Cardiology - Geeky Medics

Question 1

What is meant by stage 4 clubbing?

Answer 1

• Enlargement of the distal phalanx

Question 2

What investigations are useful in suspected aortic stenosis?

Answer 2

• Echocardiogram
• Bloods e.g. FBC, film (may show anaemia due to haemolysis)
• CXR
• ECG may show left ventricular hypertrophy

Question 3

What is the treatment for aortic stenosis?

Answer 3

1. Conservative
   - Educate pt, dental hygiene (oral bacteria may infect valve via bloodstream)
   - If left-sided heart failure, consider low salt diet & immunisations (flu vaccine etc.)
2. Meds
   - ACEi, ARB etc for LSHF
3. Surgery
   - First line: open valve replacement or transcatheter aortic valve implantation (TAVI)
   - Second line: balloon valvuloplasty

Question 4

What are the causes of aortic regurgitation?

Answer 4

ACUTE
- Aortic dissection (tear in aortic wall)
- Infective endocarditis

CHRONIC
- Aortic valve abnormality (e.g. bicuspid instead of tri, or degenerative)
- Aortic root dilatation / aortic root aneurysm e.g. idiopathic / spontaneous, aortitis (autoimmune - e.g. due to ankylosing spondylitis or giant cell arteritis - or infective - chlamydia), connective tissue dis. (Marfan syndrome, Ehlers-Danlos)