Cardio Flashcards
A 22 yr old man presents for a check up and you hear a left scapula bruit
Dx?
scapula bruit = coarctation of the aorta
What is coarctation of the aorta associated with?
Bicuspid aortic valve and turners syndrome
+ increased risk of IE
Once repaired they have a risk of ao aneurysm
What also causes raised troponin other than MI?
CCF, myocarditis, endocarditis, pericarditis, HB, tachy/brady arrhythmias
Non-Cardiac causes: PE severe pulmonary HTN, renal failure, COPD
In PAD you can do a bestride test to show the limb ischaemia.
Describe this test and what is its name
In PAD you can do a bestride test to show the limb ischaemia.
= Buerger’s test
= with the patient supine, bring their legs up 45 degrees for 2 mins. Then hang their legs off the bed. If +ve the legs go blue –> red due to reactive hyperaemia from post-hypoxic vasodilatation.
What does an ABPI <0.9 mean?
That they have PAD
AMBP should be 1
How should you investigate intermittent claudiation?
Duplex USS + CT angioplasty - these should be used to assess the revascularisation options
What are the treatment options for intermittent claudication?
Supervised exercise program
Angioplasty or stenting
Bypass surgery or graft (only when angioplasty has failed)
Vaso-dilator therapy - naftidrofuyl oxalate
How do you treat critical limb ischaemia?
Revascularisation (angioplasty or bypass surgery)
Analgesics - paracetamol + weak/strong opioids
Give 3 organisms that cause infective endocarditis and RF associated with them
Staph Aureus - IVDU/invasive procedures
Strep Viridans - dental work
Enterococcus - pelvic surgery or infections
What are the management options for SVT?
Valsalva manoeuvre
Adenosine 6mg–>12mg–>12mg
Electrical cardioversion
What are the management options for atrial flutter?
- Convert back to SR - pharmaceutically or electrically
- Rate control - CCB/BB/Digoxin
- Anti-coag
What are the key features of AF on ECG?
No P waves,
Narrow QRS,
Irregularly irregular
No isoelectric baseline
What are the ECG changes of WPW?
Short PR
Delta wave
Long QRS
ST segment and T wave discordant changes (T wave the opposite direction to the QRS)
How does AS present?
Murmur = ESM SAD Syncope Angina Dyspnoea
How can you define heart failure?
A state where the heart is unable to pump enough blood to satisfy the needs of metabolising tissues
A symptomatic condition where breathlessness, fluid retention and fatigue are associated with a cardiac abnormality that reduces cardiac output
How do you treat heart failure?
ABS
ACE-I
BB
Spironolactone (aldosterone antagonist)
What are the 3 main causes of HF?
Ischaemia HD
Cardiomyopathy
HTN
Give the stepwise treatment ladder for HTN
<45 >45/BAC
1 = ACEI CCB
2= ACE-I + CCB
3 = ACE-I + CCB + Diuretic (thiazide like)
4 = ? spironolactone//more diuretic or ab/bb