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Misc > Cardio misc > Flashcards

Cardio misc Flashcards

1
Q

What murmer does a VSD have

A

pansystolic murmer.

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2
Q

What is a LEft to right shunt?

A

Blood takes an extra trip to lungs. may lead to pumonary HTN bc more blood on the rhs

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3
Q

What would you see with a small VSD?

A

may be asymptomatic. larger holes present problems in infancy

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4
Q

How is VSD treated?

A

With surgery at infancy but may heal with age

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5
Q

Why is ASD more dangerous with age?

A

As heart compliance falls with age, the shunt
increases
This can lead to heart failure and SoB by 40
Eisenmenger’s complex

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6
Q

What is the Eisenmenger’s complex?

A

shunt reversed due to the
development of pulmonary HTN -> cyanosis and
organ damage.
ALl the blood is pumped out through the aorta, organ damagae because less oxugen to the tissues

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7
Q

What can pulmonary HTN cause?

A

Cyanosis and organ damage

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8
Q

When can ASD be asymptomatic?

A

Until adulthood?

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9
Q

what can a bicuspid aortic valve cause?

A

aortic stenosis +/- aortic regurgitation
pre-dispose an individual to IE, aortic
dilation and aortic dissection

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10
Q

How can a bicuspid aortic valve be treated?

A

valve replacement

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11
Q

What can cause eisenmenger’s be caused by?

A

A right to left shunt. pulmonary HTN

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12
Q

What does cyanosis present like?

A

Blueish tinted skin, around eyes and fingertips and lips

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13
Q

What can cause organ damage and cyanoiss?

A

Eisenmenger’s complex (all blood leaves through aorta)

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14
Q

What is Coarctation of the Aorta?

A

Aorta is narrowed at the site of the ductus

arteriosus

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15
Q

What can a severe coarction of the aorta lead to?

A

blocks aorta, collapse with heart failure

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16
Q

What can a mild coarction of the aorta lead to?

A

raised BP and systolic murmur (best heard over

left scapula, ‘scapula bruit’)

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17
Q

What murmer do you hear with mild coartcion of the aorta?

A 
systolic murmur (best heard over
left scapula, ‘scapula bruit’)
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18
Q

What are the signs of COA?

A

BP in right arm greater than BP in left arm
(Radio-femoral delay,)
systolic murmur (best heard over
left scapula, ‘scapula bruit’)

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19
Q

What can COA lead to a risk of?

A

increased risk of infective endocarditis?

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20
Q

How can COA be treated?

A

sugery insert a stent

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21
Q

What can bicuspid aortic valve pre-dispose a patient to?

A

IE, aortic

dilation and aortic dissection

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22
Q

What are the symptoms of infentile coarctation?

A

blue cyanosis. Blood from pulmonary vein to aorta, reduced O2 to tissues. neonatal death. associated with Turner’s sundrome

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23
Q

Adult coarctation?

A

Ligamentus arteriosis. (ductus closes off)

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24
Q

Feature on CXR of tetralogy of fallot?

A

boot leg shaped heart due to RV hypertrophy

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25
Q

at what percentage of O2 does cyanosis develop?

A

less than 80%

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26
Q

What are the 4 key features of tetralogy of fallot

A

VSD
Pulmonary stenosis
RV hypertrophy
Overriding aorta

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27
Q

Why do you get an overriding aorta in TOF?

A

RV hypertrophy increases the RV pressure so blood flows into LV bc of the VSD. All the blood leaves through the aota, reduced oxygenation and cyanosis in infants

28
Q

What do infants withTOF present with

A

cyanosis and toddlers may squat

29
Q

Which congenital heart conditon has the higher adult survival rate?

A

TOF

30
Q

What are the congenital heart conditions?

A

TOF, Biscuspid aortic valve, VSD, ASD, coarction of aorta

31
Q

which is the most common cong. heart defect?

A

TOF

32
Q

What can cause MI?

A

reduced blood flow to the heart muscle (clot or
atheroma)
increased distal resistance (LV hypertrophy)
reduced O2 carrying capacity (anaemia) or availability
(hypoxia)

33
Q

What causes distal resistance in heart oxygen flow?

A

LV hypertrophy?

34
Q

what is the QRISK2 score?

A

predicts risk of CVD in next ten

years.

35
Q

Characteristic feature of angina?

A

relief with rest

36
Q

ANgiogram of angina?

A

– Gold standard,

shows luminal narrowing

37
Q

What would u see in bloods for angina?

A

anaemia

38
Q

CABG vs. PCI?

A

PCTA – stenting or ballooning the narrowing, risk
of restenosis or thrombosis. Less invasive.
CABG – good prognosis but longer recovery, not
for the frail.

39
Q

what cardiac enzymes do you test for?

A

troponin, CK, myoglobin

40
Q

What are the ACS

A

unstable angina
STEMI
NSTEMI

41
Q

What condition has a rise and fall in troponin?

A

NSTEMI

42
Q

Dx if tropinin is normal but ECG changes and chest pain?

A

Unstable angina

43
Q

What is unstable angina aggrevated by?

A

anaemia

44
Q

When are ‘silent MIs’ seen?

A

diabetics and elderly

45
Q

Symptoms of MI

A

SOB, chest pain, palpatations, sweating, pain radiates to jaw and arm, lasting >20 mins, with nausea,

46
Q

signs of Mi?

A

clammy and pale,
4th heart sound
pansystolic murmur,
may later develop peripheral oedema

47
Q

What would you hear on an MI?

A

4th heart sound

pansystolic murmur,

48
Q

Advice for someone suffering MI/

A

exercise, drugs and no air travel for 2 months. return to work in 2 months after medication

49
Q

What cardiac enzyme is raised when there is muscle damamge?

A

CK-MM. creatinine kinase MM. this is elevated in periheral arterial disease

50
Q

Treatment for PAD

A

Clopidogrel (1st line) and other anti-coags

51
Q

Pain of acute pericarditis?

A

Central chest pain that radiates to the trapezium ridge
SOB, hiccups (irritation of phrenic nerve)
Relieved by sitting forwards
Worse on inspiration and lying down

52
Q

Causes of A.pericarditis?

A

Most common = viral infections (coxsackie B, EBV, mumps)

Bacterial – pneumonia, rheumatic fever, TB, staph, strep

Post-MI (Dressler’s syndrome)

Autoimmune (SLE, RA)

53
Q

HF compensatory mechanisms?

A 
Increased preload
Increased afterload - symp stimulation
Salt and water
retention - RAAS
Myocardial remodelling - myoctype hypertrophy
54
Q

ABCDE Heart failure anacronym?

A 
alveolar oedema
kerley b lines
cardiomegaly
dilated prominent upper lobe vessels
pleural effusion
55
Q

Investigations for HF?

A

FBC, LFT, TFT, BNP (B tyoe naturetic peptide), CXR, echo, ecg, CK-MM, troponin I and T

56
Q

LHF signs?

A 
cardiomegaly
Heart murmer
cool peripherals
weight loss
tachycardia
reduced BP

also: fatgique, pleural effusion, dysponea on exertion,

57
Q

RHF signs?

A 
perioheral oedema, pitting oedema, 
increased JVP
ascites
nausea
anorexia
hepatomegaly

can be caused by LHF, pulmonary stenosis, lung disease

58
Q

ECG in atrial fibrilation?

A

f waves
no clear P waves
Rapid and irregular QRS complex
irregularly irregular beat

59
Q

Treatment for Atrial fibrilation

A

CCBs, BB, Digoxin, Anticoags - warfarin,

Amidarone, electrical DC cardioversion (reset beat)

60
Q

What causes AF?

A

heart failure, HTN, rheumatic heart disease, thyrotoxicoses

61
Q

Symptoms of AF?

A

asymptomatic, over 65, palpatations, fatigure, HF

62
Q

What is used to calculate the risk of stroke from an AF?

A

CHA2DS2VASc Score

63
Q

What does the CHA2DS2VASc score take into account?

A

HTN, AGe, DM, prev stroke/TIA, vascular disease, female,

64
Q

what are F waves?

A

sawtooth flutter waves

65
Q

Intrinscic causes of bradycardia (less than 60bpm)

A

Acute ischaemia
Infarction of SAN
Sick sinus syndrome

66
Q

Extrinsic causes of bradycardia?

A

Drug therapy - BB, digoxin
Hypothyroidism
Hypothermia
Raised intracranial pressure

Misc (14 decks)

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