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Year 3 Revision > Cardiology > Flashcards

Cardiology Flashcards

(47 cards)

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1
Q

what are the causes of left heart failure?

A

ischemic heart disease
hypertension
valvulopathy
idiopathic cardiomyopathy

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2
Q

what are the causes of right heart failure?

A

left heart failure
cor pulmonale
tricuspid valvulopathy
left to right shunts

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3
Q

what are some precipitants of heart failure?

A

ischemia
infection
anemia
arrythmia

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4
Q

what is the MADHATTER3P mneumonic of heart failure?

A 
Myocardial infarction 
Anemia
Drugs (NSAIDs, negative inotropes, compliance) 
Hypertension
Arrythmia 
Thyrotoxicosis or hypothyroidism 
Temperature 
Endoarditis/eclempsia 
Renal failure/rupture of chordae 
3P: PE, peri-operative, pregnancy
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5
Q

what is the NYHC classification of heart failure?

A 
class 1: diagnosed but w/ symptoms 
class 2: symptoms upon exertion 
class 3: symptoms upon normal activity 
class 4: symptomatic at rest
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6
Q

what the symptoms of LHF vs RHF?

A

LHF: SOB, PND, orthopnea, chronic cough w/ pinkish sputum
RHF: ankle swelling, abdominal fullness, RUQ pain/tenderness, nausea

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7
Q

what are the signs of LHF vs RHF?

A

LHF: displaced apex beat, bibasal fine crackles
RHF: elevated JVP, peripheral oedema, congestive hepatomegaly
S3 = volume overload, S4 = pressure overload (diastolic heart failure)

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8
Q

what are the signs found on the CXR?

A 
A: alveolar oedema (bat wings) 
B: kerley B lines 
C: cardiomegaly 
D: upper lobe diversion 
E: pleural effusion
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9
Q

what are the signs found on the CXR?

A 
A: alveolar oedema (bat wings) 
B: kerley B lines 
C: cardiomegaly 
D: upper lobe diversion 
E: pleural effusion
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10
Q

what is the treatment of acute decompensated HF?

A 
DRABC 
stabilize patient
LMNOP (in reverse): 
sitting upright posture, O2 supplmentation 15L/min via mask, GTN sublingual every 5 minute up to 3X, moprhine 1.5 -2 mg IV, furosemide 40 - 100mg bolus IV 
correct any precipitants
monitor fluid status, sats, RR, ABG
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11
Q

what is the treatment of acute decompensated HF?

A 
DRABC 
stabilize patient
LMNOP (in reverse): 
sitting upright posture, O2 supplmentation 15L/min via mask, GTN sublingual every 5 minute up to 3X, moprhine 1.5 -2 mg IV, furosemide 40 - 100mg bolus IV 
correct any precipitants
monitor fluid status, sats, RR, ABG
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12
Q

what is the non pharmaceutical treatment for chronic HF

A 
salt restriction (2mg/day) and water restriction (2L/day) 
smoking cessation 
weight loss and diet modification 
limit caffeine 
daily weigh monitoring 
immunization
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13
Q

pharmaceutical treatment for chronic HF?

A

nyh1=ACE-I
nyh2= ACEI + BB
nyh3= ACEI + BB + spiro
nyh4 = ACEI + BB + spiro + digoxin

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14
Q

what are the s.e of digoxin?

A 
yellow vision
digoxin toxicity (reverse tick on ECG)
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15
Q

what are the s.e of spironolactone?

A 
painful gynecomastia (can change to eplenorone) 
hyperkalemia
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16
Q

what are the cardioselective beta blockers?

A

metoprolo, bisoprolol, nebivolol, carvedilol

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17
Q

what are the indications for BiV PPM for heart failure?

A

class 3, 4 NYHF, LVEF

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18
Q

what are the indications for cardiac defibrillator?

A

LVEF 3 months after CABG, LVEF

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19
Q

what are the indications for cardiac defibrillator?

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A

LVEF 3 months after CABG, LVEF

20
Q

what are the indications for BiV PPM for heart failure?

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A

class 3, 4 NYHF, LVEF

21
Q

what are the indications for cardiac defibrillator?

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A

LVEF 3 months after CABG, LVEF

22
Q

59/M gradually worsening CP over days, 2/24 Hx of central squeezing CP, occurred at rest, worse with exertion, Hx of IHD (previous MI with PCI), HTN, HLD, father and brother died from AMI; ECG shows sinus rhythm, trops and CK-MB normal

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A

unstable angina

23
Q

75/M increasingly frequent episodes of dizziness on standing; O/E slow rising pulse, systolic murmur radiating to carotids

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A

aortic stenosis

24
Q

24/F sudden sharp central CP, aggravated by movement, respiration and lying, relieved by sitting forward; vitals stable; ECG shows diffuse ST elevation

25
27/M gradual worsening SOB over 2/7, now SOB at 50m, a/w orthopnoea, PND; ECG and trops normal, TTE shows 4 chamber enlargement, EF 25%, normal valves and wall thickness
dilated cardiomyopathy
26
45/F, previously well, 1/52 Hx of fevers, SOB, palpitations; O/E pansystolic murmur radiating to axilla, Roth spots on fundoscopy, urine dipstick blood 2+; ECG shows complete heart block
infective endocarditis
27
22/M central CP while playing football; O/E ESM over left sternal edge; ECG shows LVH; he remarked that his uncle had died suddenly at 25yo on the football field
HOCM
28
22/M central CP while playing football; O/E ESM over left sternal edge; ECG shows LVH; he remarked that his uncle had died suddenly at 25yo on the football field
HOCM
29
what is the diagnostic criterion of myocardial infarction?
typical rise and fall of cardiac biomarker w/ at least one of the following: clinical symptoms of ischemia ecg ST elevation or new LBBB pathological q waves imaging evidence of loss of viable myocardium or new regional wall motion abnormality
30
what is the diagnostic criterion of myocardial infarction?
typical rise and fall of cardiac biomarker w/ at least one of the following: clinical symptoms of ischemia ecg ST elevation or new LBBB pathological q waves imaging evidence of loss of viable myocardium or new regional wall motion abnormality
31
what are the ECG and biomarker changes of ACS?
unstable angina - no trops raise, pain at rest, no ecg change NSTEMI -
32
what are top causes of aortic stenosis
rheumatic heart disease calcific disease congenital bicuspid valve/unicuspid valve
33
what are some features of acute rheumatic heart disease?
ashkoff bodies, ooooo??
34
what are the symptoms of aortic stenosis?
SAD on exertion | syncope comes first, and angina comes last
35
what are some findings of aortic stenosis
``` plateau pulse narrow pulse pressure non displaced apex beat heaving apex beat (pressure overload) presence of S4 ```
36
what are the ausculatation findings of AS
beast heard RHS 2nd intercosatal space parasternal ejection sytolic crescendo decrescendo s4 heart sound
37
what are the severity findings of AS
paraodoxical splitting of s2 absent a2 grade 4 intensity late peaking
38
what are the severity findings of AS
paraodoxical splitting of s2 (prolonged LV ejection time) absent a2 grade 4 intensity late peaking
39
what are some findings of AS on echo
thickened/calcifeid leafelts with reduced excursion | LV chamber normal size but concentrically hypertorphied
40
what are some findings of AS on echo
thickened/calcifeid leafelts with reduced excursion | LV chamber normal size but concentrically hypertorphied
41
what is the voltage criteria for ECG for LVH
s wave in v1 and tallest r wave in v5/v6 > 25 mm
42
what are the indications for AS surgical repair?
severe on echo + symptomatic | severe on echo + LVEF
43
what are the indications for AS surgical repair?
severe on echo + symptomatic | severe on echo + LVEF
44
what are the causes of acute AR?
IE dissecting aorta failure of prosthetic valve
45
what is the difference btwn acute and chronic AR presentation?
``` acute AR: low pitched early diastolic chronic AR (compensated); holo-diastolic decrescendo, high pitched blowing quality ``` acute AR presents as sudden CVS collapse, while chornic AR will present as a left ventricular failure patient chronic AR will have widened pulse pressure, while acute AR will experience acute hypotension
46
what is the difference btwn acute and chronic AR presentation?
``` acute AR: low pitched early diastolic chronic AR (compensated); holo-diastolic decrescendo, high pitched blowing quality ``` acute AR presents as sudden CVS collapse, while chornic AR will present as a left ventricular failure patient chronic AR will have widened pulse pressure, while acute AR will experience acute hypotension
47
differentiating between AR severity
mild AR = murmur only in early diastole and blowing severe = holodiastolic, displaced left ventriclar impulse, wide pulse pressure, as it gets more severe murmur may become soft or absent

Year 3 Revision (7 decks)

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