Cardiology Flashcards
Which ECG leads represent the inferior aspect of the heart?
II, III, aVF
Which ECG leads represent the anterolateral aspect of the heart?
I, aVL, V5, V6
Which ECG leads represent the anteroseptal aspect of the heart?
V2, V3, V4
Which ECG leads represent the anterior aspect of the heart?
V2-V6
Which ECG leads represent the posterior aspect of the heart?
Read upside down, V1-V3
State at least 3 causes of right axis deviation
Anterolateral MI, right ventricular hypertrophy, PE, left posterior hemiblock in Wolff Parkinson White, ASD secundum
State at least 3 causes of left axis deviation
Inferior MI, left ventricular hypertrophy, left anterior hemiblock in Wolff Parkinson White, ASD primum
State at least 5 causes of AF
Ischaemic heart disease, rheumatic heart disease, thyrotoxicosis, hypertension, alcohol, pneumonia, PE, hypokalaemia, RA
State at least 5 contraindications to thrombolysis
Aortic dissection, GI bleeding, previous allergic reaction, recent surgery, brain tumour, previous stroke, severe hypertension systolic over 200, trauma
Name at least 4 causes of high output heart failure
Anaemia, arteriovenous malformation, thyrotoxicosis, thiamine deficiency (beriberi), pregnancy, Pagets disease of bone
State 3 causes of right ventricular failure
Left ventricular failure, cor pulmonale, tricuspid valve disease, pulmonary valve disease
State 4 causes of left ventricular failure
Ischaemic heart disease, idiopathic dilated cardiomyopathy, systemic hypertension, mitral valve disease, aortic valve disease
Describe the New York Heart Association classification of heart failure
1 - no limitation of activity
2 - comfortable at rest, dyspnoea on normal activity
3 - marked limitation of ordinary activity
4 - dyspnoea at rest, discomfort with all activity
State 3 cardiogenic causes of acute pulmonary oedema
MI, arrhythmia, fluid overload
State 3 non-cardiogenic causes of acute pulmonary oedema
ARDS, upper airway obstruction, head trauma
State at least 5 causes of cardiogenic shock
MI, hyperkalaemia, endocarditis, aortic dissection, Rhythm disturbance, tamponade, tension pneumothorax, massive PE
State 5 causes of cardiac tamponade
Trauma, lung or breast cancer, pericarditis, MI, TB
Describe Becks triad of signs of cardiac tamponade
Hypotension, raised JVP, muffled heart sounds
Describe the Keith Wagener classification of hypertensive retinopathy
- Tortuosity and silver wiring
- AV nipping
- Flame haemorrhage and cotton wool spots
- Papilloedema
State 4 causes of aortic stenosis
Senile calcification, bicuspid valve, Williams syndrome, rheumatic fever
Describe the signs of aortic stenosis on examination
Slow rising pulse, narrow pulse pressure, aortic thrill, ejection systolic murmur in 2nd ICS sitting forward in end expiration and radiating to carotids
Describe the signs of aortic regurgitation on examination
Collapsing pulse, wide pulse pressure, displaced apex from volume overload, end diastolic murmur loudest at the upper left sternal edge sitting forward in end expiration, may be an Austin Flint murmur, may have De Mussets sign (head nodding) or Quinckes (capillary pulsation in nail beds)
Describe the Austin Flint Murmur
Rumbling mid diastolic murmur at the apex due to a regurgitant jet fluttering the anterior mitral valve cusp in severe aortic regurgitation
Describe the signs of mitral stenosis on cardiac examination
AF, malar flush, left parasternal heave, tapping apex (palpable S1), early diastolic opening snap, rumbling mid diastolic murmur loudest in the left lateral position in end expiration and radiating to the axilla, may have a Graham Steel murmur (end diastolic murmur secondary to pulmonary regurgitation)
Describe the signs of mitral regurgitation on cardiac examination
AF, left parasternal heave, displaced apex, soft S1, blowing pansystolic murmur loudest on the left lateral position in end expiration
Describe the signs of tricuspid regurgitation on cardiac examination
Raised JVP with giant V waves, right ventricular heave, pansystolic murmur at the lower left sternal edge in inspiration, pulsatile hepatomegaly, jaundice
What are Oslers nodes?
Painful, purple papules on finger pulps
What are Janeway lesions?
Painless palmar macules
State the major components of the Jones criteria for diagnosing rheumatic fever
Pancarditis, arthritis, subcutaneous nodules, erythema marginatum, Sydenhams chorea
State the minor Jones criteria for diagnosing rheumatic fever
Fever, raised ESR or CRP, arthralgia (without arthritis), Prolonged PR interval (without carditis), previous rheumatic fever
State 4 drug causes of acute pericarditis
Penicillin, isoniazid, procainamide, hydralazine
Describe the features of cardiac myxoma
Rare, benign cardiac tumour usually found in the left atrium. Causes clubbing, fever, weight loss, raised ESR, and similar signs to mitral stenosis (mid diastolic murmur, systemic emboli, AF) but varies with posture
State the causes of restrictive cardiomyopathy
SSHAPEN - sarcoid, systemic sclerosis, haemochromatosis, amyloidosis, primary (endocardial fibrosis), eosinophilic endocarditis (Loefflers), neoplasia (carcinoid)
State the causes of dilated cardiomyopathy
Alcohol, pregnancy (peri and post partum), Muscular dystrophy, glycogen storage disease, SLE, myocarditis, doxorubicin, cyclophosphamide, thryotoxicosis
