Cardiology Flashcards
Myoglobin
First to rise 1-2 hrs
Peak 6-8hrs
Normal at 1-2days
Ck-MB
2-6hrs
Peak 16-20
Normalised 2-3days
CK
4-8hrs
Peak 16-24hrs
Normaised 3-4days
Trop T
4-6hrs
Peak 12-24
Normalised 7-10days
AST
12-24hra
Peak 36-48
Normalised 3-4data
LDH
24-48hrs
Peak 72hrs
Normalised 8-10 days
Thin filaments
Troponin
Tropomyosin
Actin
Thick filaments
Myosin
Atrial conduction
1m/s
AV node conduction
0.05m/s
Ventricular conduction
Large diameter Purkinje fibres 2-4m/s
Quincke’s sign
AR
Nail bed fluctuations
Corrigan’s pulse
AR
Water hammer pulse
Collapsing radial pulse
Corrigan’s sign
Visible carotid pulsation
AR
De Musset’s sign
AR
Head nodding with each systole
Duroziez’s sign
AR moderate severity
Audible femoral bruits with diastolic flow
Traube’s sign
AR
Pistol shot femorals
Austin Flint murmur
AR
Functional mitral diastolic flow murmur
Argyll Robertson pupils
Syphilis
Assoc with AR and syphylitic aortitis
Muller’s sign
AR
Pulsatation of the uvula
Mitral stenosis
Rheumatic fever Two thirds female Mid diastolic Opening snap LLP Radiates to Scilla
Mitral regurgitation
MV prolapse, LV dilatation, post Mi, rheumatic fever, connective tissue disorder
Blowing PSM
LLP
Axilla
Aortic stenosis
Triad: angina, dysponea and syncope
Severe: gradients >60mmHg and valve area <0.5cm2
Bicuspid valve, degenerative calcification, rheumatic fever
Mitral valve prolapse
5% More common females Chest pains/palpitations/fatigue/asx Acid mucopolysaccharide deposit Myxomatosis degeneration
Click Increased by squatting, murmur by standing
Risks; emboli, rupture, dysrhytmias with prolonged QT,cardiac neurosis, sudden death
Machinery murmur
PDA
Pulmonary trunk -> descending aorta
Graham Steels murmur
Pulmonary regurg
Causes: severe MS, Eisenmenger syndrome
Tetralogy of Fallot
Pulmonary stenosis RV hypertrophy VSD Overriding of the aorta 25% rusher sided aortic knuckle
Pansystolic murmur
MR
VSD
CHADSVAS
Score for anticoagulant in AF Congestive HF HTN Age >75 2, 65-74 1 Diabetes Vascular disease Female
Oral anticoag if 2+
HASBLED
Anticoagulant in AF
HTN Abnormal liver function Abnormal renal function Stroke Bleeding Labour LFTS Elderly Drugs Alcohol
Adenosine
Used in SVT - transient heart block at AV node
Agonist A1 receptor which inhibits adenyl Cyclades reducing cAMP causing hyperparization by outwards potassium flux
Enhanced by dipyridamole
Reduced by aminophylline
DEAR
Avoid in asthmatics
Catecholamine polymorphic VT
AD inherited
Commonly defect in Ryan I’d INR receptor RYR2 in sarcoplasmic reticulum
Exercise or emotion induced -> syncope
Symptoms <20yrs
Tx: b blockers, ICD
Methyldola
Centrally acting
Anti hypertensive used in pregnancy
Moxonidine
Centrally acting
Used if conventional tx failed
Clonidine
Centrally acting anti-HTN
Stimulates alpha2 adrenoreceptors in vasomotor centre
MUGA scan
Multi gated acquisition scan
Nuclear imaging
Measure LV function
Use in cardio toxics
GRACE score
NSTEMI 6 month mortality
<1.5% aspirin
1.5-3 aspirin and clopidogrel, OP imaging
3-6 and 6-9 and >9% glycoprotein inhib and angiography <96hrs
Aspirin
Anti platelet
Inhibits production of thromboxane A2
Clopidogrel
Anti platelet
Inhibits ADP binding to platelet receptor
Enoxaparin
Activates antithrombin 3
Potentiates inhibition of coag factor Xa
Bivirudin
Reversible direct thrombin inhibitor
Rheumatic fever
Group A strep
Duckett Jones criteria, 2 maj or 1maj/1minor
Major: carditis, polyarthritis, erythema marginatum, subcutaneous nodules, chorea
Minor: fever, arthralgia, prv RHD, high ESR and CRP, prolonged PR interval
