure
causes of S4
- (S4) is heard directly before S1.
- always abnormal and rare to hear.
- It indicates a stiff or hypertrophic ventricle and is caused by turbulent flow from that atria contracting against a non-compliant ventricle.
Special manoeuvres can be used to emphasise certain murmurs:
Position the patient on their left side for mitral stenosis
Position the patient sat up, leaning forward and holding exhalation for aortic regurgitation
mnemonic for describing features of a murmur
how do mitral and aortic stenosis affect the heart muscle?
When pushing against a stenotic valve, the muscle has to try harder, resulting in hypertrophy:
Mitral stenosis causes left atrial hypertrophy
Aortic stenosis causes left ventricular hypertrophy