Cardiology Flashcards
What is Beck’s triad for cardiac tamponade?
1) Hypotension
2) Raised JVP
3) Muffled heart sounds
What is the most important cause of ventricular tachycardia?
Hypokalaemia
Followed by hypomagnesaemia
NOTE: severe hyperkalaemia can also cause in certain circumstances e.g. in patients with structural heart disease
What are the shockable rhythms? And their drug management?
1) Ventricular fibrillation
2) Pulsess VT
Management: Amiodaraone 300mg (or lidocaine), after 3 shocks
What are the non-shockable rhythms?
1) Asystole
2) PEA
When do you give adrenaline in cardiac arrest? Also what dose
Non-shockale- ASAP
Shockable- after 3rd shock
Repeat adrenaline every 3-5mins
Adrenaline 1mg
What are the reversible causes of cardiac arrest?
Hs:
Hypoxia
Hypovolaemia
Hypothermia
Hyperkalaemia, hypokalaemia, hypoglycaemia, hypocalcaemia, acidaemi and other metabolic disorders
Ts:
Thrombosis
Tension pneumothorax
Tamponade (cardiac)
Toxins
What is the drug management of angina?
1st line: beta-blocker or rate-limiting calcium channel blocker (e.g. verapamil or diltiazem)
2nd line: both (if used in combo with BB use elongating CCP e.g. amlodipine, MR nifedipine)
3rd line: long-acting nitrate, ivabradine, nicorandil, ranolazine (and refer for PCI/CABG)
What are the ECG changes caused by hypokalaemia?
1) U waves
2) small or absent t waves
3) Prolonged PR interval
4) St depression
5) long QT interval
What ECG changes do you expect with pericarditis?
Often global/widespread changes
1)’saddle-shaped ST elevation”
2) PR depression (most specific for pericarditis)
Side effects of GTN spray
Hypotension
Tachycardia
Headache
Characterise aortic regurgitation murmur?
Early diastolic
Loudest over R 2nd ICS sternal border
Characterise mitral regurgitation murmur?
Pansystolic
What are the complications of MI?
1) Cardiac arrest (VF- most common cause
2) Cardiogenic shock
3) Chronic heart failure
4) Tachyarrhythmia- e.g. VF
5) AV block after Inferior MI
6) Pericarditis- normally in first 48hrs
7) Dressler’s syndrome- 2-6 weeks later (fever, pleuritic pain, pericardial effusion and raised ESR)
8) Left ventricular aneurysm (persistent ST elevation LVF)
9) Left ventricular free wall rupture
10) Ventricular septal defect
11) Acute mitral regurgitation- acute hypotension and flash pulmonary oedema
Characterise aortic stenosis
narrow pulse pressure
slow rising pulse
a thrill palpable over the cardiac apex
a fourth heart sound (S4) indicative of left ventricular hypertrophy
a soft/absent S2
Causes of RBBB
1) normal variant - more common with increasing age
2) right ventricular hypertrophy
3) chronically increased right ventricular pressure - e.g. cor pulmonale
4) pulmonary embolism
5) myocardial infarction
6) atrial septal defect (ostium secundum)
7) cardiomyopathy or myocarditis
