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BPT Clinical > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Murmur - pansystolic

A

MR
TR
VSD
AP shunts

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2
Q

Murmur - mid-systolic

A

AS
PS
HOCM
ASD (pulmonary flow)

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3
Q

Murmur - early systolic

A

VSD
MR (acute)
TR

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4
Q

Murmur - late systolic

A

MV prolapse

Papillary muscle dysfunction (eg. HOCM)

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5
Q

Murmur - early diastolic

A

AR

PR

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6
Q

Murmur - mid-diastolic

A 
MS
TS
Atrial myxoma
AR (Austin Flint)
Rheumatic fever (Carey Coombs)
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7
Q

Murmur - pre-systolic

A

MS
TS
Atrial myxoma

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8
Q

Murmur - continuous

A 
PDA
AV fistula
Venous hum
Sinus of Valsalva rupture
AP connection
Mammary souffle
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9
Q

JVP - dominant a wave

A

TS
PS
Pulmonary HTN

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10
Q

JVP - dominant v wave

A

TR

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11
Q

JVP - cannon a wave

A

Complete heart block
Paroxysmal nodal tachycardia (with retrograde atrial conduction)
VT (with retrograde atrial conduction, or AV dissociation)

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12
Q

JVP - elevated CVP

A 
RV failure
TS or TR
Pericardial effusion
Constrictive pericarditis
SVC obstruction
Fluid overload
Hyperdynamic circulation
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13
Q

Hyperdynamic circulation - causes

A 
Fever
Anaemia
Thyrotoxicosis
AV fistula
Pregnancy
Exercise
Beri beri
Hypoxia
Hypercapnia
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14
Q

Pulse - anacrotic

A

AS

small volume, slow upstroke, a wave on upstroke

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15
Q

Pulse - plateau

A

AS

slow upstroke

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16
Q

Pulse - bisferiens

A

AS plus AR

anacrotic plus collapsing

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17
Q

Pulse - collapsing (waterhammer)

A 
AR
PDA
Hyperdynamic circulation
Arteriosclerotic aorta
Peripheral AV aneurysm
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18
Q

Pulse - small volume

A

AS

Pericardial effusion

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19
Q

Pulse - alternans

A

LV failure

alternating strong and weak beats

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20
Q

Apex - pressure-loaded

A

AS
HTN

(hyperdynamic, systolic overloaded)
(forceful, sustained impulse)

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21
Q

Apex - volume-loaded

A

MR
AR

(hyperkinetic, diastolic overloaded)
(forceful, unsustained impulse)

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22
Q

Apex - tapping beat

A

MS

palpable 1st heart sound

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23
Q

Apex - double/triple impulse

A

HOCM

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24
Q

Apex - dyskinetic

A

Previous large MI

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25
Q

Heart sounds - loud S1

A

MS
TS
Tachycardia
Hyperdynamic circulation

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26
Q

Heart sounds - soft S1

A

MR
Calcified mitral valve
LBBB
1st degree HB

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27
Q

Heart sounds - loud A2

A

Congenital AS

Systemic HTN

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28
Q

Heart sounds - soft A2

A

AR

Calcified aortic valve

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29
Q

Heart sounds - loud P2

A

Pulmonary HTN

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30
Q

Heart sounds - soft P2

A

PS

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31
Q

Heart sounds - S2 increased splitting on inspiration

A

RBBB
PS
VSD
MR

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32
Q

Heart sounds - S2 fixed splitting

A

ASD

33
Q

Heart sounds - S2 reversed splitting

P2 first

A

LBBB
AS
Coarctation of aorta
PDA (large)

34
Q

Heart sounds - LV S3

louder at apex, on expiration

A 
Physiological
LV failure
AR
MR
VSD
PDA
35
Q

Heart sounds - RV S3

louder left sternal edge, on inspiration

A

RV failure

Constrictive pericarditis

36
Q

Heart sounds - LV S4

louder at apex, on expiration

A 
AS
MR (acute)
HTN
IHD
HOCM
37
Q

Heart sounds - RV S4

louder left sternal edge, on inspiration

A

Pulmonary HTN

PS

38
Q

Pulmonary hypertension - signs

A 
Prominent a wave JVP
RV impulse
Loud P2
PR
TR
39
Q

Mitral stenosis - causes

A

Rheumatic

Congenital (rare)

40
Q

Mitral stenosis - signs of severity

A 
Small pulse pressure
Diastolic thrill at apex
Pulmonary HTN
Early opening snap
Long mid-diastolic rumbling murmur
41
Q

Mitral stenosis - ECG

A

P mitrale (in SR)
AF
RV systolic overload
RAD

42
Q

Mitral stenosis - CXR

A

Mitral valve calcification
Large LA - double LA shadow, displaced left main bronchus, big left atrial appendage
Pulmonary HTN - large central pulmonary arteries, pruned peripheral artery tree
Cardiac failure signs

43
Q

Mitral stenosis - surgical indications

A

Not responding to medical therapy

  • Progressive dyspnoea
  • Pulmonary oedema
  • Major haemoptysis

Valve area ≤1cm

44
Q

Mitral regurgitation - causes (chronic)

A

Degenerative disease
Mitral valve prolapse
Rheumatic
Papillary muscle dysfunction (LV failure, ischaemia)
Connective tissue disease (RA, ank spond)
Congenital (ASD, parachute valve, corrected transposition)

45
Q

Mitral regurgitation - causes (acute)

A

Infective endocarditis
MI
Surgery
Trauma

46
Q

Mitral regurgitation - signs of severity

A 
Small volume pulse
Enlarged LV
Pulmonary HTN
Soft S1
Early A2
S3
Early diastolic rumble
LV failure
47
Q

Mitral regurgitation - ECG

A

P mitrale
AF
LV diastolic overload
RAD

48
Q

Mitral regurgitation - CXR

A

Large LA
Large LV size
Mitral annular calcification
Pulmonary HTN

49
Q

Mitral regurgitation - surgical indications

A

Class III or IV symptoms
LV dysfunction
Progressive LV dimension increase

50
Q

Mitral valve prolapse - signs

A

Systolic click

  • Valsalva (murmur longer, click earlier)
  • Handgrip (murmur shorter)
51
Q

Mitral valve prolapse - associations

A

Marfans
ASD
Anorexia nervosa

52
Q

Aortic regurgitation - causes (chronic)

A 
Rheumatic
Congenital
Seronegative arthropathy
Marfans
Aortitis
Dissecting aneurysm
Old age
53
Q

Aortic regurgitation - causes (acute)

A

Infective endocarditis
Marfans
HTN
Dissecting aneurysm

54
Q

Aortic regurgitation - signs of severity

A 
Collapsing pulse
Wide pulse pressure
S3
Soft A2
Decrescendo diastolic murmur length
Austin Flint murmur
LV failure
55
Q

Aortic regurgitation - ECG

A

LV hypertrophy

56
Q

Aortic regurgitation - CXR

A

LV dilation
Aortic root dilatation / aneurysm
Valve calcification

57
Q

Aortic regurgitation - surgical indications

A

Symptoms (dyspnoea on exertion)
LV function (low EF)
Progressive LV dilatation (LVESD more than 5.5 cm)

58
Q

Aortic stenosis - causes

A

Degenerative (senile, calcific)
Rheumatic (rare in isolation)
Calcific bicuspid valve

59
Q

Aortic stenosis - signs of severity

A 
Plateau pulse
Aortic thrill
Paradoxical splitting S2
S4
Systolic murmur (long, late, harsh peak)
LV failure
60
Q

Aortic stenosis - ECG

A

LV hypertrophy

61
Q

Aortic stenosis - CXR

A

LV hypertrophy

Valve calcification

62
Q

Aortic stenosis - surgical indications

A 
Symptoms (exertional angina, dyspnoea, syncope)
Critical obstruction (area less than 0.7 cm²/m², or valve gradient less than 70 mmHg)
63
Q

Tricuspid regurgitation - causes

A 
Functional (RV failure)
Rheumatic
Infective endocarditis
Congenital (Ebstein's anomaly)
Tricuspid valve prolapse
RV papillary muscle infarction
Trauma
64
Q

Tricuspid regurgitation - signs of severity

A 
JVP dominant v wave
RV heave
Pansystolic murmur (lower sternum, inspiration)
Pulsatile liver
Oedema, ascites, pleural effusion
65
Q

Tricuspid regurgitation - CXR

A

RV or biventricular enlargement

Box-shaped heart, narrow cardiac base (Ebstein’s anomaly)

66
Q

Pulmonary stenosis - causes

A

Congenital

Carcinoid syndrome

67
Q

Pulmonary stenosis - clinical signs

A 
Peripheral cyanosis
Reduced pulse
JVP dominant a wave, elevated
RV heave
Thrill (pulmonary area)
S4
Ejection systolic murmur (pulmonary area, inspiration louder)
Pulsatile liver (presystolic)
(Signs of severity:
Late peaking ESM
Absence of ejection click
S4
RV failure)
68
Q

Constrictive pericarditis - clinical signs

A 
Low BP
Pulsus paradoxus
JVP (raised, Kussmaul's sign, prominent x and y descent)
Apex beat impalpable
S3
Hepatosplenomegaly
Oedema/ascites
69
Q

Hypertrophic cardiomyopathy - clinical signs

A 
Pulse (sharp, jerky)
JVP prominent a wave
Apex double/triple impulse
S4
Late ESM (left sternal edge)
PSM (apex due to MR)
Valsalva (louder murmur)
70
Q

Hypertrophic cardiomyopathy - ECG

A

LV hypertrophy
Lateral ST segment / T wave changes
Deep Q waves
Conduction defects

71
Q

Hypertrophic cardiomyopathy - CXR

A

LV enlarged, hump along border

No valve calcification

72
Q

Atrial septal defect - clinical signs

A

Fixed splitting S2
Pulmonary ESM (louder inspiration)
Pulmonary HTN

73
Q

Atrial septal defect - ECG

A

RAD
RBBB
RV hypertrophy

74
Q

Atrial septal defect - CXR

A

Increased pulmonary vasculature
Enlarged RA and RV
dilated pulmonary artery
Small aortic knob

75
Q

Atrial septal defect - surgical indications

A

Left to right shunt 1.5 to 1

76
Q

Ventricular septal defect - clinical signs

A 
Pansystolic murmur (left sternal edge, louder expiration)
MR

(associated Down syndrome)

77
Q

Ventricular septal defect - ECG

A

LV hypertrophy

78
Q

Ventricular septal defect - CXR

A

LV hypertrophy
Increased pulmonary vasculature
Enlarge RV

79
Q

Ventricular septal defect - surgical indications

A

Left to right shunt more than 1.5 to 1

BPT Clinical (7 decks)

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