Cardio Questions

Question 1

Raised JVP causes

Answer 1

RV failure Tricuspid stenosis or regurgitation Pericardial effusion or constrictive pericarditis SVC obstruction Fluid overload Hyperdynamic circulation

Question 2

Systolic murmurs

Answer 2

Pansystolic= MR, TR + MVP Mid systolic= AS, PS Biological valve replacement Hypertrophic cardiomyopathy VSD, ASD (pulmonary flow murmur)

Question 3

Diastolic murmurs

Answer 3

AR or PR (Early) MS or TS (Mid to Late) Atrial myxoma

Question 4

Continuous murmur

Answer 4

PDA AV fistula Combined AR/AS, MR/MS

Question 5

Mitral stenosis causes

Answer 5

Rheumatic, calcification, after MR repair, congenital

Question 6

Mitral stenosis ECG findings

Answer 6

P mitrale in sinus. Bifid in lead II, A fib = chronicity, RAD

Question 7

Mitral stenosis indications for surgery

Answer 7

SOBOE, <1cm

Question 8

Mitral regurgitation causes

Answer 8

o Chronic= degenerative Dx, MVProlapse, rheumatic, papillary muscle (LVF, ischaemia), CT Dx (RA, ank spond), Congenital Acute= IE, MI, Surgery, trauma

Question 9

Mitral regurgitation ECG findings

Answer 9

P mitrale AFib Right axis deviation

Question 10

Mitral regurgitation indications for surgery

Answer 10

Chronic- NYHA 3-4 or LVF Acute- haemodynamic compromise

Question 11

Aortic Regurgitation Causes

Answer 11

Chronic- -Valvular- rheumatic, congenital (bicuspid valve, VSD), seronegative arthropathy (esp AS) -Aortic root- Marfan’s, Aortitis, Dissecting aneurysm, old age Acute -Valvular= IE, Aortic root= Marfan’s, HTN, dissecting aneurysm

Question 12

Aortic Regurgitation indications for surgery

Answer 12

Symptoms- SOBOE Worsening LV function (Low EF_ Progressive LV dilatation (end systolic dimension >5.5cm

Question 13

Aortic valve area in stenosis

Answer 13

significant stenosis <1cm. Critical <0.7cm or valve gradient >70mmHg

Question 14

Aortic Stenosis Causes

Answer 14

Degenerative calcified AS, rheumatic, calcified bicuspid

Question 15

Aortic stenosis indications for surgery

Answer 15

Symptoms- exertional angina, SOBOE, Exertional syncope Critical obstruction- catheterisation data Severe LVH

Question 16

Tricuspid regurgitation causes

Answer 16

Functional- RV failure Rheumatic Infective endocarditis- IVDU Congenital- ebsteins anomaly Tricuspid valve prolapse RV papillary muscle infarction Trauma

Question 17

HOCM consequences

Answer 17

Heart failure Arrhythmias Mitral regurgitation (systolic anterior motion of the mitral valve leaflets) Sudden cardiac death

Question 18

HOCM ECG

Answer 18

LVH, lateral ST and T wave changes, deep q waves, conduction defects

Question 19

ASD ECG

Answer 19

RAD + RBBB + RVH

fixed split S2 = pathognomic

Question 20

Manouvres

Answer 20

Isometric handgrip- increases afterload Valsalva- reduced preload MVP + HOCM= louder w valsvalva AS and HOCM= quieter w isometric handgrip