Cardiovascular Flashcards
Best urgent investigation for suspected AAA?
Bedside abdo USS
Beck’s triad
Hypotension, distended neck veins, muffled heart sounds = pericardial effusion
Mitral stenosis
Mid-diastolic murmur with opening snap
Mitral regurgitation
Pan-systolic murmur radiating to the axilla
Aortic regurgitation
Early diastolic murmur with collapsing pulse
After an MI, when is VF most likely to start?
First few hours after MI
ECG changes for acute pericarditis
Widespread concave ST segment elevation and PR interval depression
First line treatment of hypertension in pregnancy
Labetolol. If asthmatic then nifedipine
Management of SVT
Vagal manouvre, Adenosine, Beta blocker, Calcium channel blocker, digoxin
Cardiac features of Turner’s syndrome
Coarctation of the aorta
Cardiac features of Downs Syndrome
AVSD
Hypertension treatment
Under 55: ACEi or ARB
Over 55 or Afro-carribean: CCB (step 2 is ACEi or ARB)
HCM
Mid systolic murmur and jerky pulse. Symptoms worsen after exercise. Worsen with valsalva but improving with squatting
First line anti-anginal
Beta blocker or CCB (e.g. nifedipine)
Short QT interval, which medication?
Digoxin
Screening for AAA
Men over the age of 65.
If <3cm = discharged
If 3-4.4cm = yearly USS
If 4.5-5.5cm = 3 monthly USS
If >5.5cm = vascular surgery
How does clopidogrel work
Blocks platelet ADP receptors
When can you drive following a coronary angioplasty (successful)
1 week
Unexplained collapse, when you can you drive?
Cannot drive for 6 months
Hypocalcaemia ECG changes?
Prolonged QT interval
Wolff Parkinson White ECG changes?
Shortened PR and delta waves
Ejection systolic murmur with narrow pulse pressure
Aortic sclerosis
Murmur associated with AS
AR
Murmur associated with Marfans syndrome
AR (more commonly aortic root dilatation)
Diagnosis criteria for IE?
Modified Dukes criteria:
MAJOR criteria: 1. Blood cultures; 2. Echo showing vegetations
MINOR criteria: IVDU, temp >38, embolic phenomena, predisposing heart lesion, immunologic phenomena, BC not meeting major criteria
(NEED 2 majors or 1 major and 3 minor)
Target BP for over 80s
Clinic reading of 150/90 or home reading of 145/85
60 year old man post coronary angio develops severe right foot pain. Pulse present. Tissue loss of lateral 2 toes and levido reticularis.
Cholesterol embolisation
Treatment of pericarditis
NSAIDs until asymptomatic alongside colchicine for 3 months
Drug that works by inhibiting thromboxane A2 production?
Aspirin
Drug that works activating antithrombin 3
Enoxaparin
Harsh systolic murmur over the precordium, doesn’t change with inspiration. Biventricular hypertrophy.
VSD (pansystolic murmur)
Bisferiens - associated with?
Mixed AS and aortic incompetence
Collapsing pulse
AR
Pulsus paradoxus
Left ventricular failure
Plateau
AS
What type of pulse:
A) noted when taking BP, doubling in rate as Mercury level falls
B) Severe COPD
C) Pulse volume decreases markedly with inspiration
D) Slow upstroke and prominent in the brachial and carotid pulses
A) Pulsus alternans
B) Pulsus paradoxus
C) Pulsus Paradoxus
D) Plateau
