Cardio 7 Flashcards
Most common cause of death in MI?
Ventricular fibrillation
what Ix are essential to investigating PE?
Hx
examination - respiratory and CXR
wells score <4
> d dimer
= CTPA
wells score high
CTPA neg for PE
?
consider proximal leg vein uss scan if DVT suspected
CTPA or V/Q
when V/Q
renal impairment as contrast in CTPA bad
V/Q better for maternal outcome
V/Q worse for foetus
acute pulmonary oedema
Mx?
sit up
Iv loop diuretic
oxygen if need be
vasodilate if need be ; MI/ severe HTN
NIV: resp failure
role of beta blockers in HF?
if HR >50 fine to continue
contraindicated in following:
but if HR <50
OR
2/3rd degree Hearrt Block
OR
Shock
Pts with acute HF and shock?
Mx
use of inotropic agents: dobutamine
vasopressor
> norepinephrine
mechanical circulatory assistance
Stable chest pain
Ix?
CT angiography
2nd line is non invasive functional imaging
> MPS with SPECT
Mx of complete Heart Block?
transvenous pacing
ORBIT score
haemoglobin
age - 74
bleeding Hx
Renal impairment GFR <60
Treatment with antiplatelets
ORBIT score
haemoglobin criteria
<130
<120
haematocrit
<40%
<36%
renal impairment ORBIT
<60mL/min
high bleeding risk ORBIT?
4-7
8.1 bleeds per 100 patients
Nicorandil
S/E
associated with GI ulceration
aphthous ulcers
left ventricular strain pattern
t wave inversion in leads V5 and V6
long saphenous vein
anterior to medial malleolus
severe symptomatic mitral stenosis
mid diastolic murmur
accentuated with pt on left decubitus position
malar rash on cheeks
ECG changes from severe mitral stenosis?
left atrial hypertrophy can occur
bifid p wave ; broad notched p waves
in Lead II
= left atrium gives greater contribution to the p wave
Orthostatic hypotension
SBP <20
3 minutes
ASD
types?
ejection systolic
split S2
ostium secundum
ostium primum
most specific ECG finding in pericarditis?
PR depression
most common cause of endocarditis?
staph aureus
IE in valve surgery ? 2 months
staphylococcus epidermis
Ludwig’s angina
non cardiac condition
progressive cellulitis
invades the floor of the mouth and soft tissues of the neck
widened mediastinum on CXR?
8.0-8.8 cm at the level of the aortic knob on portable anteroposterior chest films
low bleeding risk
medical mx of STEMI
aspirin + ticagrelor
fondaparinux
PCI mx of STEMI
low bleeding risk
loading dose of 300mg aspirin
+ prasugrel
unfractionated heparin and fondaprinux
QT interval
time between start of Q wave and end of T wave
> 430ms
450ms
biventricular failure implies?
failure of both ventricles
Land R
heart failure with reduced ejection fraction
systolic dysfunction left ventricle is not able to pump blood out effectively
> outflow problem
musculature problem
dilated cardiomyopathy / IHD
Diastolic dysfunction
HOCM
preserved ejection fraction
p450 inducers which cause INR to fall?
phenytoin
rifampicin
carbamazepine
p450 inhibitor which causes INR to increase= increased bleeding risk
clarithromycin
allopurinol
amiodarone
SSRI
how to spot pacemaker on an ECG
long straight lines preceding QRS complexes
long QT syndrome
inherited delayed repolarization of ventricles
loss of function/ blockage of K+ channels
