Cardiology Flashcards
Give causes of secondary hypertension.
CHAPS - Cushing’s, Hyperaldosteronism, Aortic Coarctation, Pheochromocytoma, Stenosis of renal artery
Give red flags in hypertension.
- Young patient (< 40)
- Severe hypertension (>180/120)
- Evidence of organ damage - papilloedema, heart failure, encephalopathy
- Features of secondary cause eg. cushinoid features, palpitations, renal bruits
What is the gold-standard test for diagnosing hypertension?
Ambulatory Blood Pressure Monitoring (ABPM)
What blood pressure cut-off is suggestive of hypertension?
> 140/90 in clinic or > 135/85 in ABPM
Which patients with new hypertension would warrant an emergency referrak?
> 180/120 or evidence of organ damage (particularly papilloedema)
Which investigations should be performed in a newly diagnosed hypertensive patient?
Urinalysis
ECG
Fundoscopy
Blood tests - Us&Es, cholesterol and HbA1C
Mrs R is 45 years old and newly diagnosed with hypertension. What is the first-line anti-hypertensive agent for her?
ACEI or ARB
Mrs R is 45 years old and newly diagnosed with hypertension. She completes a trial of Lisinopril but her BP is still 145/95. Which medications could be trialed next?
ACEI/ARB and CBB or Thiazide diuretic
Mrs R is 45 years old and newly diagnosed with hypertension. She completes a trial of Lisinopril but her BP is still 145/95. Her GP adds Amlodipine but her BP remains high. Which medications could the GP try now?
ACEI/ARB + CCB + Thiazide diuretic
What is the first-line anti-hypertensive agent in patients with T2DM?
ACEI/ARB
Mr D is a 60-year-old male who has been newly diagnosed with hypertension. What would be the first-line anti-hypertensive?
CCB
Mr D is a 60-year-old male who has been newly diagnosed with hypertension. His GP commences Amlodipine but his BP remains high at 150/100. What would be the next step?
CCB + ACEI/ARB or thiazide diuretics
Add ACEI/ARB or a thiazide diuretic
Mr D is a 60-year-old male who has been newly diagnosed with hypertension. His GP commences Amlodipine but his BP remains high at 150/100. After addition of Lisinopril, his BP is still high. What would be the next step?
Add a thiazide diuretic
ACEI + CCB + thiazide diuretic
What is the first-line anti-hypertensive agent in patients of African-Caribbean heritage?
CCB
Which medications may be considered in resistant hypertension?
Spironolactone, beta-blockers or alpha-blockers
What are the first-line medications for stable HF with reduced ejection fraction?
ACEI + Beta-blocker
Beta-blockers should not be prescribed with which medications?
non-dihydropyridine calcium blockers such as verapamil or diltiazem
Spironolactone causes which electrolyte imbalance?
Hyperkalaemia
Inverted T waves may be a sign of…
Myocardial ischaemia
Which coronary artery is most likely to be affected in a lateral STEMI?
LAD or Left cirumflex
Which coronary artery is most likely to be affected in an inferior STEMI?
RCA
What is the treatment for haemodynamically unstable fast AF?
DC Cardioversion or IV Amiodarone
What CHADS-VASC score suggests that anti-coagulation is indicated?
2 or more
Aortic regurg and ST elevation inferior leads suggests…
Proximal aortic dissection
Which electrolyte abnormality is associated with thiazide diuretics?
Hypokalaemia
How long after an MI does Dressler syndrome tend to present?
2-3 weeks
Give causes of diastolic murmurs.
ARMS - Aortic Regurg & Mitral stenosis
Slow-rising pulse suggests…
Aortic stenosis
What is the normal cardiac axis?
-30 to 90 degrees
Give 3 causes of systolic murmurs.
Aortic Stenosis
Mitral Regurg
Tricuspid Regurg