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Bertie -3rd Year > Cardio > Flashcards

Cardio Flashcards

1
Q

What three investigations would you perform for chest pain?

A

1) ECG
2) Troponin (+ive - angio) (-ive -> ETT)
3) Echo (regional wall abnormalities

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2
Q

What are the top Ddx for chest pain?

A

Cardiac:

  • ACS
  • aortic dissection
  • pericarditis

Respiratory:

  • PE
  • pneumonia
  • pneumothorax

Gastro:

  • oesophageal spasm
  • oesophagitis
  • GORD

MSK
- costochondritis

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3
Q

What are the cardiac causes of collapse?

A

1) vasovagal
2) arrhythmia
3) outflow obstruction
- left sided = aortic stenosis, HOCM
- right sided = PE
4) postural hypotension

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4
Q

Pan-Systolic Murmur (louder on inspiration)
JVP to earlobes

What is it ?

A

Tricuspid regurgitation

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5
Q

What are the DDx of Raised JVP?

A

1) right sided heart failure
2) tricuspid regurgitation
3) constrictive pericarditis

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6
Q

An ECG reveals ST elevation in leads 1 aVL, V5 and V6. Which coronary artery is affected.

A

Lateral MI - Left circumflex

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7
Q

What parameters make up the CHA2D2-VASc score? and what score should be offered anti coagulation

A 
Congestive Heart Failure
Hypertension 
Age >75 (x2 points) 
Diabetes Mellitus 
Stroke/TIA symptoms (x 2 point) 
Vascular disease
Age 65-74 (1 point) 
Sex (1 point for female)

Anticoagulate > 2

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8
Q

What is Decubitus angina?

A

symptoms occur when lying down

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9
Q

What is Prinzmetal angina?

A

– symptoms caused by coronary vasospasm

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10
Q

What are the ECG criteria for STEMI?

A

≥ 1mm elevation in consecutive limb leads, ≥2 mm of ST segment elevation in 2 contiguous precordial leads in men (1.5 mm for women)
new or presumably new left bundle branch block

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11
Q

What conditions can you not use ECG criteria to diagnose a STEMI ?

A

LBBB or Left ventricular hypertrophy

Because these conditions may mask or simulate ischaemic ST changes

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12
Q

Outline the management of NSETMI

A

Aspirin + other antiplatelet (e.g. clopidogrel, ticagrelor)
Fondaparinux – if low bleeding risk unless coronary angiography planned within 24 hrs of admission
LMWH – if coronary angiography is planned

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13
Q

What is a GRACE score?

A

Estimates admission-6 month mortality for patients with acute coronary syndrome.

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14
Q

Why must heparin be administered with warfarin initially?

A

warfarin causes an initial pro-thrombotic phase because it blocks protein C and protein S.

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15
Q

What are the Beck’s triad features of tamponade?

A

Muffled heart sounds
Raised JVP
Low blood pressure

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16
Q

What is Dressler Syndrome?

A

Pericarditis 2-10 weeks post MI

17
Q

AF management: What re the guidelines?

A

If < 48 hrs since onset of AF
DC OR chemical cardioversion (flecainide or amiodarone)

If > 48 hrs since onset of AF anticoagulate for 3-4 weeks before attempting cardioversion

18
Q

What is a Delta wave?

A

slurred upstroke on QRS complex

19
Q

What is the management of an SVT if the patient is not haemodynamically stable?

A

Synchronised DC cardioversion

20
Q

Name 4 clinical features of HOCM

A

Jerky carotid pulse
Double apex beat
Ejection systolic murmur
Family history of sudden death at a relatively young age (< 65 yrs)

21
Q

What features might you see on ECG in salicylate overdose?

A 
Signs of hypokalaemia
-­‐
flattened/inverted T waves,
U waves,
prolonged PR interval,
ST depression
22
Q

In hypertensive retinopathy what signs indicate grade one hypertension

A

Silver wiring

23
Q

In hypertensive retinopathy what signs indicate grade two hypertension

A

AV nipping

24
Q

In hypertensive retinopathy what signs indicate grade three hypertension

A

Flame haemorrhages

25
Q

In hypertensive retinopathy what signs indicate grade 4 hypertension

A

Hard exudates, cotton wool spots, papilloedema

26
Q

What might cause a 4th heart sound?

A

Atria contracting forcefully in an effort to overcome an abnormally stiff or hypertrophic ventricle. Ie hypertension (Tennessee )

27
Q

What might cause a 3rd heart sound?

A

Volume overload in heart failure (Kentucky)

28
Q

What are the ECG features of LVH

A

Tall R waves and deep S waves on V2-V4

29
Q

What are the cardiac causes of chest pain?

A

Ischaemic Heard disease
Aortic dissection
Pericarditis

30
Q

What are the respiratory causes of chest pain

A

PE
Pneumonia
Pneumothorax

31
Q

ST elevation in V1-V4, which artery is affected

A

LAD

32
Q

ST elevation in V5, V6, I and aVL, which artery is affected

A

Circumflex artery ( Lateral MI)

33
Q

ST elevation in II, III, aVF. Which artery is affected?

A

RCA (inferior MI)

34
Q

What does RILE mean?

A

Right sided murmurs are louder on INSPIRATION

Left sided murmurs are louder on EXPIRATION

35
Q

What are the causes of Right heart failure?

A

1) Secondary to left heart failure

2) Pulmonary hypertension (due to PE, COPD)

36
Q

What are 6 important causes of AF?

A 
Ischaemic Heart Disease
Rheumatic Heart disease
Thyrotoxicosis 
Pneumonia 
PE 
Alcohol
37
Q

What is the classical triad presentation of Aortic Stenosis?

A

SOB
Syncope
Angina

38
Q

What are the causes of tricuspid regurgitation ?

A

Valve leaflet damage (IE)

RV dilatation

39
Q

What artery supplies the SA node?

A

RCA 60% of the time and left circumflex 40% of the time

Bertie -3rd Year (10 decks)

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