cardio investigations

Question 1

hypertension

Answer 1

Blood pressure monitoring

• ABPM if clinic BP >140/90 mmHg
• HBPM if ABPM declined/not tolerated

Question 2

peripheral vascular disease

Answer 2

Compare and contrast pulses in both legs

ABPI: Ankle-Brachial pulse index
- Measures ratio of systolic BP in ankle:upper arm

• Normal: 0.9 - 1.2
• Claudication: 0.4 - 0.85
• Severe claudication: 0 - 0.4
• Duplex US
• CT/MRI/catheter angiography

Question 3

stable angina

Answer 3

diagnosis mainly clinical
ECG may show pathological Q waves, LBBB or ST-segment and T wave abnormalities

CT Coronary Angiography (CTCA)
- Diagnostic

Question 4

STEMI

Answer 4

ECG
Troponin = positive

ST segment elevationin leads consistent with area of ischaemia, Q waves, T wave inversion

Left Bundle Branch Blockalso diagnoses a ‘STEMI’

Question 5

Unstable angina

Answer 5

ECG
- May include non-specfic changes, abnormal T waves or ST depression

Troponin negative

Question 6

NSTEMI

Answer 6

ECG
- ST segment depressionin a region
- Deep T Wave Inversion
- Pathological Q Waves(suggesting a deep infarct - a late sign)

Troponin = positive

Question 7

DVT

Answer 7

D-dimer
doppler USS

Question 8

aortic dissection

Answer 8

CT Angiography

• Shows true and false lumen, effect on organ perfusion

Question 9

Afib

Answer 9

ECG =
Irregularly irregular pulse
no P waves
narrow QRS

Question 10

bradycardia

Answer 10

ECG