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Finals- Medicine > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What is an atrial myxoma?

A

A benign tumour which is usually found in the left atrium of the heart, it is found in 30-40 year old women

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2
Q

What are the symptoms of atrial myxoma?

A 
Intermittent syncope 
SOB
Fever 
Malaise
Cachexia
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3
Q

How do you treat atrial myxoma?

A

Minimally invasive right thoracotomy

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4
Q

What are the symptoms of constrictive pericarditis?

A

Progressive dyspnoea
Fatigue/ weakness
Peripheral oedema

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5
Q

How do you manage constrictive pericarditis?

A

Pericardiectomy via. Sternotomy incision

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6
Q

What are the causes of constrictive pericarditis?

A

Post MI
Cardiac surgery
TB

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7
Q

What are the symptoms of acute pericarditis?

A 
Pleuritic chest pain which is relieved by sitting forward
Pericardial rub 
Tachypnoea
Tachycardia 
Non productive cough 
SOB
Flu symptoms
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8
Q

What are the causes?

A 
Post MI- dresslers 
Viral 
Hypothyroidism 
CTD
Trauma
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9
Q

How do you investigate acute pericarditis?

A

Bedside ECG showing widespread ST elevation
Bloods
Transthoracic echo

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10
Q

How do you treat acute pericarditis?

A

Ibuprofen and colchicine

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11
Q

What does acute coronary syndrome consist of?

A

Unstable angina, NSTEMI,STEMI

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12
Q

What is the pathogenesis of ACS?

A

Atherosclerosis

Plaque fissure becomes thrombosis which causes vasoconstriction and ultimately ischaemia.

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13
Q

What is the clinical presentation of ACS?

A

Severe crushing chest pain which is present at rest (whereas angina is <20 mins and relievable)
The pain is retrosternal radiating to arm/neck/jaw

Sweating, palpitations, dyspnoea, nausea, sense of impeding doom

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14
Q

How long does ACS pain last?

A

Usually>20 mins and it isn’t relieved by 3xGTN sprays

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15
Q

What are the findings of ACS on examination?

A

Pallor, sweating, tachycardia- sympathetic sx

Myocardial impairement- hypotension, increased JVP, basal creps, 3rd heart sound, pulmonary and peripheral oedema

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16
Q

What are the risk factors for ACS?

A 
HT 
Increased cholesterol
Smoking
Alcohol
FHx
Previous IHD 
DM
Increased BMI
Male
Age
17
Q

What IX should be carried out for ACS?

A

Bloods- lipids, glucose, cholesterol, clottimg
Troponin’s on admission and again 6-12 hours later
ECG should be done within ten minutes

Others= ECHO, CXR, CT angiogram

18
Q

What are the differentials for ACS?

A 
Aortic dissection
Coronary spasm
Pericarditis/myocarditis
MSK (costochondritis) 
PE 
PT x 
GORD 
PUD
19
Q

What is the acute management of NSTEMI/UA?

A

Morphine + metaclopramide
Oxygen (if sats less than 94%)
Nitrates (GTN)
Antiplatelets (300mg chewable aspirin + ticagrelor/clopidogrel)
Anticoagulant (fondaparinux, 2.5mg for 72 hrs)

Grace score (mortality) , DAPT score (assess bleeding risk), angiographic assessment, revascularisation options (PCI, CABG)

20
Q

What is the acute management of STEMI?

A

Morphine and metaclopramide
Oxygen
Nitrates
Antiplatelets (300mg aspirin + ticagrelor+clopidogrel)
Anticoagulant (fondaparinux 2.5mg for 72 hours)

PCI if <120 mins, target 150mins call- balloon time
Second line = thrombolysis if >120 mins

21
Q

How do you treat ACS in the lifelong?

A

Lifelong aspirin- 75mg OD
Continue a 2nd anti platelet for 1 year- ticagrelor/clopidogrel
ACE-I
Beta blocker (lifelong) bisoprolol 2.5mg OD
Lifelong atorvastatin 80mg OD
Treat underlying problema- HF/HT

22
Q

What are the complications of ACS?

A 
Darth Vader 
Death 
Arrythmia
Rupture
Tamponade 
Heart failure
Valve problem 
Aneurysm of ventricle 
Dressler syndrome 
Emboli 
Recurrence
23
Q

What is becks triad?

A

It signifies tamponade, low BP, increased jVP, quiet heart sounds

24
Q

What are the sx of dresslers syndrome?

A

Fever
Chest pain
Pericardial effusion
Exertional dyspnoea

25
Q

What is the clinical presentation of chronic stable angina?

A

Retrosternal pain/discomfort/tightness which is radiating to the arm/neck/jaw

It occurs on exertion and is usually less than ten mins, it is relieved with rest and GTN spray

26
Q

What is the classification of severity of ACS?

A 
1= angina with strenous exertion 
2= angina with moderate exertion 
3= angina with mild exertion 
4= angina at rest
27
Q

What are the causes of CSA?

A

CAD- atheroma, thrombus
Valve disease- increases workload
Cardiomyopathy- decreased contractility
Anaemia- increased demand

28
Q

What investigations are needed for chronic stable angina?

A

Hx
Examination- DM, HT, CHF, valve disease
ECG, bloods, CXR, ECHO

Further tests…

  • angiography- invasive - anatomical test
  • CT coronary angiography- non invasive
  • exercise tolerance test - show ST depression and T inversion during exertion (functional test)
29
Q

What is the management of chronic stable angina?

A

1) Lifestyle- diet, weight (BMI<25), exercise, smoking, alcohol
2) Symptom relief- GTN spray

3) anti anginal
1st line= beta blocker
2nd line= CCB if beta blocker contraindicated
3rd line= combine BB and CCB
4th line= long acting nitrate or Ivabradine or nicorandine or ranolazine

Finals- Medicine (1 decks)

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