Cardiology Short Flashcards

Question

Signs of severity of AS?

Answer 1

``` 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 ```

Answer 2

``` 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 ```

Answer 3

right ventricular failure rheumatic infective endocarditis ebstein's anomaly

Answer 4

rheumatic heart disease

Answer 5

``` 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 ```

Answer 6

p mitrale AF right axis deviation

Answer 7

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

Answer 8

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

Answer 9

``` class III or IV symptoms left ventricular dysfunction left ventricular dimensions have increased progressively ```

Answer 10

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

Answer 11

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

Answer 12

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

Answer 13

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

Answer 14

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

Answer 15

``` 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 ```

Answer 16

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

Answer 17

``` 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 ```

Answer 18

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

Answer 19

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

Answer 20

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

Answer 21

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

Answer 22

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

Answer 23

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

Answer 24

VSD PDA ASD

Answer 25

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

Answer 26

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

Answer 27

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

Answer 28

``` pulmonary hypertension haemoptysis APO AF emboli infective endocarditis ```

Answer 29

``` degenerative calcification bicuspid aortic valve rheumatic congenital IE ```

Answer 30

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

Answer 31

``` left ventricular failure sudden death pulmonary hypertension AF VT heart block IE haemolytic anaemia ```

Answer 32

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

Answer 33

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

Answer 34

``` early opening snap increased length of the murmur signs of pulmonary hypertension signs of pulmonary congestion low pulse pressure ```

Answer 35

severe with symptoms or pulmonary hypertension

Answer 36

age > 70 shortened life expectancy contraindications to anticoagulation

Answer 37

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

Answer 38

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

Answer 39

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

Answer 40

``` marfan's syndrome ehler's danlos osteogenesis imperfecta polycycstic kidney disease SLE ```

Answer 41

``` stroke chordal rupture endocarditis arrhythmia sudden death progression to severe MR ```

Answer 42

pulmonary artery systolic pressure > 25mmHg

Answer 43

congenital - including aneuploid syndromes ischaemic iatrogenic

Answer 44

``` infective endocarditis pulmonary hypertension left ventricular dysfunction aortic regurgitation ventricular arrhythmias eisenmenger's syndrome ```

Answer 45

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

Answer 46

central cyanosis and pulmonary hypertension

Answer 47

asymmetrical septal hypertrophy | systolic anterior motion of the mitral valve

Answer 48

``` heart failure atrial fibrillation ventricular arrhythmias sudden death angina endocarditis ```

Answer 49

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

Answer 50

Caused by blood from atrial contraction hitting a stiff ventricular wall