Cardio Flashcards
Shockable rhythms for cardioversion
Ventricular fibrillation
Ventricular tachycardia
PEA and A systole non shockable
Adenosine is used in
Supra ventricular tachycardia
Atrial fibrillation RATE control treatment:
First line: metoprolol ( or verapamil)
Second line: digoxin
Also possible option: DC cardioversion
Hyperkalaemia treatment
Dextrose/ insulin (drives potassium uptake into cells) + calcium gluconate (stabilise cardiac membrane) + resonium (potassium binder)
Atrial fibrillation rhythm control treatment
Verapamil, Sotalol,
Quinine
Flecanide
Causes of AF
Pirates Pulmonary Disease Ischaemia Rheumatic Disease Anaemia/ Atrial myxoma Thyrotoxicosis ETOH Sepsis Chronic AF - HTN, CHF
Four commonest precipitatants of CHF
Ischemia
Infection
Arrhythmia
Anaemia
Fever with new onset murmur:
Infective endocarditis unless proven otherwise
Three commonest pathogens causing IE
Staph Aureus- IVDU and acute
Strep viridans - dental work and subacute
Enterococcus - gastro related
IE empirical treatment
Benpen
Flucloxacillin
Gentamicin
Signs of congestive heart failure
Gallop rhythm
Elevated JVP
Lung crackles -
Peripheral oedema
Chest Pain Red Flag Ddx
PETMAP Pulmonary embolus Esophageal rupture Tamponade Myocardial infarct Aortic aneurysm Pneumothorax
Anacrotic pulse
Slow rising pulse suggesting Aortic stenosis
Loudest on expiration, squatting
Pulsus alterans
Alternating weak and strong pulse - suggesting severe chronic heart failure
Collapsing pulse
Collapsing water hammer pulse suggests aortic regurgitation. Other signs may include a wide pulse pressure, quincke’s nail bed pulsations, de musset’s head bobbing sign.
Regurgitation heard loudest at left sternal heart border
Jerky pulse
HOCM
3 signs of HOCM
Harsh ejection systolic murmur
Double apex beat
Jerky pulse
Bisferiens pulse
Mixed aortic stenosis and regurgitation
Bounding pulse
CO2 narcosis
Sepsis
Liver failure
Irregularly irregular
Atrial fibrillation
Thready pulse
Barely palpable pulse found in shock
Acute management of acute coronary syndrome
DRSABCD ECG TRoPoNin
MONASH- morphine, (oxygen), nitrate, aspirin/clopidogrel, statin, heparin
PCI( within 2 hours if STEMI, within 24 hours if nstemi)
CCU
Long term pharmacological management of ACS
SAABC Statin ACEi Aspirin Beta blocker Clopidogrel
What are the three mortality benefit drugs for CHF?
ACEi
Cardio selective Beta blocker
Spironolactone
What are the cardio selective beta blockers ?
Carvedilol
Metoprolol -HFPEF
Bisoprolol - HFREF
5 reversible causes of cardiac arrest
H and T
Hypothermia Hyper hypokalaemia High acid Hypovolaemia Hypoxia
Toxin Trauma PneumoThorax Thromboembolism Tamponade
Which arteries and leads are affected in inferior STEMI?
RCA, II, III, aVF
Which arteries and leads are affected in anterior STEMI?
LAD,
V2, V3, V4, V5
Which arteries and leads are affected in lateral STEMI?
LCx, I, aVL, V5,V6
