Cardiology Notes Flashcards
chest pain relieved by sitting up and leaning forward?
pericarditis
what sort of symptoms would you get in pericarditis?
non productive cough, dyspnoea, flu like symptoms
pericarditis on ECG?
saddle shaped ST elevation, PR depression
when would a patient typically get pericarditis?
2-10 weeks post MI
what is the triad of symptoms in Dresslers syndrome
triad of fever, pleuritic chest pain and pericardial effusion
which valve is affected in IV drug users in endocarditis?
tricuspid
what is the criteria for classification of endocarditis
Duke
signs and symptoms (from jane)
fever roth spots oslers nodes murmur janeway lesions anaemia nails (splinter haemorrhages) emboli
Investigations (BBUCE)
Blood cultures (3 separate cultures from 3 peripheral sites Bloods for anaemia Urinalysis (macroscopic haematuria) CXR Echo
native valve tx
amox and gent
native valve severe sepsis
flucloxacillin
prosthetic valve (or suspected MRSA)?
Vancomycin + Rifampicin + Gent
Native valve severe sepsis and risk factors for resistant pathogens
Vancomycin IV + Meropenem IV
complications of endocarditis?
HAAES Heart failure Arrythmia Abcess formation in cardiac muscle embolic formation
what do you give to someone with a heart rate of less than 40 or symptomatic bradycardia?
IV atropine
what is definition of SVT?
narrow complex tachycardia (>100bpm, qrs <0.12s)
what manouvre can you do in SVT?
valsalva manouvre
what do you give in SVT after the valsalva manoeuvre?
IV adenosine or verapamil
what maintenance therapy do you give?
bbs or verapamil
AF, what wave missing on ECG?
P wave
saw tooth baseline at 150bpm?
atrial flutter
treatment for pre excited AF
flecainide
the two shockable rhythms ?
VF and pulseless VT
broad complex tachycardia?
vt
acute management of vt?
iv amiodarone
o Congenital accessory conduction pathway between atria and ventricles
wpw
what wave do you see on ECG?
delta wave
what is the treatment of WFW?
requires ablation
what is holiday heart syndrome?
binge drinking in person without any clinical evidence of heart disease
slow rising pulse
aortic stenosis
collapsing pulse?
aortic regurg
bounding pulse?
acute CO2 retention
radiofemoral delay
coarctation of aorta
jerky pulse?
hypertrophic obstructive cardiomyopahty
pulsus paradoxus
contrictive pericarditis, cardiac tamponade
systolic pressure drops > 10 Hg with inspiration ?
pulsus paradoxus
how does conns cause hypertension ?
Increased aldosterone, causing increased salt and water retention. Potassium goes down
what is the effect of aldosterone on sodium and potassium ?
causes increased (retention) of sodium and decreased potassium
normal and abnormal Bps?
♣ Normal <120 / <80 ♣ Pre-hypertension 120-139 / 80 – 89 ♣ Stage 1 140-159 / 90 – 99 ♣ Stage 2 160-179 / 100-109 ♣ Severe ≥180 / ≥110
ECG change in hypertension ?
LVH
how do you treat resistant hypetension ?
higher doses of thiazide or spironolactone
what can you add if diuretic is insufficient in treating hypertension ?
alpha or beta blocker
rib notchin in babies on CXR?
coarctation of aorta
tetrallogy of fallot?
PROVe pulmonary stenosis ventr septal defect over riding aorta RV hypertrophy
cyanosis on first day of life? boot shaped heart?
tetralogy of fallot
Wide, fixed split S2, ejection systolic murmur 2nd/3rd IC space
atrial septal defect
harsh pansystolic murmur left sternal edge ?
ventricular septal defect
continuous machinery murmur below left clavicle
persistent ductus arteriosus
Cyanosis first day of life, egg-shaped ventricles
- Transposition of the great vessels
when do fallots present?
2 months
which murmur would you get a large systolic JVP?
triscupid regurg
raised fixed JVP?
superior vena cava obstruction
JVP rising on inspiration ?
cardiac tamponade, constrictive pericarditis
large V waves?
triscupid regurg
cannon a waves?
complete heart block
drug that causes blurred yellow vision headache?
digoxin toxicity
s2 splitting during inspiration ?
normal
when is S3 heard?
LVF, constrictive pericarditis
s4 heard in ?
HOCM 1,2,3,4
why is aspirin not given to children ?
due to risk of reyes syndrome
tall tented t waves?
hyperkalaemia
S1, Q3, T3 pattern ?
pulmonary embolism