Cardiology Flashcards
Which anti-hypertensive/AF med should be stopped in HF?
CCBs
At what point do both micro and macroscropic changes become visible in cardiac tissue post MI?
12-24 hours post occlusion
Which artery supplies the left atrium?
Left circumflex artery
Which artery supplies the left ventricle?
Left marginal artery - branch of circumflex
Which cardiac defect is associated with turner’s syndrome?
Co-arctation of the aorta
Main 3 problems associated with Kartagener’s syndrome
Dextrocardia, bronchiectasis and infertility - last 2 due to ineffective cilia
Which cardiac defects are associated with Marfan’s syndrome?
Aortic root dilatation (causes aortic regurg), mitral valve prolapse and mitral regurg. Risk aortic dissection
Which cardiac defects are associated with congenital rubella syndrome?
PDA, ASD and pulmonary stenosis
What pulmonary artery systolic pressure is indicative of pulmonary hypertension?
> 30mmHg
Presentation of dilated cardiomyopathy
Left bundle branch block and right axis deviation - can present weeks to months post partum
Presentation of HOCM
Exertional syncope/pre-syncope. ECG shows LVH or asymmetrical septal hypertrophy
Cause of wolf-parkinson white
Abnormal congenital accessory pathway (bundle of Kent) bypassing AVN with episodes of tachyarrythmia. Allows a re-entry circuit
ECG signs of WPW
SHortened PR interval, Delta wave (slow upstroke of initial portion of the QRS complex) and QRS prolongation. ST segment and T wave are often in the opposite direction to the QRS complex. Can be exacerbated by valsalva manouvre.
Treatment for WPW
Only definitively treat when high risk of sudden cardiac death - radiofrequency catheter ablation. If low risk can offer pharmacological management for the tachyarrythmias,
What is wenkebache phenomenom?
2nd degree mobitz type 1 heart block - PR progressively gets longer until it drops a beat
Features of Marfan’s
Pectus excavatum, ectopic lentis, pes planus, high arched palate, recurrent pneumothorax, aortic root dilation, mitral prolapse and positive wrist and thumb signs
When would you hear VSD murmur?
Pan-systolic
What type of pacemaker mode is used in patients with chronic AF causing bradycardia?
VVI mode
What is pulsus paradoxus?
A decrease in SBP of >10mmHg upon inspiration - in pericarditis or pericardial effusion it is a sign of impending tamponade and circulatory collapse
If patient develops bundle branch block post MI, which vessel is most likely affected?
LAD
Treatment for symptomatic mobitz type 2 heart block?
Permanent pacing as can develop to complete heart block
Likely cause of large JVP V-wave
Tricuspid regurgitation
Features of tricuspid regurgitation
JVP v-wave, peripheral oedema, right ventiricular failure, Pan-systolic murmur, paradoxical splitting of second heart sound, pulsatile liver, tender hepatomegaly, ascites and right atrial hypertrophy
What is dressler sydrome?
A complication of transmural MI, weeks after initial infarct. Causes mild fever and pleuritic chest pain (exacerbated by lying down/relieved by sitting forward). Friction rub may be heard.
What does an opening snap in early diastole indicate?
Severe mitral stenosis
Which organism is most likely to cause rheumatic fever?
Group a strep aka strep pyogenes
What is kussmaul’s sign?
Distension od the jugular veins during inspiration whilst sitting up
Machinery like murmur in bady which is loud systolic extending into diastole
PDA
