Cardiology

Question 1

Syndromes associated with cardiovascular disease

Answer 1

• Down’s syndrome- low set ears, epicanthic folds, flat nasal bridge
• Ankylosing spondylitis- ?mark posture, restricted neck movements
• Marfan’s syndrome- tall, arachnodactyly, arm span >height
• Turner’s syndrome- webbed neck, cubitus valgus, short stature, infertility
  -Noonan’s syndrome- similar to Turner’s but cna be present in men and women
• William’s syndrome- elfin facies
• Holt- ORam syndrome- triphalangeal thumb, radial hypoplasia

Question 2

Aortic stenosis- differential diagnoses

Answer 2

-aortic sclerosis
- pulmonary stenosis (aortic 2nd heart sound normal, murmur louder on inspiration)
- VSD- very loud murmur hears all over praecordium, maximal at the sternal edge, much more likely to be associated with a thrill
- HOCM- jerky pulse, murmur gets quiter if patient crouches down due to increased afterload and splinting open of the outflow track. No ejection click, normal 2nd heart sound, young person
- subaortic membrane (rare)- no ejection click, normal 2nd heart sound
- supravalvular obstruction (v rare)- no ejection click, normal 2nd heart sound

Question 3

Aetiology of aortic regurgitation

Answer 3

Acute AR