Cardiology Flashcards
Systolic murmurs
Aortic stenosis
Pulmonary stenosis
Tricuspid regurgitation
Mitral regurgitation
Aortic stenosis
Crescendo-decrescendo murmur radiating to carotids
Ejection systolic murmur
LV hypertrophy on ECG. Echo. CXR
Surgical valve replacement or transcatheter replacement then warfarin, consider abx prophylaxis
Mitral regurgitation
Holosystolic murmur
Radiates to axilla
Rheumatic fever
TTE, ECG, CXR. Surgical repair/replace
Tricuspid regurgitation
Holosystolic murmur
IVDU, HIV, hepatitis
Mitral stenosis
Mid-late diastolic rumbling murmur
Malar flush
Opening snap (OS=MS)
Rheumatic fever
Balloon valvotomy
Aortic regurgitation
Early diastolic murmur
Collapsing pulse
Infective endocarditis
ST-T wave changes on ECG, also colour Doppler and CXR. Aortic valve replacement.
Varicose veins
Permanently dilated SC veins. Risk factors - age, FH, female, DVT.
Assess for reflux w/ duplex USS.
Treat - thermal ablation, phlebectomy, foam sclerotherapy.
Sclerotherapy
Administer local anaesthetic. Clean leg with antiseptic. Mark vein. Elevate leg then inject foam under ultrasound guidance. Sclerosant is made into foam and injected to fill the vein. This blocks the vein, stops blood flow and destroys it.
Complications include pigmentation, headaches, and visual changes.
Ruptured abdominal aortic aneurysm
Usually asymptomatic but if rupture - abdo/flank/back pain, shock, LOC
Exam - hyperlipids, Marfan, scars, distention, renal bruit, shock
Rupture - ABCDE, aortic USS, bloods, ?CT angio. Cannula, analg, abx, BP 70-90
Abdominal aortic aneurysm screening
Single ultrasound at 65.
Under 3cm - discharge.
3 - 4.4cm - annual USS
4.5 - 5.4 cm - 3 monthly USS
5.5 cm - 2 week wait to vascular
Abdominal aortic aneurysm elective management
Lifestyle - stop smoking, aspirin, statin, hypertension management
Cross-match 2 units RBCs
EVAR (stent graft) if woman, comorbid or age > 70 - low hospital stay, high long-term complications incl endoleak
Open aortic repair - laparotomy
Congestive heart failure management
Conservative - lifestyle, exercise, cardiac rehab
Ramipril + bisoprolol + spironolactone + dapagliflozin
Refer to specialist - consider inotropes, LVAD, transplant
SVT management in stable patients
start continuous cardiac monitoring
1) valsalva maneouvre
2) carotid sinus massage
3) adenosine - AV node blockade - give as a rapid bolus unless asthma, COPD, heart failure or block + warn abt doom
6mg > 12mg > 12mg
SVT management in unstable patients
synchronised (to R waves) DC shock under sedation
no shock during T wave > VF
then consider B blockers, CCBs, ablation
