Cardiology Flashcards
S3 or S3/S4
CHF
S4 alone
HTN
HFPEF
Continuous murmur
Pulmonary AVM
PDA
Coarctation aorta
Loud S1
Exercise Short PR MS/TS ASD PDA
Soft S1
LBBB
Long PR
Severe MS
MR/AR
Variable S1
AF
AV block
Tamponade
Wide split S1
RBBB
ASD
Ebstein’s
Loud S2
A2 - sev HTN, coarctation, aneurysm
P2 - pHTN, ASD
Soft S2
A2 - sev AS, AR
P2 - PS
Physiologic split S2
During inspiration
Paradoxical split S2
Delayed closure of aortic valve During expiration (not inspiration) 1. LBBB 2. WPW 3. AS 4. HOCM/LVOT
Fixed split S2
Heard EQUALLY in both inspiration and expiration
ASD
Persistent/wide split S2
Heard in inspiration and expiration but LOUDER in inspiration (inc venous return)
RBBB
Rhythm control AF - CHF
EF>40% = amio or sotalol EF<40% = amio
Rhythm control AF - CAD
Amio
Sotalol (need QTc <440, not in renal)
Dronedarone
Rhythm control AF - no CHF or CAD
Sotalol
Dronedarone (not perm AF or CHF, hepatotoxic)
Propafenone (not in CAD, CHF, liver, renal)
Flecainide (not in CAD, CHF, liver, renal)
When to do rhythm control
- Stable, <1 yr onset AF
- Symptomatic/QOL
- Paroxysmal recurrent episodes
- CMO
- Hard to rate control
NYHA IV/LVAD Driving
None
Non reversible VT/VF driving
6 mos/none
Unexplained syncope
3 mos/12 mos symptom free
ICD insertion
Primary - 1 month
Secondary - 6 mos
Commercial - none
Familial hypercholesterolemia dx
LDL >5 plus
- Tendon xanthoma
- Family member LDL>5
- Family early CVD M<55, F<65
Familial DLD Tx
- Statin
- Ezetimibe
- PCSK9 inhibitor
Target LDL <2.5 (2 if CAD) and 50%
POTS Definition
Sustained HR inc >30 bpm 10 mins standing
With no drop in BP >20/10
POTS Tx
Na 10 g/d Water 3-4 L Compression stockings Exercise Midodrine, fludrocortisone Other: methyldopa, ivabradine, clonidine
PAD Screening
Rule In 1. Femoral bruit 2. Pulse abnormality Rule out 1. No pulse abnormality
PAD Symptoms
Rule In 1. Cool to touch 2. Bruit 3. Pulse abnormality 4. Discolouration Rule Out 1. No pulse abnormality
PAD Tx
Stop smoking, exercise, foot care Pharm 1. Statin in all 2. ACEi in all 3. ASA/Plavix - definitely in symptomatic. Consider ASA+riva 2.5 4. T2DM management 5. PDE5 inhibitor - not in chf
Diffuse T wave inversion
Increased ICP
RV strain pattern
STD/T wave inversion V1-V3, inferior leads
LVH Criteria
- LV strain - STD, T wave inv V4-6
2. R I and S III >25 mm OR S V1 and tallest R V5/6 >35 mm
Biphasic T waves V1/V2
Wellen’s
Critical pLAD stenosis
Persistent STE post MI
LV aneurysm
Q waves
Small T waves
Posterior MI
STD V1-V3
Tall broad R waves
Upright T
Dominant R in V2
Canon a waves
AV dissociation - AV block, VT
Notched P wave
P mitrale
Mitral stenosis
Peaked T waves
Hyperkalemia
Hypokalemia
T wave inversion
U wave
STD
Long PR
Brugada
Type 1 - domed ST and negative T wave V1-3
Type 2 - saddle ST
High risk SCD
J waves
Hypothermia
Deflection at J point (right after QRS)
Also get Brady, ventricular ectopy, VT/VF
Digoxin use ECG
Fast atrial arrhythmia
AV block
ST scooping
Bidirectional VT
LAFB
L axis deviation
qR I/AVL
rS II/III/AVF
LPFB
R axis deviation
rS I/AVL
qR II/III/AVF