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Basic Physician's Training Monash > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Indications for AICD

A
  • 2o Prevention: Hx VT/VF arrest, sustained/symptomatic VT
  • Hereditary cardiac conditions w High risk SCD: HOCM, LQT, ARVD, Brugada
  • LVEF <30%, >1month post MI
  • CCF/CM- LVEF <35%
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2
Q

Indications for PPM

A
  • Irreversible symptomatic Bradycardiac
  • CHB, 2nd degree HB
  • Bi, Tri fascicular block + recurrent syncope
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3
Q

Indications for CRT

A
  • EF<35%
  • SR
  • QRS>150
  • NYHA II despite OMT
    can use in AF but has to have another indication for pacing and high expected need for pacing
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4
Q

Heart Transplant referral Indications

A

Intractable HF NYHA III-IV

When you have to start downtitrating HF management

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5
Q

Heart Transplant contraindications

A

Malignancy
Other organ failure
Active infection
Poor compliance

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6
Q

Torsades-de-points ECG findings

A

VT with multiple ventricular foci

QRS complexes varying in amplitude, axis and duration

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7
Q

Long QT ECG findings

A

Men: >0.45
Women: >0.47
correct for HR + age. QRS must be normal

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8
Q

KVLQT1/KCNQ1

A

Long QT 1 - regulates K channels

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9
Q

HERG

A

Long QT2 - regulates K channels

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10
Q

SCN5A Increase

A

Long QT3- regulates Na channels

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11
Q

SCN5A Decrease

A

Brugada Syndrome

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12
Q

LQT1 ECG

A

Hill like/peaked T wave

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13
Q

LQT2 ECG

A

U wave within T wave

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14
Q

LQT3 ECG

A

long ST segment

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15
Q

Brugada ECG + Inheritance

A

Right precordial ST Elevation on ECG

Autosomal Dominance

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16
Q

ARVD ECG findings

A
  • Epsilon wave
  • T wave inversion in V1-3
  • Prolonged S-wave upstroke of 55ms in V1-3
  • Localised QRS widening of 110ms in V1-3
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17
Q

Severe Mitral Stenosis

A

Mean gradient >10mmHg

Valve Area <1.0 cm2

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18
Q

Severe Aortic Stenosis

A

Mean Gradient > 40mmHg
Valve Area <1cm2
Velocity >4m/s
DI <0.25

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19
Q

Impaired Diastolic filling
Abnormal septal motion
Exaggerated x descent

A

Pericardial Tamponade

20
Q 
Rapid early diastolic filling, delayed late diastolic filling
Kussmaul sign
Septal bounce
Ventricular interdependence
Exaggerated x descent
Sharp y descent
A

Constrictive Pericarditis

21
Q

Impaired Diastolic filling
Kussmaul sign
LVEDP > RVEDP by 5mmHg

A

Restrictive cardiomyopathy

22
Q

MoA of Ezetimibe

A

down-regulates ABCA-1 transporter (gut absorption)

23
Q

Target of Evolocumab

A

PCSK9

24
Q

Target of Alirocumab

A

PCSK9

25
Q

JVP- Dominant a wave

A

pulmonary hypertension, TS, PS

26
Q

JVP- Cannon a wave

A

complete heart block, VT with AV dissociation

27
Q

JVP- Dominant v wave

A

TR

28
Q

JVP- Sharp y descent

A

severe TR, constrictive pericarditis

29
Q

JVP- Prominent x and y descent

A

RV infarction

30
Q

Valve Replacement- AR

A

Severe AR with symptoms
Severe AR with resting LVEF <50% even if asymptomatic Severe AR undergoing CABG or surgery of ascending aorta or another valve

31
Q

Valve Replacement- AS

A
  • Severe AS with high gradient and symptoms
  • Severe AS undergoing CABG or surgery of ascending aorta or of another valve
  • Asymptomatic patients with severe AS and LVEF <50% not due to another cause
  • AS symptoms with exercise TTE showing symptoms are AS related
32
Q

Percutaneous Valvuloplasty- MS

A
  • Symptoms + Mod/Sev MS
  • Asymptomatic. Mod/Sev MS with:
  • -High risk HD compromise (PulmHT, desire for pregnancy)
  • -High thromboembolic risk
33
Q

Aortic Stenosis Examination Findings

A 
Slow rising pulse
S4
Paradoxical splitting of the second heart sound
Aortic thrill
Length and harshness of murmur
LVH – displaced apex beat
LVF – a late sign
34
Q

Mitral Stenosis Examination Findings

A 
Small pulse pressure
Soft first heart sound
Early opening snap
Long diastolic murmur
Diastolic thrill @ apex
PHT signs
35
Q

Mitral Regurgitation Examination Findings

A 
Small volume pulse
Displaced forceful apex
Pansystolic murmur -> axilla
S3
Soft S1
A2 early
Early diastolic rumble
AF
LVF signs
36
Q

Aortic Regurgitation Examination Findings

A 
Collapsing pulse
Wide pulse pressure
Long decrescendo diastolic murmur
S3
Soft A2
Austin Flint murmur (low pitched rumbling mid-diastolic and presystolic murmur @ apex)
LVF
37
Q

Mitral Valve Prolapse Examination Findings

A

Click -> high pitched late-systolic murmur extending throughout systole

38
Q

Tricuspid Regurgitation Examination Findings

A 
JVP: Large v-waves, elevated
Right ventricular heave
Pansystolic murmur @ the lower sternal edge (increases with inspiration)
Large, pulsatile liver
Ascites
Peripheral oedema
39
Q

Pulmonary Stenosis Examination Findings

A

Ejection systolic murmur peaking late in systole
Absent ejection click
S4
RVF signs

40
Q

ASD Examination Findings

A

wide fixed splitting of S2

mid diastolic flow murmur over tricuspid area (when significant shunt present)

41
Q

VSD Examination Findings

A

harsh pansystolic murmur @ left sternal edge
systolic thrill
mid diastolic flow murmur over mitral area (when significant shunt present)

42
Q

Patent Ductus Arteriosus Examination Findings

A

continuous murmur over pulmonary area

mid diastolic flow murmur over mitral area (when significant shunt present)

43
Q

Features of a cholesterol emboli

A

Levido reticularis
Purpura
Renail failure
Eosinophilia

44
Q

Poor prognostic features of HOCM

A

syncope
family history of sudden death
young age at presentation
non-sustained ventricular tachycardia on 24 or 48-hour Holter monitoring
abnormal blood pressure changes on exercise

45
Q

Features suggesting VT rather than SVT with aberrant conduction

A 
AV dissociation
fusion or capture beats
positive QRS concordance in chest leads
marked left axis deviation
history of IHD
lack of response to adenosine or carotid sinus massage
QRS > 160 ms

Basic Physician's Training Monash (16 decks)

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