Cardiology

Question 0

Myocardial infarction

Answer 0

Basic management: BOOMAR
Bed rest, opiates, oxygen, monitor, anti coagulate, reduce clot size
Presentation: crushing central chest pain, shortness of breath, pain radiating to left arm or jaw

Question 1

Aortic stenosis

Answer 1

SAD: syncope, angina, dyspnoea
Systolic murmur at right upper sternal border
Left ventricular hypertrophy

Question 2

Acute limb ischaemia

Answer 2

Pulseless, paraesthesia, pain, paralysis, pallor, perishing cold
Give thrombolytic factor eg tissue plasminogen activator via local arterial catheter or open surgery/angioplasty

Question 3

Aneurysm and AAA

Answer 3

Often symptomless show up incidentally
US used to stage
If greater than 5.5 cm treat with open laparotomy
Dissection: sudden onset severe pain radiating to back, collapse, expansile abdo mass, shock, hypotension, profound anaemia

Question 4

Pulmonary embolism

Answer 4

sudden dyspnoea and pleuritic chest pain
calf pain/swelling
RF: current combined pill user/malignancy/recent surgery
Management: LMWH

Question 5

Pericarditis

Answer 5

sharp pain relieved by sitting forwards
may be pleuritic in nature
Diagnosis with ECG which shows ST elevation in all leads
treat with NSAIDS or surgery in extreme cases

Question 6

MI - left circumflex artery

Answer 6

ST elevation in leads V5+6

Question 7

MI - LAD

Answer 7

ST elevation in leads V1-4

Question 8

MI - right anterior descending

Answer 8

ST elevation in leads 2,3, and aVF

Question 9

Mitral stenosis

Answer 9

Hx of rheumatic fever
Px breathlessness and AF
O/E malar flush, tapping apex beat and right ventricular heave, mid diastolic murmur