Cardiology Flashcards
1
Q
Tamponade vs CCF
A
Features that support tamponade include:
- Pulmonary oedema not present
- Normal heart size
- No significant cardiac murmurs
- No bundle branch blocks or hypertrophy on ECG
2
Q
Pericarditis- Beck’s triad
A
Hypotension
Jugular venous distension
Muffled heart sounds
3
Q
Causes of Mobitz II block
A
- Anterior MI (septal infarction with necrosis of the bundle branches)
- Idiopathic fibrosis of the conducting system(Lenegre-Lev disease)
- Cardiac surgery esp those occurring close to the septum (eg MVR)
- Inflammatory conditions (Rheumatic fever, myocaridtis, Lyme disease)
- Autoimmune conditions (SLE, systemic sclerosis)
- Infiltrative myocardial disease (amyloidosis, sarcoidosis)
- Hyperkalemia
- Drugs (CCB, Beta blockers, digoxin, amiodarone)
4
Q
Main causes of bifascicular block
A
- Ischemic heart disease
- Structural heart disease
- Aortic stenosis
- Anterior MI
- Lenegre-Lev disease
- Congenital heart disease
- Hyperkalemia
* *A new-onset bifascicular block in the context of chest pain is highly associated with proximal LAD occlusion even in the absence of ST segment changes
5
Q
Clinical significance of bifascicular block
A
- Often associated with structural heart disease (50-80%) and extensive fibrosis of the conducting system
- risk of progression to complete heart block (1-4% per year)
- Patient presenting with syncope have a 17% annual risk of progression
- *Syncope or pre syncope in the context of a bifascicular block is an indication for admission and monitoring. If other causes of syncope are not identified on work up, pacemaker insertion is recommended
