Cardio

Question 1

Name all affected leads in interior STEMI + its blood supply

Answer 1

Right Coronary Artery: II, III, aVF

ST depression in I, aVL

Question 2

Name all affected leads in anterior STEMI + its blood supply

Which leads are considered septal?

Answer 2

Left Anterior Descending: V1-V4

V1-2 considered ‘septal’

If LAD occluded, will present with anterolateral STEMI

Question 3

Name all affected leads in lateral STEMI + its blood supply

Explain why isolated lateral STEMI is rare

Answer 3

Left Circumflex: V5-6, I, aVL

ST depression in III, aVF

LCx occlusion would result in Inferior-posterior-lateral STEMI

LAD occlusion would result in anterolateral STEMI

Isolated lateral infarction due to occlusion of smaller branch arteries such as the D1, OM or ramus intermedius

Question 4

Name 5 ECG signs of PE

Answer 4

1. Sinus tachycardia
2. RBBB (?R straining)
3. Right Axis Deviation (?R straining)
4. R straining (T wave inversion and ST depression in inferior and anterior leads)
5. S1 Q3 T3: deep S wave in lead I, Q wave in III, inverted T wave in III
6. AF

Question 5

Presentation of aortic dissection

+ 3 findings on examination

Answer 5

Sudden tearing chest pain radiating to back

1. Radial-radial delay
2. Disparity in BP of both arms (> 20)
3. Early diastolic murmur from Aortic regurg

Question 6

4 GI causes of chest pain

Answer 6

1. Reflux
2. Oesophageal spasm
3. Gastritis, oesophagitis
4. Oesophageal candidiasis in immunocompromised pat
5. Oesophageal varices
6. Mallorry-Weiss (small hole)

Question 7

2 Musculoskeletal causes of chest pain

Answer 7

1. Costochondritis

2. Tietze’s (more localised and swelling)

Question 8

What’s MONABASH in management of NSTEMI?

Answer 8

Morphine
Oxygen
Nitrates
Aspiris

Beta-blocker
ACEi
Statin
Heparin

Question 9

3 cardiac causes of syncope

Answer 9

1. Arrhythmia
   - Tachy/brady, Long QT associated w VT
2. Outflow obstruction
   - AS, PE
3. Postural hypotension
   - > 20 SBP difference