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BPT Clinical > Cardiology Short > Flashcards

Cardiology Short Flashcards

1
Q

Causes of clubbing

A 
cyanotic congenital heart disease
infective endocarditis
lung carcinoma
chronic pulmonary suppuration (bronchiectasis, abscess, empyema)
idiopathic pulmonary fibrosis
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2
Q

Causes of postural hypotension

A 
H - hypovolaemia, hypopituitarism
A - addison's disease
N - neuropathy
D - drugs
I - idiopathic
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3
Q

Causes of elevated JVP

A 
right ventricular failure
tricuspid stenosis or regurgitation
pericardial effusion/constrictive pericarditis
SVC obstruction
fluid overload
hyperdynamic circulation
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4
Q

Causes of a dominant a wave in JVP

A

tricuspid stenosis
pulmonary stenosis
pulmonary hypertension

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5
Q

Causes of cannon a waves in JVP

A

complete heart block

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6
Q

Causes of a dominant v wave in JVP

A

tricuspid regurgitation

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7
Q

Causes of peripheral oedema

A 
heart failure
hypoprotinaemia - cirrhosis, nephrotic syndrome, malabsorption 
DVT
drug induced
lymphoedema
lipoedema 
hypothyroidism
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8
Q

Causes of leg ulcers

A 
venous stasis ulcer
ischaemic ulcer
malignant ulcer
infection
neuropathic
diabetes
pyoderma gangrenosum
rheumatoid arthritis
lymphoma
haemolytic anaemia
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9
Q

Signs of severity of mitral stenosis?

A 
small pulse pressure
early opening snap
length of the mid diastolic rumbling murmur
diastolic thrill at apex
presence of pulmonary hypertension
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10
Q

Signs of severity of MR?

A 
small volume pulse
signs of LV failure
displaced apex beat
soft S1 and loud S3 
signs of pulmonary hypertension
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11
Q

Signs of severity of aortic regurgitation?

A 
collapsing pulse
wide pulse pressure
length of decrescendo diastolic murmur
S3
soft A2
signs of left ventricular failure 
Austin flint murmur (diastolic murmur caused by limitation to mitral inflow by the regurgitation jet)
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12
Q

Causes of left ventricular failure?

A

volume overload
pressure overload
myocardial disease

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13
Q

Causes of volume overload left ventricular failure?

A

aortic regurgitation
mitral regurgitation
patent ductus arteriosus

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14
Q

Causes of pressure overload left ventricular failure?

A

systemic hypertension

aortic stenosis

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15
Q

Causes of dilated cardiomyopathy?

A 
EtOH
haemochromatosis
sarcoidosis
drugs
radiation
neuromuscular disease
connective tissue disease 
genetic
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16
Q

Causes of loud S1?

A

mitral stenosis
tricuspid stenosis
tachycardia
hyperdynamic circulation

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17
Q

Causes of soft S1?

A

mitral regurgitation
calcified mitral valve
left bundle branch block
first degree heart block

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18
Q

Causes of loud A2?

A

congenital aortic stenosis

systemic hypertension

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19
Q

Causes of soft A2?

A

calcified aortic valve

aortic regurgitation

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20
Q

Causes of increased normal splitting of the second heart sound? (wider on inspiration)

A

RBBB
pulmonary stenosis
VSD
MR

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21
Q

Causes of fixed splitting of the second heart sound?

A

ASD

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22
Q

Causes of reversed splitting of the second heart sound?

A

LBBB
aortic stenosis
coarctation of the aorta
PDA

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23
Q

Causes of third heart sound?

A 
left ventricular failure
AR
MR
VSD
PDA
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24
Q

Causes of fourth heart sound?

A

AS
systemic hypertension
HCM

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25
Q

Signs of severity of AS?

A 
small volume slow rising pulse
aortic thrill
length, harshness and lateness of the peak of the systolic murmur
fourth heart sound
reversed splitting of the second heart sound
left ventricular failure 
pressure loaded apex beat
soft S2
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26
Q

Signs of TR?

A 
large v waves on JVP
right ventricular heave
pansystolic murmur loudest at the lower edge of the sternum, louder on inspiration 
pulsatile liver 
ascites
peripheral oedema
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27
Q

Causes of TR?

A

right ventricular failure
rheumatic
infective endocarditis
ebstein’s anomaly

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28
Q

Causes of MS?

A

rheumatic heart disease

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29
Q

Examination findings of MS?

A 
mitral facies 
loud S1, opening snap 
P2 in pulmonary hypertension
diastolic murmur
low pitched rumble loudest at apex (best heard with patient in left lateral position with the bell) 
diastolic thrill at the apex 
tapping apex beat 
signs of right heart failure
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30
Q

ECG findings of MS?

A

p mitrale
AF
right axis deviation

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31
Q

CXR findings of MS?

A

mitral valve calcification
enlarged left atrium
signs of pulmonary hypertension
signs of cardiac failure

32
Q

Causes of MR?

A 
degenerative disease
mitral valve prolapse
rheumatic disease
papillary muscle dysfunction (ischaemia)
left ventricular dilatation 
infective endocarditis
connective tissue disease
cardiomyopathies
congenital
33
Q

Indications for surgery in MR?

A 
class III or IV symptoms 
left ventricular dysfunction
left ventricular dimensions have increased progressively
34
Q

Causes of AR?

A 
endocarditis
congenital abnormalities
rheumatic disease
radiation induced 
hypertensive aortopathy
connective tissue disease (ankylosing spondylitis, marfan’s syndrome)
degenerative aortopathy (including tertiary syphilis) 
aortic dissection
35
Q

Signs of AR?

A

low diastolic BP
wide pulse pressure
displaced apex, hyperkinetic
diastolic thrill at left sternal edge when patient breathes out
soft A2
S3
signs of LVF
decrescendo diastolic murmur (may also concurrently have an ejection systolic murmur)
corrigans sign - prominent carotid pulsations
water hammer pulse

36
Q

Indications for surgery in AR?

A

severe symptomatic AR
asymptomatic with LVEF < 50%
having other cardiac surgery
dilated LV

37
Q

Signs of severe AS on TTE?

A

maximum velocity > 4m/s
mean gradient > 40mmHg
aortic valve area < 1cm
index AVA < 0.6cm/m

38
Q

Signs of pulmonary stenosis?

A 
peripheral cyanosis
giant a waves on JVP
right ventricular heave
thrill over pulmonary area
ejection systolic murmur loudest over the pulmonary area 
S4
39
Q

Signs of hypertrophic cardiomyopathy?

A 
sharp rising jerky pulse
prominent a waves on JVP
double or triple impulse apex beat
late systolic ejection murmur loudest at left lower sternal edge - louder with valsalva 
fourth heart sound
40
Q

ECG findings of HCM?

A

downsloping ST depression and TWI in inferolateral leads
abnormal Q waves in anterior and lateral leads
P wave abnormalities reflecting LA enlargement
left axis deviation
increased voltages

41
Q

Signs of ASD?

A 
R ventricular heave
wide heart sounds, fixed S2 splitting
mid systolic flow/ejection murmur at second intercostal space - not due to the defect but due to increased flow on right side of heart 
cyanosis
clubbing
elevated JVP
hepatic congestion
tricuspid regurgitation
peripheral oedema
42
Q

Signs of VSD?

A

harsh pansytolic murmur maximal at the left lower sternal edge, louder on expiration
hyperkinetic displaced apex

43
Q

Signs of PDA?

A

continuous flow murmur - loudest at the first left intercostal space
collapsing pulse with sharp upstroke
low diastolic blood pressure

44
Q

Signs of coarcation of the aorta?

A

radiofemoral delay
hypertension in arms only
midsystolic murmur over the praecordium and back

45
Q

Features of tetralogy of fallot?

A

VSD
R ventricular outflow obstruction and pulmonary stenosis
R ventricular hypertrophy
overriding aorta

46
Q

What are the manifestations of marfan’s syndrome?

A 
AR
ectopia lentis
arm span > height
dural ectasia
pectus excavatum
joint laxity
scoliosis
pes planus
47
Q

What is eisenmenger’s syndrome?

A

a left to right shunt causing increased pulmonary blood flow, pulmonary vessel injury, increased pulmonary vascular resistance and pulmonary hypertension which leads to reversal of the shunt from right to left

48
Q

What are the causes of eisenmenger’s syndrome?

49
Q

TTE findings for HCM?

A

LVOTO
septal assymetrical hypertrophy
left ventricular hypertrophy
systolic anterior motion of the mitral valve

50
Q

What is the management for HCM?

A 
beta blockers
non dihydropyridine calcium channel blockers
septal myectomy 
amiodarone/sotalol for arrhythmia
ICD if high risk for SCD
51
Q

What are the risk factors for SCD in HCM?

A 
family history of SCD
unexplained syncope
history of VF
VT or non sustained VT
LV wall thickness > 30mm
LVOTO
52
Q

What are the complications of MS?

A 
pulmonary hypertension
haemoptysis
APO
AF
emboli
infective endocarditis
53
Q

What are the causes of AS?

A 
degenerative calcification
bicuspid aortic valve
rheumatic
congenital
IE
54
Q

How would you clinically differentiate aortic sclerosis from aortic stenosis?

A

in aortic sclerosis - normal pulse character/volume, apex beat not displaced, normal second heart sound

55
Q

What are the complications of AS?

A 
left ventricular failure
sudden death
pulmonary hypertension
AF
VT
heart block
IE
haemolytic anaemia
56
Q

What is the gallavardin phenomenon?

A

when the murmur of AS is heard loudest over the mitral area

57
Q

How do you classify the severity of MS?

A

valve area
mild > 1.5cm
moderate 1-1.5cm
severe < 1cm

58
Q

What are the signs of severity of MS?

A 
early opening snap
increased length of the murmur
signs of pulmonary hypertension
signs of pulmonary congestion
low pulse pressure
59
Q

What are the indications for treatment of MS?

A

severe with symptoms or pulmonary hypertension

60
Q

Which patients should receive a bioprosthetic valve?

A

age > 70
shortened life expectancy
contraindications to anticoagulation

61
Q

Differential diagnosis for precordial pansystolic murmur?

62
Q

What are the signs of severity of AR?

A 
wide pulse pressure
long duration of murmur
third heart sound
austin flint murmur
signs of pulmonary hypertension
signs of left ventricular failure
63
Q

What is the austin flint murmur?

A

a mid diastolic murmur heard at the apex caused by severe AR leading to functional MS

64
Q

What is characteristically heard in mitral valve prolapse?

A

a mid systolic click heard at the apex followed by a late systolic crescendo-decrescendo murmur

65
Q

What conditions are associated with mitral valve prolapse?

A 
marfan's syndrome
ehler's danlos
osteogenesis imperfecta
polycycstic kidney disease
SLE
66
Q

What are the complications of mitral valve prolapse?

A 
stroke
chordal rupture
endocarditis
arrhythmia
sudden death
progression to severe MR
67
Q

What is the definition of pulmonary hypertension?

A

pulmonary artery systolic pressure > 25mmHg

68
Q

What are the causes of VSD?

A

congenital - including aneuploid syndromes
ischaemic
iatrogenic

69
Q

What are the complications of VSD?

A 
infective endocarditis
pulmonary hypertension
left ventricular dysfunction 
aortic regurgitation
ventricular arrhythmias
eisenmenger's syndrome
70
Q

What are the indications for VSD closure?

A 
increasing pulmonary:systemic blood flow
left ventricular dilatation
left ventricular dysfunction
recurrent endocarditis
development of AR
acute rupture of interventricular septum (ischaemic)
71
Q

What are the hallmark features of eisenmenger’s syndrome?

A

central cyanosis and pulmonary hypertension

72
Q

What is the mechanism of outflow tract obstruction in HCM?

A

asymmetrical septal hypertrophy

systolic anterior motion of the mitral valve

73
Q

What are the complications of HCM?

A 
heart failure
atrial fibrillation
ventricular arrhythmias
sudden death
angina
endocarditis
74
Q

What is S3?

A

Third heart sound heard early in diastole either due to hyperdynamic states or when the ventricle is dilated

75
Q

What is S4?

A

Caused by blood from atrial contraction hitting a stiff ventricular wall

BPT Clinical (10 decks)

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