cardiovascular Flashcards
what are the 3 main symptoms of aortic stenosis?
SOB, chest pain, syncope
on exertion
what can happen to heart rate post MI?
bradycardia
how do you measure central cap refill?
press on sternum for 5s, should reperfuse <2s.
what does left axis deviation in an ecg usually mean?
LVH
what does right axis deviation in an ecg usually mean?
RVH
what are some examples of blood tests that go in the gold bottle?
U and Es
CRP
troponin
LFTs
bone profile
thyroid function
what is shock?
state of cellular and tissue hypoxia due to mismatch between o2 supply and demand.
how do you treat hyperkalaemia?
calcium glucanate-stabilises myocardium
insulin and dextrose
salbutamol nebs
what does the chadsvasc score do?
stroke risk in AF
what does the hasbled score do?
bleeding risk in AF
what are the 2 important causes of irregularly irregular rhythm?
atrial flutter with variable block
AF
what are 2 things you can temporarily do to slow someone’s heart rate?
give drug called adenosine (reduces conduction time in the atrioventricular node of the heart)
carotid massage
what is Beck’s triad?
cardiac tamponade:
low BP
muffled heart sounds
raised JVP
how can you treat hyperkalaemia?
calcium gucanate-stabilises myocardium
insulin and dextrose
salbutamol nebs
why does long lie cause hyperkalaemia?
rhabdomyolysis-muscles release potassium.
what is the significance of Marfan’s in chest pain?
it affects big vessels and valves. can cause aortic aneurysms and aortic dissections.
what is cardiac tamponade?
blood or fluid fills the sac around the heart, compressing the heart.
what is a potential complication of myocarditis?
arrythmias like VF, VT
what is the affect of oestrogen on the cardiovascular system?
it decreases plaque formation bc it stops LDL deposition in tunica intima.
however it increases production of coagulation factors in liver so makes your blood more prone to clot .
what big change should happen to someone’s bloods post infusion?
increased haemoglobin
what is a boot shaped heart classically associated with?
tetralogy of fallot
what additional blood tests should look at/do if patient has a low Hb?
MCV
B12
folate
ferritin
what is the difference between pericardial effusion and cardiac tamponade?
pericardial effusion can cause cardiac tamponade. becomes cardiac tamponade when heart stops being able to expand properly due to blood present in the sac.
what blood vessel supplies the AVN and the effect of this?
right coronary artery
means if you see heart block it can be due to a RCA infarct
what is prinzmetal angina?
just another word for unstable angina
what leads are supplied by the right coronary artery?
inferior -II, III, aVF
what is first line treatment for bradycardia with adverse outcomes like syncope and shock?
IV atropine
what does widespread saddle shaped ST elevation suggest?
acute pericarditis
what is the preferred first line treatment for acute pericarditis?
naproxen, colchine has also been used in some cases, can also use other NSAIDs
what is the preferred first line treatment for acute pericarditis?
naproxen, colchine has also been used in some cases, can also use other NSAIDs
what cardiac issue is adenosine used for?
narrow complex tachycardias
what is dressler’s syndrome and why does it happen?
pericarditis post MI-can be with or without pericardial effusion
antibodies from damaged heart tissue trigger immune response
what are the classic findings of pericarditis?
chest pain, fever
raised ESR
ECG findings: widespread concave st-elevation, pr depression, reciprocal st depression and pr elevation in avr
what is the nice guideline target for BP control in diabetes?
target <130/80
what is the treatment for torsades de pointes?
IV magnesium sulfate
what are the causes of raised BNP?
heart failure
age over 70
LVH
renal dysfunction (egfr<60)
ischaemia
hypoxia (eg PE)
sepsis
COPD
diabetes
liver cirrhosis
what are the rules post MI and driving?
driving may resume 1 week after ACS if successful PCI and EF>40%
if not treated successfully driving may resume after 4 weeks provided no other disqualifying condition
what are the ECG changes that are considered normal variants in athletes?
sinus bradycardia
junctional rhythm
first degree heart block
Mobitz type 1 (Wenckebach phenomenon)
what would haemolytic anaemia look like on bloods?
normocytic anaemia
high reticulocyte count
what happens in DIC?
a disease process messes up your clotting pathways so you get a tendency to both bleed and clot at the same time.
which arteritis causes an absent limb pulse and unequal BP in upper limbs due to aortic occlusion?`
takayasu’s arteritis
what are the symptoms of pericarditis?
chest pain -may be pleuritic or relieved sitting forwards
nonproductive cough, dyspnoea, flu-like symptoms, tachycardia, tachypnoea
what are some important things that increase the QT interval?
hypokalaemia
hypomagnesaemia
lithium
TCAs
citalopram+escitalopram
antipsychotics
what is the most appropriate initial management of intermittent claudication?
supervised exercise and cardiovascular risk management
what is an ecg finding sensitive to cardiac tamponade?
electrical alternans -beat to beat variation of QRS
this is due to heart ‘swinging’ in pericardial fluid.
how does antiphospholipid syndrome present?
venous +arterial thromboses
recurrent foetal loss
thrombocytopaenia
paradoxical rise in APTT
what is fat embolism syndrome?
trauma leads to release of fat emboli
causes cascade leading to sx of:
resp -high RR, low 02, high temp, high HR
derm -non blanching petechial rash
CNS -confusion, agitation
if a patient is allergic to aspirin which medication may they also react to?
sulfasalazine
