Cardiology Flashcards
PR depression
Pericarditis
Chadvasc vs Hasbled
Scores after MI
Chadvasc - start anticoagulants
Hasbled - risk factors not to anticoagulatoon
Calcium chloride vs glutinate in hyperkalaemia
Calcium chloride contains about 3 times more elemental calcium than an equal volume of calcium gluconate. Therefore, when hyperkalaemia is accompanied by haemodynamic compromise, calcium chloride is preferred.
patient had PCI for MI but is now complaining of worsening chest pain
a few hours post PCI suggest the procedure has failed and that myocardial ischaemia is ongoing.
If patients treated with PCI for MI are experiencing pain or haemodynamic instability post PCI, urgent coronary artery bypass graft (CABG) is recommended.
just started warfarin + bruise
skin necrosis is a side effect
occurs within first 10 days of warfarin + INR is in therapeutic range
initially, warfarin is procoagulant so should be taken with heparin
caution with warfarin in what diseases/ drugs
liver disease
P450 inhibitors: amiodarone, ciprofloxacin
cranberry juice
NSAIDs- displace warfarin from albumin
raynaud’s + ischaemic limb disease
Beurger’s disease aka. thromboangiitis obliterans.
- small and medium vessel vasculitis
- smoking
- ischaemic ulcers
- intermittent claudication
- Raynaud’s
- superficial thrombophlebitis
gold standard test for pulmonary HTN?
right heart catheterization for pressures with Swan-Ganz catheter
what special test do you do in peripheral vascular disease
Buerger’s Test - elevate legs and look at angle it goes pale
ABPI cut off for critical limb ischaemia
ABPI<0.8 is critical - do not apply pressure bandage or worsen ischaemia!!!!
orthostatic hypotension treatment
fludocortisone
hypokalaemia ECG features
U waves, small/absent T waves, prolonged PR, ST depression, long QT
hypothermia ECG features
bradycardia, J wave, first degree heart block, long QT, arrythmias
what two very common cardiac drugs should not be used together because they cause severe bradycardia
verapmil, b-blockers
Eye findings infective endocarditis
Roth spots
Blood cultures INf endocarditis
3 cultures
From 3 sites
2 before abx
Acute infective endocarditis
Pseudomonas
Staph Aureus
Infective endocarditis symptoms
Myalgia Septic arthritis Poly arthritis Splenomegaly Heart failure PE Stroke Critical limb ischaemia
ABPI vessels used
Anterior and posterior tibial artery —— find using Doppler probe
Brachial artery
Signs of acute limb ischaemia
Unilateral 6Ps
Pain
Pale
Pulseless
Paraesthesia
Poikilothermia — adapt to environment either freezing or warm
Paralysis
Causes of acute limb ischaemia
Thrombotic
Emboli
Trauma
Iatrogenic - stop taking anticoagulants
Organism rheumatic fever
Group A
Beta- haemolytic
Streptococcus
Criteria for infective endocarditis vs rheumatic fever
Modified Duke’s (IE)
Modified Jones (rheum f)
Indications for heart surgery in infective endocarditis or rheum fever
Severe carditis
Severe valvular incompetence causing heart failure
Streptococcal rheumatic fever treatment
Admit and bed rest
IM benzypenicillin 1.2grams stat
Oral penicillin 10 days
Depending on severity of murmur patients may require long term/ lifelong (after surgery) antibiotic prophylaxis to prevent recurrence That could result in cardiac damage
Long term = 10 years/ until age 25
Lifelong = severe valve damage or surgery was needed
Ecg pericarditis
Widespread shaped ST elevation in leads where qrs complex is positive
IX for pericarditis
Serial ECGs
- widespread saddle ST elevation
Echocardiogram
- pericardial effusion
Troponin
- is the pericarditis secondary to a silent MI
- trop may be elevated if there is concurrent myocarditis
Mx pericarditis
NSAIDs
Pericardial effusion vs congestive HF
Both have cardiomegaly
CHF had pulmonary congestion (especially in hila)
Raised JVP in CHF or if pericardial tamponade
