Cardiology Flashcards
If the person’s blood pressure is between 140/90 mmHg and 180/120 mmHg what is the method of diagnosis?
ambulatory blood pressure monitoring (ABPM) Or HBPM.
- 2 measurements taken per hour between 8am-10pm. Average of 14 readings.
- 7 day reading, 2 taken every hour (1 min apart) with the first day reading discarded, and the average taken.
Refer to same-day specialist if the reading is
a) 140/90
b) 160/100
c) 180/120
c) 180/120
What do you use to assess stroke risk in AF?
CHA2DS2VASC score
if scored more than 2 - offer anticoagulation
if its is 1 - then consider.
(considers, CHF, Hypertension, Diabetes, Vascular and Stroke (CVS)
What score do you use to assess bleeding risk?
Orbit Score / Has-bled
Sweating, jaw and arm ache, crushing central or dull chest pain. What treatment would you do if the presented within 2 hours of symptom onset?
PCI
if more than 2 hours - Fibrinolysis
What is Rheumatic fever?
Rheumatic fever can develop if strep throat and scarlet fever infections are not treated properly, and can effect the heart, joints, brain and skin.
What do you expect to see in blood results for rheumatic fever?
Group A streptococcus antibodies
Raised CPR/ESR
Positive throat swabs
ECG - Prolonged PR Interval
Whats the difference between pericarditis and cardiac tamponade?
Pericarditis - Inflammation of the sac surrounding the heart. Symptoms SHARP, constant STERNAL pain, slightly relieved when sitting forward. worse when coughing or on inspiration, or lying on left side.
Hear pericardial friction rub heard during expiration.
cardiac tamponade - compression of the heart due to cardiac effusion - fluid/blood filling up in the sac. (Beck’s Triad) - Hypotension, muffled sounds and raised JVP.
What test do you do for acute pericarditis?
TOE ECHO
ECG - Wide spread saddle-shaped ST elevation and PR depression.
What do you do to investigate and diagnose Infective Endocarditis
Blood cultures Echo U & E's - check renal function Diagnosis - Duke Criteria (Prolonged fever of Unknown Origin), vascular phenomena (stroke, limb ischemia, physical findings of septic emboli) Persistently positive blood cultures (2 or more).
How do you test for orthostatic hypotension, and what are the key findings?
Standing/lying BP for 3 mins
a drop in 20 mmhg Systolic
and 10 mmhg Diastolic
What side HF has the following symptoms: Confusion, orthopnoea, restless, cyanosis & Crackles, and how is it measured?
Left side - Lung
BNP (Brain neurotic Peptide)
BNP is released in response to heart damage or heart stretch?
What side HF causes the following symptoms: Weight gain, oedema, ascites, hepato/splenomegaly)
Heart stretch.
Right sided HF.
What do is the investigation for arterial occlusion?
ABPI <0.5 is critical (refer to vascular MDT)
0.6-0.9 intermittent claudication (exercise management, angio or bypass)
What organism causes infective endocarditis?
Staphylococcus Aureus
What organism causes infective endocarditis?
Staphylococcus Aureus
What is the most common complication of hypertrophic obstructive cardiomyopathy?
Sudden death due to ventricular arrhythmia
What is the most common complication of hypertrophic obstructive cardiomyopathy?
Sudden death due to ventricular arrhythmia
How do you confirm the diagnosis of ACS?
resting 12-lead ECG and a blood sample taken for high-sensitivity troponin I or T measurement
What is the gold standard treatment of ST elevation MI?
PCI
What investigations are used to assess peripheral vascular disease?
Doppler US
Angiogram
ABPI
What should you not rely on when considering ACS as a diagnosis?
- Response to GTN
2. No ECG changes
How would you diagnose suspected ACS 72 hours after with no complications?
ECG -
Pathological P waves
T waves flattened or T waves inversion
Left branch bundle block (WiLLiaM) in leads V1 and V6
Troponin I and T allows you to differentiate between what two conditions?
Unstable Angina and Myocardial Infarction
What other conditions can cause an increase in serum troponin?
Anything which damages the heart muscle: arrythymias, Pericarditis, PE, myocarditis.