Cardiology Flashcards
What end of bed signs may you see in a patient during a Cardiology examination?
Mallar flush (MR)
Pallor
Cyanosis
Oedema
Dyspnoea
What hand signs may you see in a patient in CV exam?
Pallor
Cyanosis
Tar staining
Xanthomata
Arachnodactyly
Pigmentation
Give 3 causes of clubbing.
Cyanotic heart disease
Cystic fibrosis
Lung cancer
Ulcerative colitis
Bronchiectasis
Benign mesothelioma
Infective endocarditic
Idiopathic pulmonary fibrosis
Neurogenic tumours
GI disease
What nail signs may you see?
Splinter haemorrhages
Janeway lesions
Osler’s nodes
What may cause a radio-radial delay?
Subclavian stenosis
Aortic dissection
Aortic coarctation
What may cause a collapsing pulse?
Aortic regurgitation
PDA
High output states (anaemia, AV fistula, thyrotoxicosis)
Fever
Pregnancy
What pulse characters are there?
Normal
Slow-rising (AS)
Bounding (AR and CO2 retention)
Thready (hypovolaemia)
Which conditions may give a narrow pulse pressure?
SBP - DBP <25mmHg
Aortic stenosis
Cardiac tamponade
Congestive heart failure
Which conditions may give a wide pulse pressure?
SBP - DBP >100mmHg
Aortic regurgitation
Aortic dissection
What may cause a raised JVP?
Cardiac tamponade
Congestive heart failure
Restrictive cardiomyopathy
Constrictive pericarditis
What is a positive result for a hepatojugular reflux?
sustained rise and >4cm rise
What eye signs may be noted on CVS exam?
Xanthelasma
Corneal arcus
Conjunctival pallor
Kayser-Fleischer rings
Brushfield spots
Which thoracic scars may you note in a CVS exam?
Median sternotomy scar (CABG)
Anterolateral thoracotomy scar (minimally-invasive cardiac surgery)
Infraclavicular scar (pacemaker)
Left mid-axillary scar (ICD)
Which valves may be accentuated by expiration?
Aortic (lean forward and exhale)
Mitral (left lateral decubitus and exhale)
Which values are accentuated by inspiration?
Tricuspid (exhale)
Pulmonary (exhale)
What clinical signs of aortic regurgitation exist?
Aortic area, diastolic murmur, accentuated by leaning forward and breathing out
Collapsing pulse
Displaced apex beat
Wide pulse pressure
DeMusset’s sign (head bobbing)
Corrigan’s sign (distension and collapse of carotid arteries in the neck)
Quincke’s sign (nail bed pulsations)
Traube’s sign (pistol shot sounds over femoral artery)
What are the clinical features of mitral stenosis?
Mitral area, diastolic murmur, accentuated by left lateral decubitus position and breathing out; radiates to axilla
Low volume pulse (character)
Malar flush
What is the Ebstein anomaly?
Congenital tricuspid regurgitation due to valves displaced downwards into the right ventricle causing regurgitation
What criteria is used to determine CTPA or D-Dimer in PE?
Well’s Score
DAMN BC
DVT likely
Another DDx less likely than PE
Mobility (>3 days or surgery in 4 weeks)
Medical history of PE
HR >100bpm
Blood in cough
Cancer Hx (last 6 months or palliative)
How do you treat patients presenting with AF?
Stable
<48 hours = rhythm control
Bisoprolol; Amiodarone (if HF)
>48 hours = rate control
Unstable
DC Cardiovert
What are the complications of DC cardioversion?
Stroke
Pulmonary vein stenosis
Cardiac tamponade
