Cardiology Flashcards
What are the ECG findings in hypokalaemia?
U waves Small or absent T waves Prolonged PR interval ST depression (in hypokalaemia you have no Pot and no Tea, but a long PR and a long QT)
On an ECG, which are the inferior leads?
II, III, aVF
On an ECG, which are the lateral leads?
I, aVL, V5, V6
On an ECG, which are the anterior leads?
V3, V4
On an ECG, which are the septal leads?
V1, V2
Which scoring system determines the need for anti-coagulants in AF?
CHA2DS2-VASc
Which scoring system identifies risk of stroke in patients who have had a TIA?
ABCD2
Which scoring system estimates the risk of major bleeding for patients with AF and on an anti-coagulant?
HAS-BLED
Which scoring system estimates the 10yr risk of a CV event?
QRISK3
What is an inotrope and describe the different types.
Inotrope = medicine that changes the force of the heart’s contractions
- positive inotropes strengthen the force of the heart beat
- negative inotropes weaken the force of the heart bean
What is Dressler’s syndrome?
Delayed secondary pericarditis following injury to the heart, e.g. MI, occurs 2-6 weeks post-injury
- -> fever, pleuritic pain, pericardial effusion, raised ESR
- treat with NSAIDs
What is the Valsalva manoeuvre?
Forced exhalation against closed airway (by closing mouth and holding nose)
In a stable patient with supraventricular tachycardia, what are the 1st and 2nd line treatment options?
1st = valsalva manoeuvre 2nd = IV adenosine
What ECG finding would indicate SVT?
Narrow complex tachycardia (sudden onset)
How does adenosine act on the heart?
Decreases heart rate and reduces conduction velocity, especially at the AV node
What is the 1st-line investigation in suspected PE?
CT pulmonary angiogram
2nd = V/Q scan
What ECG changes might you see in a patient with PE?
S1Q3T3 - large S wave in lead 1 - large Q wave in lead 3 - inverted T wave in lead 3 RBBB Right axis deviation
What is Takotsubo cardiomyopathy?
‘Broken heart syndrome’, also ‘apical ballooning syndrome’
Cardiomyopathy induced by severe stressful triggers
It is a differential for ST elevation in a patient with no obstructive coronary artery disease
Ototoxicity is a side effect of which medication?
Loop diuretics
What ECG features are associated with hypothermia?
Bradycardia J waves 1st degree heart block Long QT interval Atrial and ventricular arrhythmias
On an ECG, what are Q waves indicative of?
Previous MI
On an ECG, what are Delta waves a feature of?
Wolff-Parkinson White syndrome
On an ECG, what is saddle ST elevation associated with?
Pericarditis
Describe the murmur in aortic stenosis.
Ejection systolic
Aortic area
Radiating to carotids
Describe the murmur in tricuspid regurgitation.
Pansystolic
Tricuspid area
Radiates to 4th intercostal space
Describe the murmur in mitral regurgitation.
Pansystolic
Mitral area
Radiates to axilla
Describe the murmur in mitral stenosis.
Mid-diastolic
Mitral area
Radiates to axilla
Describe the murmur in aortic regurgitation.
Early diastolic
High-pitched and ‘blowing’ in character
What is an Austin-Flint murmur?
Severe aortic regurgitation
Mid-late diastolic
‘Rumbling’ in character
What is a Graham-Steel murmur?
Pulmonary regurgitation
High-pitched and ‘blowing’ in character (like aortic stenosis)
What heart murmur are you likely to find in Down’s Syndrome?
Harsh pansystolic murmur best heard at the left sternal edge
- due to ventricular septal defect
What is the treatment for Torsades de Pointes?
Magnesium sulphate
Name four ECG changes that are normal variants in athletes.
Sinus bradycardia
Junctional rhythm
1st degree heart block
Wenckeback phenomenon
What medication is contraindicated in aortic stenosis?
Nitrates (e.g. GTN spray) due to risk of hypotension
Name five ECG changes seen in hypothermia.
Bradycardia J wave (small hump at end of QRS complex) Long QT interval First degree heart block Atrial and ventricular arrhythmias
What is the reversal for warfain?
Prothrombin complex concentrate
What is the first line treatment for stable angina?
Beta blocker
What angina medication should be avoided with beta blockers?
Verapamil
