Cardiology Flashcards
Hyperkalaemia ECG changes
Tall T waves
Prolonged PR interval
Flattened/absent P waves
Severe hyperkalaemia ECG changes
Wide QRS
Sine wave pattern
Ventricular tachycardia/ventricular fibrillation/asystole
Loud S2
Pulmonary hypertension (loud P2)
Systemic hypertension
Soft S2
Aortic stenosis
Widely split S2
Deep inspiration
RBBB
Pulmonary stenosis
Fixed in the middle S2
Atrial septal defect
Reverse split S2
LBBB
Severe aortic stenosis
ASD
Type of murmur
Loudest when
Ejection systolic murmur
Louder on inspiration
Mitral regurgitation
Type of murmur
Loudest when
Pansystolic
Louder on expiration
Loud S1 causes
Hyperdynamic states
Tachycardic states
Left-to-right shunts
Short PR interval
Soft S1 causes
Hypo-dynamic states
Mitral regurgitation
Poor ventricular function
Long PR interval
Split S1 causes
RBBB
LBBB
VT
Inspiration
Ebstein’s anomaly (congenital tricuspid regurgitation)
Variable intensity S1 (causes)
Complete heart block
Atrial fibrillation
Cannon a waves (causes)
Atrial contraction against closed tricuspid
Complete heart block
Tricyclic overdose (ECG changes)
Sinus tachycardia
Widening of QRS
Prolongation of QT interval
Syncope
Previous MI
HR 80
Displaced apex beat
No chest pain
ST elevation and Q waves on ECG
Ventricular tachycardia
Left ventricular aneurysm (ECG changes)
Persistent ST elevation and Q waves
Restoring sinus rhythm in a young patient with acute onset AF
Flecainide
Causes of upper zone fibrosis
Coal workers pneumoconiosis
Histiocytosis
Ankylosing sponylitis
Radiation
TB
Sarcoidosis
Causes of lower zone fibrosis
Most connective tissUe disorders (RA…)
Astbestosis
Idiopathic
Drugs (methotrexate)
Constrictive pericarditis signs
Earliest: hepatomegaly
- pericardial knock
- ascites
Giant a waves (and v waves)
Tricuspid regurgiation
Collapsing pulse
Aortic regurgitation
Arterio-venous fistula
Patent ductus arteriosus
Slow rising pulse
Aortic stenosis
Bisferiens pulse
double shudder due to mixed aortic valve disease
Jerky pulse
HOCM
Alternans pulse
Severe LVF
Pulsus paradoxus
Excessive reduction in pulse with inspiration (drop in BP)
Tamponade
Ventricular compression
Constrictive pericarditis
Severe asthma
Septal MI
ST elevation
Blood vessel
V1-V2
Left anterior descending
Anterior MI
ST elevation
Blood vessel
V3-V4
Left anterior descending
Lateral MI
ST elevation
Blood vessel
V5-V6
Left anterior descending
Left anterior descending localisation
Septal MI
Anterior MI
Lateral MI
Inferior MI
ST elevation
ST depression
Blood vessel
II, III, aVF
aVL (reciprocal STD)
Right coronary artery (RCA)
Posterior MI
ST elevation
ST depression
Blood vessel
V7-V9
V1-V3
left circumflex and RCA
B-type natriuretic peptide
Origin…
Cardiac ventricles
Complete heart block secondary to an inferior myocardial infarction
Management
Manage conservatively
Vessel supplying AV node
Right coronary (90% of patients)
Long QT causes
Electrolytes:
Drugs:
Others:
Electrolytes: hypokalaemia, hypocalcaemia
Drugs: tricyclic antidepressants, antihistamines, erythromycin, clarithromycin, amiodarone, haloperidol
Congenital long QT
MI
Cerebrovascular incident (SAH)
hypothermia
HOCM treatment
ABCDE
Amiodarone
Beta blocker or verapamil for symptoms
Cardioverter defibrillator
Dual chamber pacemaker
Endocarditis prophylaxis
Brugada
Features
ECG findings
Palpitations, syncope, sudden death
ST elevation V1 to V3
Valvular issue in pulmonary hypertension
Functional tricuspid regurg (pansystolic murmur)
Post-MI signs of LVF
Which treatment to add?
Aldosterone antagonist -> e.g. epleronone
SVT + asthma = ?treatment
Verapamil
Angiodysplasia of gut linked to which valvular disorder?
Aortic stenosis
Management of cocaine-related MI
IV benzodiazepines
AV block (heart block) affected by which MI territory?
Inferior MI
Hypercalcaemia ECG changes
Shortening of QT interval
J waves (in severe hypocalcaemia)
Which area has fastest conduction velocity in heart?
Purkinje fibres
Digoxin toxicity ECG changes
Prolonged PR interval
Short QT interval
ST depression
Inverted T waves
Anti-anginal treatment
- Statin and aspirin
- Beta-blocker or calcium channel blocker (verapamil or diltiazem)
- Titrate monotherapy to max dose
- Add the other from 2nd line
- If thinking of adding ivabradine or nicorandil - assess for PCI first
S3 (ventricular gallop rhythm)
LVF
Normal in children/young adults
Troponin I binds to…
actin
Factors causing high pulse pressure (high SBP)
Reduced aortic compliance
High stroke volume
