Cardio knowledge tutor Flashcards
A man presents with pleuritic central chest pain and dyspnoea following a viral illness. His pain is worse when lying down is a stereotypical history of:
Acute pericarditis
Features
- chest pain: may be pleuritic. Is often relieved by sitting forwards
- other symptoms include non-productive cough, dyspnoea and flu-like symptoms
- pericardial rub
- tachypnoea
- tachycardia
a 40-year-old female presents with dyspnoea and fatigue. On examination a mid-diastolic murmur is heard. An echocardiogram shows a pedunculated mass in the left atrium
Atrial myxoma
- non-cancerous tumour growing on upper side of heart, commonly on atrial septum
Betablockers side effects
- bronchospasm
- cold peripheries
- fatigue
- sleep disturbances
- erectile dysfunction
With respect to infective endocarditis, which one of the following organisms is most associated with patients with no past medical history?
Staph aureus
- patients with no pmh
Strep viridians
- patients with poor dental hygiene
staph epidermis
- first 2 months following prosthetic valve surgery
Sound characteristic of mitral regurgitation
split s2
ACE Inhibitors
Inhibits the conversion angiotensin I to angiotensin II
a 50-year-old woman with a history of rheumatic fever presents with dyspnoea. On examination she is found to be in atrial fibrillation, with a loud S1, split S2 and a diastolic murmur
she most probably has?
- mitral stenosis
- main cause is rheumatic fever
a 70-year-old woman is found to have a pan-systolic murmur after presenting with dyspnoea. A soft S1 and split S2 is also noted
mitral regurgitation
Ischaemic changes in leads I, aVL +/- V5-6 would be most likely caused by a lesion of the:
left circumflex
ischaemic changes in leads V1-V4
left anterior descending
quick comparison of aortic stenosis and mitral stenosis sounds?
aortic stenosis - soft s2, narrow pulse pressure, slow rising pulse
mitral stenosis - opening snap, low volume pulse
mitral regurgitation sound
soft s1
an ECG shows a constant PR interval but the P wave is often not followed by a QRS complex
second degree heart block
a man develops a cardiac arrest shortly after being admitted with a myocardial infarction. The ECG monitor shows rapid, irregular waveforms
ventricular fibrillation
progressive prolongation of the PR interval until a dropped beat occurs
type 1 second degree heart block
PR interval constant by P wave not followed by QRS complex
TYPE 2 SECOND DEGREE HEART BLOCK
Third degree heart block
no association between P waves and QRS complexes
ECG changes in II, III, aVF would be most likely caused by a lesion of the:
right coronary artery
what molecule responsible for carrying cholesterol into intima
LDL
ischaemic changes in leads V4-6, I, aVL
left anterior descending or left circumflex
patent ductus arteriosus sound
reversed split s2
mitral regurgitation sound
- third heart sound
- widely split s2
- quiet s1
Mid-late diastolic murmur, ‘rumbling’ in character
mitral stenosis
Austin-Flint murmur (severe aortic regurgitation)
Holosystolic murmur, high-pitched and ‘blowing’ in character
- mitral regurgitation
2. tricuspid regurgitation
clinical signs of cardiac tamponade
- hypotension
- raised JVP
- muffled heart sounds
becks triad
a 60-year-old man is found to have recurrent episodes of atrial fibrillation than terminate sponatenously after 1-2 days
paroxysmal atrial fibrillation
a 50-year-old man with no history of arrhythmia develops atrial fibrillation whilst being treated for pneumonia in hospital
first time atrial fibrillation
A patient develops acute heart failure 10 days following a myocardial infarction. On examination he has a raised JVP, pulsus paradoxus and diminished heart sounds is a stereotypical history of:
left ventricular free wall rupture
A 25-year-old man is investigated for recurrent syncope and dyspnoea. On examination he has an ejection systolic murmur is a stereotypical history of:
Hypertrophic obstructive cardiomyopathy
results in predominantly diastolic dysfunction
left ventricle hypertrophy → decreased compliance → decreased cardiac output
Ischaemic changes in leads I, aVL +/- V5-6 would be most likely caused by a lesion of the:
left circumflex
low volume pulse often seen in:
mitral stenosis
dilated cardiomyopathy
- dilated heart leading to predominantly systolic dysfunction
- all four chambers are dilated, LHS more so than RHS
- alchohol abuse
- feature of DMD
what might a collapsing pulse indicate?
- patent ductus arteriosus
- aortic regurgitation
Warfarin mechanism of action
Inhibits carboxylation of clotting factor II, VII, IX and X
think 1972
a 60-year-old man with a history of tuberculosis presents with dyspnoea and fatigue. On examination the JVP is elevated, there is a loud S3 and Kussmaul’s sign is positive. Hepatomegaly is also noted
constrictive pericarditis
a patient is noted to have persistent ST elevation 4 weeks after sustaining a myocardial infarction. Examination reveals bibasal crackles and the presence of a third and fourth heart sound
left ventricular aneurysm
Malar flush is/are most characteristically seen in:
mitral stenosis
Left ventricular free wall rupture
patient presents with acute heart failure secondary to tamponade.
- raised JVP
- pulsus paradox
- diminished heart sounds
A 25-year-old man is investigated for recurrent syncope and dyspnoea. On examination he has an ejection systolic murmur
example of:
hypertrophic obstructive cardiomyopathy
A 70-year-old woman is found to have a pan-systolic murmur after presenting with dyspnoea. A soft S1 and split S2 is also noted
mitral regurgitation
Continuous ‘machinery’ murmur
patent ductus arteriosus
A patient is noted to have persistent ST elevation 4 weeks after sustaining a myocardial infarction. Examination reveals bibasal crackles and the presence of a third and fourth heart sound
most likely has
left ventricular aneurysm
Collapsing pulse, wide pulse pressure, diastolic murmur
aortic regurgitation
early diastolic murmur, high-pitched and ‘blowing’ in character
aortic regurgitation
Progressive prolongation of the PR interval until a dropped beat occurs -
second degree heart block (Mobitz type 1)
Persistent ST elevation following recent MI, no chest pain in a question is most likely to indicate:
Left ventricular aneurysm
A 70-year-old man presents with chest pain and dyspnoea. On examination he has an ejection systolic murmur which radiates to his carotids
aortic stenosis
Is characterized by decreased compliance, secondary to ventricular hypertrophy
hypertrophic obstructive cardiomyopathy
a patient is noted to have a new early-to-mid systolic murmur 10 days after being admitted for a myocardial infarction
could be due to:
Ischaemia of the papillary muscle
a 70-year-old man is treated with a beta-blocker to control his atrial fibrillation. A previous attempt to cardiovert him failed
example of
Permanent atrial fibrillation
persistent ST elevation following recent MI, no chest pain
left ventricular aneurysm
Causes predominately diastolic dysfunction
hypertrophic obstructive cardiomyopathy
causes predominantly systolic dysfunction
dilated cardiomyopathy
Hypertrophic obstructive cardiomyopathy associated with what age group and why?
- sudden death in young athletes due to ventricular arrhythmia
right coronary artery originates from
anterior aortic sinus
left coronary artery originates from
the left posterior aortic sinus
Left coronary artery divides into
- left anterior descending artery
- circumflex branches
the right coronary artery gives off the…
- posterior interventricular (descending) artery
- supplies right atrium and part of left atrium and SA node in 60% of cases
what supplies the SA node in 60% of cases?
- right coronary artery
