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BPT Clinical Exam > Cardio Long > Flashcards

Cardio Long Flashcards

1
Q

Cx of AMI to ask about in Hx

A

Arrhythmia
CCF
Angina
Embolic events

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2
Q

Optimal MEdical treatment for stable angina

A
  1. Aspirin +/- Clopidigrel (for one year post ACS)
  2. Statin - Target LDL <1.8
  3. HTN - ACEi/ARB; Taget BP <130/80
  4. HR - BB aiming HR <70
  5. Exercise 3x per week for >150 mins/week
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3
Q

Specific IE Hx questions

A
  • Presenting Sx - malaise, fever, anaemia
  • Embolic phenomena: Brain, viscera, kidneys, haematuria, loin pain
  • Recent procedures
  • Hx of rheumatic fever, heart disease, or heart operations
  • IVDU
  • Immunosuppression?
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4
Q

CAuses of culture negative IE

A
  1. PRevious ABx use
  2. Exotic organism: HAemophilis parainfluenza, histoplasmosis, Brucella, Candida, Q fever
  3. Right sided IE (rarely)
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5
Q

Dukes Criteria for IE

A

Two major Criteria, OR 1 major and 3 minor, OR 5 minor

Major:

  • Typical organism on 2 separate BCs
  • Evidence of endocardial involvement on TTE
  • Single positive BC for Coxiella burnettii or anti phase IgG ab >1:800

Minor:

  • Predisposing cardiac condition or IVDU
  • Fever
  • Embolic vascular phenomena
  • Serological or acute phase abnormalities
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6
Q

DDX for IE

A 
Atrial myxoma
Occult malignant neoplasm
SLE
PAN
Post Strep GN
Pyrexia of unknown origin
Cardiac thrombus
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7
Q

Precipitants of CCF

A
  1. Arrhythmia
  2. Non-compliance with FR/meds/high salt
  3. AMI
  4. PE
  5. Anaemia
  6. Infection/fever
  7. Thyrotoxicosis
  8. Anaesthesia and surgery
  9. Pregnancy
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8
Q

Sx of LVF

A

Dyspnea

ORthopnea/PND

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9
Q

Sx of RVF

A

Oedema
Ascites
Anorexia
Nausea

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10
Q

CVS risk factors

A 
MAle
Age
HTN
Chol
Smoking
Diabetes
FHx of early CAD
OCP or premature menopause
Obesity
Low physical activity
Erectile dysfunction
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11
Q

RF for dilated cardiomyopathy

A

ETOH
FHx
HAemochromatosis

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12
Q

NYHA classification

A

I - No limitation of physical activity
II - Angina/dyspnea on moderate activity
III - Angina/dyspnea on mild activity
IV - Angina/dyspnea at rest

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13
Q

Ix for cause of hypertriglyceridemia

A

hypothyroid
DM
ETOH

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14
Q

Ix for HTN

A

UEC
-If K+ low consider hyperaldosteronism: ARR (High)
- OTher causes: Renovascular disease, Cushings, Liddle’s syndrome
24 hour urine catecolamines
Urine ACR PCR
OSA work up
CT Angio -?RAS

CVS Risk:

  • BSL
  • Chol
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15
Q

Causes of uncontrolled HTN

A
  1. Compliance
  2. Hyperaldosteronism
  3. Cushings
  4. Coarctation of the aorta
  5. RAS
  6. Phaeo
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16
Q

Tavi Cx

A

Heart block
AR
Tavi thrombosis

17
Q

CI to TAVI

A 
Aortic annulus too small
LV apical thrombus
Peripheral vascular access issues
Active endocarditis
Life expectancy <1 yr
18
Q

SEvere AS

A

Gradient >40 mmHg
Area <1 cm2
Velocity <0.25 DI
Flow 4

19
Q

Moderate AS

A

Gradient 20-40
Area 1-1.5
Velocity <0.25

20
Q

HASBLED

A
  • Hypertension
  • Abnormal renal/liver function
  • Stroke
  • Bleeding history or predisposition
  • Labile INR
  • Elderly
  • Drugs/alcohol
21
Q

CHADSVASC

A
  • Congestive heart failure / left ventricular dysfunction
  • Hypertension
  • Age ≥ 75 (x2)
  • Diabetes
  • Stroke (x2)
  • Vascular disease
  • Age 65-74
  • Sex (female) (x2)
22
Q

Severe MS

A

Area of <1 cm2

Mean gradient >10 mmHg

23
Q

Indication for PPM

A
  1. SND
    - Only if symptomatic
  2. AV block
    - Pace even if symptomatic in Type 2 AV block, high degree AV block, CHB
    - Otherwise only if symptomatic
24
Q

Mx of MS

A

MEdical therapy
-BB, diuretics if overloaded

Balloon valvuloplasty

25
Q

Indications for Balloon valvuloplasty in MS

A

Mod to severe MS (<1.5 cm2 area)

Symptomatic

Asymptomatic +

  • New AF
  • PASP >50mmHg at rest
26
Q

Contraindications for balloon valvuloplasty in MS

A

> mild MR
LA thrombus
Heavy calcification
Predominant subvalvular involvement

27
Q

Indications for AR repair

A

If Symptomatic - Treat

If asymptomatic:

  • Resting EF <50%
  • Cardiac surgery/CAGS
  • Rest EF >50%, but LV Diastolic >70mm or LV systolic >50 mm
28
Q

Indication for ICD

A

PRimary -1 month post MI with LVEF <35%

Secondary

  • Sustained VT with Hemodynamic compromise
  • VT with syncope
  • Cardiac arrest
29
Q

Indication for CRT

A

LVEF <35%, QRS >150 ms, SR, LBBB

30
Q

Causes of LVF

A
  • Volume Overload: AR, MR, PDA
  • Pressure overload: HTN, AS
  • Myocardial disease: Ischaemic, dilated cardiomyopathy
31
Q

Causes of Dilated Cardiomyopathy

A 
Idiopathic
ETOH
Myocarditis
Familial
Tachycardia induced
Peripartum
Neuromuscular disease
CTD
Sarcoid
Haemachromatosis
Drugs
Radiation
32
Q

Causes of RHF

A
  • Volume overload: ASD, TR
  • Pressure overload: PS, Pulmonary HTN
  • Myocardial disease: Cardiomyopathy secondary to LVF, Right ventricular infarction
33
Q

Signs of Cardiac Tx rejection

A
  • Pericarditis Sx
  • Decreased LVEF
  • ECG changes -reduced voltage, atrial arrhythmia
34
Q

Prognosis in Cardiac Tx

A

10 year survival 50%

35
Q

CAuse of chronic CArdiac Tx failure

A

Chronic allograft vasculopathy

BPT Clinical Exam (11 decks)

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