Cardiology Flashcards
JVP A wave
Atrial contraction
JVP C wave
invisible flicker in x descent due to closure of tricuspid valve
JVP X descent
atrial stretch and drop in pressure due to downward movement of heart
JVP V wave
passive filling of blood into right atrium against closed tricuspid valve
JVP y descent
opening of tricuspid valve abd passive movement of blood from right atrium to right ventricle.
Absent A waves
atrial fibrrilation (no coordinataed contractions)
Large A waves
tricuspid stenosis
right heart failure
pulmonary hypertension
Cannon A waves
AV dissociation
- Atrial flutter and atrial tachycardias
- 3rd degree heart block
- VT, V ectopics
Giant v waves
tricuspid regurgitation
Steep x descent
Tricuspid stenosis
Tamponade (cardiac restriction)
Steep y descent
cardiac contriction
Slow y descent
Tricuspid stenosis
Early diastolic murmur
Aortic regurg
Aortic regurg
dyspnoea, orthopnoea etc
wide pulse pressure
nail bed pulsation (Quincke)
history of rheumatic fever
Machine like murmur
PDA
Ejection systolic murmur
AS
PS
ASD
Tetralogy
HOCM
Late systolic murmur
MV prolapse
Coarctation
Pansystolic murmur
MR
TR
VSD
Thiazide diuretic mechanism
inhibit sodium-chloride symporter in distal distal part of distal convoluted tubule -> high sodium load to distal part of distal tubule -> physiological secretion of potassium
THIAZIDE -> LOW POTASSIUM
Risk of asystole in bradycardia
complete HB with borad QRS
recent asystole
Mobitz II
V-pause >3s
When to pace in HF?
All of:
NYHA III- IV
LV EF >35% with dilated ventricle on optimal medical therapy
QRS >130ms
Beck triad of tamponade
Hypotension
muffled heart sound
distended neck veins
S3
Audible in children and young adults
Pathological in MR, VSD, CCF, pericarditis - anything that results in rapid LV filling
HOCM poor prognostic features
young at diagnosis
family history of sudden death
syncopal symptoms
VT on Holter
abnormal BP changes on exertion
Pericarditis ECG changes
Saddle ST elevation
PR depression
Bisferiens pulse
mixed aortic valve disease
Collpasing pulse
Aortic regurgitation
Slow rising
Aortic stenosis
Jerky pulse
HOCM
Alternanas pulse
Severe LVSD
- ejection fraction reduced meaning end diastolic volume elevated - > stretch of myocytes meaning ejection fraction of next beat is improved -> alternating strong and weak pulses
Pulsus paradoxus
excessive reduciton in pulse with inspiration (left ventricular compression, tamponade, severe asthma as venous return in compromised
LONG QT syndrome channels?
Long QT usually due to loss of function or blockage of potassium channels
RILE (murmurs)
- Right sided murmur heard best on inspiration
- Left sided murmur heard best on expiration
PR prolongation
IHD
DIg toxicity
Hypokalaemia
Aortic root abscess
Lyme
Sarcoid
idiopathic
AF in WPW
Avoid AV node blockers (may degenerate in to VF as accessory pthway preferred) i.e. bblockers, digoxin, verapamil
HOCM and ACEI?
Avoid
(anything that reduce preload/afterload such as nitrate, ACEI, nifedipine-type calcium antagonists
loop diuretic mechanism
inhibit Na-K-Cl cotransporter in thick ascending limb of loop of henle
reducing absorption of NaCl
Ostium primum ASD
RBBB with LAD
Ostium secundum ASD
RBBB with RAD
most sensitive ecg finding in pericarditis
PR depression
