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BPT annoying facts > Cardiology 2 > Flashcards

Cardiology 2 Flashcards

1
Q

Most specific feature of VT on ECG?

A

AV dissociation on ECG

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2
Q

Commonest form of SVT?

A

AVNRT

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3
Q

Wide QRS complex mechanism?

QRS = QAT

A
  • QRS going through another pathway in the BBB
  • Anterograde bypass pathway - prolongs QRS
  • Tachycardia of atrial origin - takes longer to engage Purkinje of his fibres
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4
Q

Narrow QRS complex mechanism?

RS

A

Re-entry circuit ( commonest cause)

Simultaneous firing down of Purkinje of his fibres down both bundle pathway

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5
Q

Long QT - prone to Sudden cardiac death when?

Treatment for Long QT?

A

QTc > 500 msecs

Primary prevention = B-blockers
Secondary prevention = ICD

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6
Q

Most likely cause of Sudden cardiac death in adulthood ( < 40 yrs old)

Treatment of that condition?

A

HOCM

HOCM
Primary prevention = B-blockers
Secondary prevention = ICD

*Special
Septal LV thickness = ETOH injection
Concentric = surgical myotomy

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7
Q

When suspecting Brugada - do what?

A

Flecainide challenge

-ECG will show down slopping ST + RBBB

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8
Q

What usually cause Rheumatic MS?

A

B-hemolytic streptococcal infection

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9
Q

Indications of MR replacement?

A

Symptomatic = EF > 30%

Asymptomatic = EF < 50% / new AF or pHTN/ CABGs

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10
Q

Indications of AR replacement?

A

Symptomatic

Asymptomatic = EF < 50% / Aortic root dilatation > 5.5 cm / 5 cm in Marfan

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11
Q

Indications of MS replacement?

A

Valve area < 1.5 cm + Rheumatic heart disease

New AF/ pHTN

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12
Q

Indications of AS replacement?

A

Symptomatic - but can’t have open heart surgery

Asymptomatic - Reduced EF

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13
Q

Indications of Mitral clip?

A

MR with Heart failure!

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14
Q

Indications of percutaneous mitral commisurotomy?

A

Left atrial thrombus
Severe MR
Contraindicated to surgery

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15
Q

Having what heart condition - not advisable to get pregnant?

A

pHTN > 35 mmHg = abortion
EF < 40%

Left obstructive valve defects - MS/AS = high mortality!

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16
Q

Surgical intervention for IE indications?

A

1.Severe MR/AR causing HR with pulmonary oedema
2.Fever and blood culture positive despite 7 days IV abx
3.Fungal infection
4.Extension of infection, abscess into perivalvular tissue +/- perforation
*
Abscess > 20 cm in right side
Abscess > 10 cm in left side

17
Q

How strep pneumococcus causing sudden cardiac death/arrythmias?

A

Pneumolysin ( Choline-binding peptide A) - damage heart

Activate PAFR

18
Q

Commonest cause of restrictive cardiomyopathy?

A

Amyloidosis - wild type, restriction leads to left sided HF

19
Q

Commonest cause of Constrictive cardiomyopathy?

A

TB - constrictive leads to right sided HF

20
Q

Elevated PVR ( > 3 Woods unit) means

A

fixed vascular disease! in setting of pulmonary hypertension

21
Q

Vasoreactive definition in pulmonary hypertension?

A

reduction in mPAP after vasodilators by 10 mmHG = dihydropyridine CCB

22
Q

Congenital bicuspid aortic - need to investigate for what condition?

A
  1. Coarctation of aorta

2. Shunts!

23
Q

what’s common complication post Tetralogy of fallot repair?

A

Pulmonary regurgitation

24
Q

in what condition when aortic root dilatation > 5cm - surgery indicated?

A

Marfan

Bicuspid AV

25
Q

AL or ATTR amyloidosis - which one better prognosis?

A

ATTR amyloidosis

26
Q

What do you see on echo of cardiac amyloidosis?

A

‘Apical sparing’ pattern, granular appearance

27
Q

chronotropic effects what?

Inotropic effects what? affected by what?

A

Chronotropic = Heart rate

Inotropic = Contractility
Acidosis - reduces contractility

28
Q

keith-wagner grade for hypertensive retinopathy?

A

Grade 1 = isolated narrowing of arterioles
Grade 2 = arterio-venous nicking
Grade 3 = Hypertensive retinal hemorrhage/exudates
Grade 4 = papilloedema ( blurred margin optic disc)

29
Q

MS is severe when what is present?

A

Transmitral gradient > 1 0 mmHG
Mitral valve area < 1.5 cm2
Enlarge left atrium
pHTN

30
Q

Dilated cardiomyopathy - what is seen on ECHO?

A

Regional wall abnormality but non-coronary distribution

31
Q

Right coronary artery supplies what mainly?

A

SA node
AV node
Bundle of His

32
Q

Left Anterior Descending Artery supplies what mainly?

A

Main and proximal Left bundle branch

33
Q

What artery mainly supplies RBB?

A

LAD - septal perforators

BPT annoying facts (62 decks)

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