Cardiology Flashcards
Inferior ECG leads for Right Coronary Artery
II,III,aVF
Lateral ECG leads for Left Circumflex Artery
I,aVL,V5,V6
Antero-Septal ECG leads for Left Anterior Descending Artery
V1,V2,V3,V4
Is pulseless electrical activity of heart a shockable rhythm
No
Rhythms that are shockable by AED
Ventricular fibrillation(v-fin) and pulseless ventricular tachycardia (pulseless v-tach)
What is Beck’s triad
Classical signs of acute cardiac tamponade:Low BP,distended jugular veins and muffled heart sounds
What should be considered in all immunocompromised patients who are hypotensive
Sepsis/Septic Shock
Phenomenon when an unrepaired heart septal defect is reversed over time
Eisenmenger syndrome
Narrow complex tachycardia cause
Supraventricular tachycardia
Causes of cardiac chest pain in children
Left Ventricular Outflow Tract Obstruction(LVOTO)
-Aortic stenosis
-HOCM
Inflammation
-Myocarditis
-Perocarditis
Arrhythmias
Rare causes
-Kawasaki disease if coronary arteries are involved
-congenital defects of coronary arteries
Main drugs for heart failure
- Beta blockers
- Ace inhibitors/ARB
- Diuretics
- SGLT 2 inhibitors
Main cause of mitral stenosis
- Rheumatic heart disease
- Infective endocarditis
- Radiotherapy
Signs of atrial fibrillation
- Absence of p waves
- Absence of f waves
- Irregular rhythm of QRS complexes
Causes of MR
- Primary: structural defects eg MVP, RHD
- Secondary: Atrial MR, nonischemic CMP, ischemic CMP
Causes of stenotic valvular lesions
Congenital
Senile
Rheumatic
Causes of Tricuspid regurgitation
Primary: Prolapse, infection, congenital
Secondary: AF, pulm HTN, RH dilatation
Causes of Aortic regurgitation
Young: Bicuspid AV, Marfans, Anky spon
Old: Degenerative, atherosclerotic dilatation, leutic disease(syphilis)
Inheritance pattern of Marfan and the involved gene
Autosomal dominant, 50%
Fibrillin 1
Causes of regurgitant valvular disease
Congenital
Rheumatic
Senile
ischemic
Functional
Infective
Traumatic
Valve dysfunction often associated with valvular AF
Mitral regurgitation
Section of coronary arteries most likely to be affected in heart block
Proximal branch of Right coronary artery, perfuses AV node
What is a third degree heart block
Complete AV node dissociation, no r/s between p and qrs
irregular PR interval
normal PP and RR intervals
What are the types of 2nd degree heart block
Mobitz type 1: PR lengthens until one beat is not conducted
Mobitz type 2: PR remains normal but some beats are not conducted
What is a first degree heart block
All beats are conducted but PR interval is lengthened >200ms( 5 small sq)
Causes of aortic stenosis
- Bicuspid aortic valve in children
- Degenerative
Sx and prognostication of aortic stenosis
ASD
Prognosis
Angina 5yr
Syncope 3yr
Dyspnea 2yr
Duke Major criteria for IE
- Positive blood c/s x2 or high risk organism
- Positive findings on TTE/TEE
Duke minor criteria for IE
- Predispositions for IE( eg prev IE, IVDU, prosthetic valve)
- Febrile
- Vascular phenomenon(Osler, janeway, roth, splinter)
- Immunologic phenomenon
- Microbiologic findings on blood c/s that does not meet major crit.
5 drug classes for Heart failure drugs
Beta Blockers
Diuretics
ACE-i/ARB + Entresto(Sacubitril-Valsartan)
SGLT2 inhibitor
Renal diet
Low protein about 0.8g
Low phosphate
Low K
Fluid restriction
Low salt
HAS BLED score components
Hypertension
Abnormal kidney/liver function
Stroke
Bleeding
Labile INR
Elderly >65
Drugs or alcohol
NOT a contraindication checklist for anticoagulation
CHAD VASC score
Congestive Cardiac Failure
Hypertension
Age
Diabetes
Vascular Disease
Sex
Stroke Hx
Definition of pulmonary hypertension
Mean pulmonary wedge pressure above 20 measured using Swan Ganz catheter
Type of STEMI in pericarditis
Global saddle shaped STE
Key investigations for any Shortness of breath/ desaturation
- Arterial Blood Gas
- ECG
- Troponins/ cardiac enzymes
Subtypes of atrial fibrillation
- Paroxysmal AF that resolves within 1/52 of treatment
- Persistent: continuous AF >1/52
- Longstanding persistent: >1 year
- Permanent AF: Persistent AF where therapeutic attempts no longer made to maintain sinus rhythm
CHA2DS2 VASc score components
Cardiac Failure
Hypertension
Age
DM
Vascular disease hx
Atherosclerotic Disease
Sex
HAS BLED Score
Hypertension
Abnormal liver or kidney function
Stroke hx
Bleeding diathesis or medications
Labile INR
Elderly >65
Drugs that predispose to bleeding or Drinking(alcohol)