Cardiology Flashcards
What electrolyte abnormalities can cause a long QT interval?
- Hypocalcaemia
- Hypomagnasaemia
- Hypokalaemia
How would you describe Torsades de pointes?
It is a polymorphic ventricular tachycardia
How do you treat torsades des pointes?
IV Magnesium infusion
What causes Torsades de pointes?
Anything which causes QT prolongation
- Congenital long QT syndromes
- Antipsychotics
- Electrolyte abnormalities
- Anti-Arythmic medications such as amiodarone
- Clarithromycin/erythromycin
- Hypothermia
- Subarachnoid haemorrhage
What is the treatment for regular narrow complex tachycardia?
IV Adenosine (bolus)
What is the treatment for broad complex tachycardia?
IV amiodarone
First line treatment for SVT?
Vagal maneuvre
Then adenosine (if vagal manoeuvre fails)
What is the most common cause of death in patients following a myocardial infarction?
Ventricular fibrillation
What is meant by “lone AF”?
AF in a patient:
- <60 years old
- No other heart condition
- Heart is structurally normal on echo
How do you interpret ABPI measurements?
Ankle brachial pressure index
<0.5 severe arterial disease
0.5-0.8 arterial disease or mixed arterial and venous disease
0.8-1.3 no evidence of significant arterial disease
>1.3 suggests arterial calcification
Abdominal Aortic Aneurysm
Cut offs for treatment?
abdominal aorta measures between 3.0 and 4.4 cm in diameter, – ultrasound scan should be repeated every year.
If the aorta measures between 4.5 and 5.4 cm in diameter - ultrasound scan should be repeated every three months.
If the aorta measures 5.5 cm or more in diameter, then the patient should be referred for vascular surgery.
Causes of Pansystolic murmur?
- mitral regurgitation
- tricuspid regurgitation
- ventricular septal defect
What is Beck’s triad?
Triad of cardiac tamponade
- raised JVP
- hypotension
- muffled heart sounds
How does Papillary muscle rupture present?
- post MI if left ventricle affected (2-7 days later)
- acute mitral regurgitation (pan systolic murmur)
- pulmonary oedema
- cardiogenic shock
Papillary muscles attach to the tricupsid and mitral valve leaflets via chordae tendinae and prevent regurgitation
What is the murmur of mitral stenosis?
Diastolic rumbling murmur best heard at the apex
Opening snap
What is Brugada syndrome
- Mutation in cardiac sodium channels
- more common in East Asian people
- can present as sudden death
- or syncopal episode
- heart is structurally normal
- brugada sign on ECG
Treatment: ICD
45 year old patient with hypertension who is NOT diabetic what is the first line treatment
Ace inhibitor or ARB
75 year old patient with hypertension who is not diabetic what is the drug of choice?
Calcium channel blocker
65 year old patient with hypertension and diabetes what is the drug of choice
Ace inhibitor or ARB regardless of age
65 year old black woman with HTN
Black patients of any age - calcium channel blocker
65 year old black woman with HTN was started on amlodipine but c/o ankle swelling - what alternative should you give her
THIAZIDE LIKE DIURETIC e.g. Indapamide
What is the treatment for asyatole
Epinephrine / adrenaline
What is the first line treatment for sinus bradycardia if the patient is haemodynamically unstable?
Atropine
Coarctation of the aorta is associated with which congenital condition?
Turner syndrome
Why is adenosine used in SVT?
Stuns the AV node for a short period to terminate some causes of SVT
Half life of adenosine is seconds
What is Eisenmenger’s syndrome?
What is Dressler’s syndrome?
