Cardiology overview

Question 1

What are the consequences when the myocardium malfunctions?

Answer 1

heart failure

Question 2

What are the consequences when the valves malfunction?

Answer 2

heart failure

endocarditis

Question 3

What are the consequences when the conduction system malfunctions?

Answer 3

arrhythmia

- tachy, brady, sudden death

Question 4

What are the consequences when the coronary blood supply malfunctions?

Answer 4

angina

myocardial infarction

Question 5

What are the 5 types of bradycardia and their symptoms?

Answer 5

sinus bradycardia (asymptomatic, tired)
slow atrial fibrillation/flutter (tired, dizzy, breathless)
2nd degree heart block (none, dizzy)
3rd degree heart block (tired, dizzy, breathless, sudden death, syncope)
asystole (sudden death)

Question 6

What are some causes of sinus bradycardia?

Answer 6

drugs, fitness, conduction disease, hypothyroidism

Question 7

What are some causes of slow atrial fibrillation or flutter?

Answer 7

The same as atrial fibrillation

Question 8

What are some causes 2nd degree heart block?

Answer 8

drugs, conduction disease, age, surgery, aortic endocarditis

Question 9

What are some causes of 3rd degree heart block?

Answer 9

drugs, conduction disease, age, surgery, aortic endocarditis

Question 10

What are some causes of asytole?

Answer 10

same causes as ventricular tachycardia, conduction disease

Question 11

How would you treat bradycardia?

Answer 11

pacemaker

Question 12

What are the 3 main types of tachycardia and their symptoms?

Answer 12

atrial fibrillation/flutter (none, tired, dizzy, breathless, palpitations, 'off')
supraventricular tachy (intermittent palpitations, syncope, presyncope)
ventricular fibrillation/tachycardia (dizzy, breathless, sudden death, syncope)

Question 13

What are some causes of atrial fibrillation/flutter?

Answer 13

Anything that causes atrial stretch - hypertension, HF, valve disease, lung disease, obesity, age, hyperthyroid

Question 14

What are some causes of supraventricular tachycardia?

Answer 14

accessory pathways e.g. WPW

Question 15

What are the causes of ventricular fibrillation/tachycardia?

Answer 15

anything that affects ventricles - heart failure, cardiomyopathy, drugs, metabolic derangement, severe disease, genetic

Question 16

How would you treat atrial fibrillation/flutter?

Answer 16

rate - betablockers, digoxin, CCB

anticoagulate with warfarin/NOAC if high stroke risk

Question 17

How would you treat supraventricular tachycardia?

Answer 17

vagal manoevers
IV adenosine
DC cardioversion (shock)
reccurent attacks - betablockers, flecaindie 
ablation

Question 18

How would you treat ventricular fibillation/tachycardia?

Answer 18

immediate DC cardioversoin
anti-arrythmic - betablockers, amiodarone
implantable cardioverter defibrillator

Question 19

When someone has heart problems what are the 4 apsects you check? How would you check for each?

Answer 19

myocardium (BNP, transthoracic/oesophageal echo, myocardial perfusion scan)
valves (BNP, echos)
conduction system (ECG, holter monitors, implantable loop recorder)
coronary arteries (CT coronary angiogram, invasive angiogram, myocardial perfusion scan)

Question 20

What are some cardiovascular causes of syncope?

Answer 20

arrhythmia
aortic stenosis
vasovagal

Question 21

What are some cardiac causes of chest pain?

Answer 21

IHD - angina, unstable angina, MI
pericarditis
aortic dissection
aortic stenosis

Question 22

What are some non-cardiac causes of chest pain?

Answer 22

pneumonia, pulmonary infection
pneumothorax 
neuromuscular - nerve root pain, fibromyalgia 
herpes zoster
trauma
oesophageal pain e.g. reflux 
non-organic

Question 23

What are some causes of low blood pressure?

Answer 23

Shock - haemorrhagic, septic, cardiogenic
postural hypotension - autonomic neuropathy, iatrogenic
Addison’s
anorexia

Question 24

What are some cardiac causes of oedema?

Answer 24

congestive cardiac failure - ischaemic, valvular, myopathic, copulmonale, hypertensive
venous stasis - inferior vena cava obstruction

Question 25

What are some non-cardiac causes of oedema?

Answer 25

hypoproteinaemia - liver disease, nephrotic syndrome, malnutrition pre-eclampsia venous stasis - varicose veins, DVT

Question 26

What are some causes of hypertension?

Answer 26

essential hypertension hypertension in pregnancy - pre-eclampsia renal disease - diabetic nephropathy

Question 27

What are some causes of cardiac arrest/sudden death?

Answer 27

``` myocardial infarction cardiomyopathy ventricular arrhthmia drug toxicity e.g. digoxin elecrolyte abnormalities PE pulmonary embolism, aortic stenosis and dissection ```

Question 28

What are some cardiac causes of leg pain/swelling?

Answer 28

ischaemia - atherosclerostic, emoblic | cardiac failure

Question 29

What are some non-cardiac causes of leg pain/swelling?

Answer 29

``` DVT MSK - fractures, goat, OA, RA, cartilage.ligament damage, infective arthritis diabetic neuropathy cellulitis growing pain leg ulcer ```

Question 30

What are some causes of murmurs?

Answer 30

valvular disease - degenerative, rheumatic infective congenital heart disease funcitonal murmurs - cardiomyopathy, LV dilation, aortic dissection innocent - childhood, pregnancy Marfan's

Question 31

What are some causes of arrhythmias?

Answer 31

``` AF heart block sinus tacchycardia ventricular ectopics supraventricular tachy ventricular tachy ```

Question 32

What are some cardiac causes of shortness of breath?

Answer 32

heart failure - ischamic, hypertensive, valvular, cardiomyopathic

Question 33

What are some non-cardiac causes of shortness of breath?

Answer 33

lung disease - obstructive, restrictive, infective, malignant pneumothorax PE hyperventilation syndrome

Question 34

What tests should you do for someone referred for stable angina?

Answer 34

ECG FBC, U&E, glucose, lipids CT coronary angiogram

Question 35

What tablets should you use to treat stable angina?

Answer 35

``` BB Aspirin/clopidogrel nitrates long acting calcium antagonist statin - atorvostatin ```

Question 36

What are some SE of angina medications to look out for?

Answer 36

tired and run down from BB | huge headache from GTN

Question 37

What are the triad of signs in pericardial effusion?

Answer 37

hypotension, muffled heart sounds, jugular vein distension