Cardiology

Question 1

What are reversible causes of atrial fibrillation?

Answer 1

electrolytes, hyperthyroidism, sepsis **, volume status

Question 2

What is significance of S3 in young and old?

What is significance of S4 in young and old?

Answer 2

S3: worse prognostic sign in older people, S3 normal in youth
S4: pathologic in youth, S4 means stiff ventricle in older people

Question 3

A patient presents to ED a week after having STEMI with hypotension, muffled heart sounds and JVD, and found to have equalization of chamber pressures on RHC, diagnosis?

Answer 3

Beck’s triad signficant for cardiac tamponade

Question 4

An elderly male passes out while turning head in church. Diagnosis? and what test is indicated if this happens infrequently vs frequently?

Answer 4

Vaso-vagal syncope
Frequent: holter
Infrequent: tilt-table

Question 5

Old man passes out when moving from sitting to standing. Dx? What could be underlying pathophys cause?

Answer 5

Orthostatic hypotension

Adrenal insufficiency and autonomic dysfunction

Question 6

A patient passes out when lying or sitting and may feel palpitations. Dx? What could be indictable meds? EKG shows 3 distinct P waves and irregular, dx?

Answer 6

SVT or VT
QT prolonging meds (antipsychotics or TCAs)
MAT

Question 7

What are risks for sudden cardiac death?

Answer 7

Massive LV hypertrophy
Personal hx of syncope
FH sudden death
Hypotension with exercise