Cardiology Flashcards
Heart failure and AF
Digoxin as 2nd line
AF rate control
Beta blockers, Calcium blockers and 3rd line Digoxin 2nd line if HF
Unstable NSTEMI
Coronary angiography
Stable NSTEMI
GRACE
Malignant hypertension
severe hypertension + Bilateral retinal hemorrhage and exudates
STEMI management
aspirin, Clopidogrel; unfractioned heparin - PCI patients
Two types of ASD
Ostium primium and secundum
Ejection systolic murmur, Fixed splitting S2
ASD
RBBB and LBBB
William Marrow V1 and V6
1st line for HF
Beta blocker and ACE inhibitor
Second line for HF
Aldosterone antagonist
Patient symptomatic on ACE and ARBs
Sucubitril-Valsartan
HF + AF preferred drug
Digoxin
AF unstable patient >HR and
DC cardioversion
Ventricular tachycardia broad complex management
Loading dose of amiodarone
management of bradycardia
Atropine 500mcg upto 3 mg- 1st line
Transcutaneous pacing
Isoprenaline or adrenaline titration to response
Management of Torsades (polymorphic VT)
IV MGSO4
Angina management
Beta blocker or calcium blocker as 1st line
Calcium blocker - verapamil or diltiazem
With beta blocker - Nifedipine
3rd line: Long acting nitrate, Ivabradine and nicorandil
Young man, AF, 0 CHADVAS score next step??
Transthoracic Echo - valve disease
Painful bones, renal stones, abdominal groans, and psychic moans.
Hypercalcemia
Diarrhoea, vomiting, impaired thirst, weight loss, oliguria and hypovolemia
Hypernatremia
Mental state changes, altered personality, lethargy, confusion, hyper reflexes and seizures due to electrolyte imbalance
Hyponatremia
K <= 4.5 and Hypertensive - 3rd line
Spironolactone
K >4.5 and 3rd line antihypertensive
Beta blocker or alpha blocker
u waves on ECG associated with
Hypokalemia
Can be caused by thiazides like diuretics
Tall T waves are seen in what electrolyte
Hyperkalemia
can be due to ACE-inhibitors
Apical ballooning of chest, Raised troponin and ST elevation
Takotsubo Cardiomyopathy
Trigger is stress
Weak or absent pulse, variation in BP, chest pain (like MI)
Aortic Dissection
Splinter Hemorrhages
Infective endocarditis
Slow rising pulse
Aortic stenosis
Pan-systolic murmur of the left heart
Mitral Regurgitation
ST depression in lead V1-V3, Tall R waves in V1-V3, inverted T wave in lead aVR and all other leads are normal + Chest pain
Posterior wall MI
Transfer PCI time
120 minutes
AF cardioversion drugs
Amiodarone (preferred if SHD)
Flecainide
Same day referral for hypertension
> 180/120; papilloedema; new onset confusion; heart failure or kidney failure
1st line investigation for Suspected CAD, angina
Contrast enhanced CT coronary angiogram
Pulsus paradoxus
> 10 mmHg fall in Bp during inspiration
Severe asthma and cardiac tamponade
Slow rising pulse
Aortic stenosis
Collapsing pulse
Aortic regurgitation; PDA
Bisferiens pulse
TWO systolic peaks; Mixed aortic valve
Jerky pulse
HOCM
Rupture of papillary muscle leads to
Early to mid systolic murmur that radiates to axilla