Cardiovascular Flashcards
80yo male with past history of heart disease (AMI, aortic stenosis) presents with leg oedema, increased SOB on exertion and orthopnoea
Congestive cardiac failure
Causes: ischaemia, valvular disease, hypertension, congenital, cardiomyopathy, right heart disease
60yo male with CVD risk factors has chest discomfort and SOB brought on after 10-15 minutes of exertion that is relieved with rest. Occurs frequently, same every time
Stable angina
60yo male with CVD risk factors that has worsening chest discomfort and SOB brought on with exertion. Less exertion required over time to bring on pain. Relieved with rest
Unstable angina
60yo male with CVD risk factors presents with 10/10 chest pain radiating to the shoulder and jaw. Associated nausea, sweating and SOB
AMI
Apex beat felt in the anterior axillary line, what has happened to the LV?
Left ventricular hypertrophy
80yo male presents with a systolic crescendo-decrescendo murmur in the aortic region
Aortic stenosis
Causes: degenerative calcific valve, congenital bicuspid valve, congenital AS, rheumatic fever
75yo male with long-standing HTN presents with an early diastolic decrescendo murmur in the aortic region and a widened PP
Aortic regurgitation
Causes:
- Acute: infective endocarditis, Marfan’s syndrome, dissecting aneurysm of aortic root
- Chronic: rheumatic, congenital, long-standing HTN, aortic root dilation (eg/ Marfan’s)
50yo female with past history of rheumatic fever presents with a mid-late diastolic murmur over the apex associated with increasing orthopnoea and leg oedema
Mitral stenosis
Causes: rheumatic fever, congenital parachute valve
A patient with a history of heart disease presents with a pan-systolic murmur in the apex region and tachypnoea
Mitral regurgitation
Causes:
- Acute: MI, infective endocarditis, trauma/surgery, spontaneous rupture of myxomatous cord
- Chronic: mitral valve prolapse, degenerative, rheumatic fever, papillary muscle dysfunction, cardiomyopathy, connective tissue disease, congenital
77yo male with left heart failure presents with a new onset pansystolic murmur in the left lower sternal edge. Associated with this is a pulsatile liver and raised JVP
Tricuspid regurgitation
Causes: RVF, rheumatic, IE, valve prolapse, papillary muscle infarction, trauma, congenital
11yo female from a developed country presents with a fever, arthralgia affecting large joints and a rash following a sore throat. On examination a murmur is heard
Acute rheumatic fever
40yo male presents with increasing dyspnoea and episodes of syncope. On examination, the LV is enlarged, he has a murmur consistent with mitral regurgitation and an audible S4
Hypertrophic cardiomyopathy
35yo presents with signs of left ventricular failure as well as mitral and tricuspid regurgitation
Dilated cardiomyopathy
66yo presents with intermittent palpitations, these are described as fast and irregular. On ECG, no p waves are seen
AF
Patient presents with occasional palpitations. These are sudden onset, occur at rest, regular and fast. Palpitations either resolve suddenly or by vasovagal maneouvres
SVT
55yo male with a family history of sudden cardiac death presents acutely unwell with hypertension, tachycardia and chest discomfort. ECG shows wide complex tachycardia
VT
ECG shows fixed prolongation of PR interval (>0.2s) with no failure of AV conduction
1st degree conduction block
ECG shows progressive prolongation of PR interval with eventual loss of AV conduction for 1 beat
Second degree (I) conduction block
ECG shows fixed, unchanging PR intervals with occasional loss of AV conduction for 1 beat
Second degree (II) conduction block
ECG shows complete, persistent loss of conduction from the atria to the ventricles
Third degree conduction block
33yo male presents with vague symptoms including chest pain, fatigue and dyspnoea following a viral infection 3 weeks previously
Viral myocarditis
Other causes: other infection, sarcoidosis, giant cell myocarditis, acute rheumatic fever, toxic (diphtheria), drugs, transplant rejection
An obese 45yo lady presents to the doctor for a check up, she is well and routine bloods are ordered. What are they likely to show?
Dyslipidaemia
Middle-aged male presents with hypotension, distant heart sounds and an elevated JVP
Pericardial tamponade
25yo male presents with sharp chest pain that is relieved by sitting forward. ECG shows generalised ST depression
Acute pericarditis
Causes: viral infection, idiopathic, post-MI, after pericardiotomy, uraemia, neoplasia, connective tissue disease, hypothyroidism, other infection, acute rheumatic fever
An overweight individual with T2DM presents with worsening eye symptoms
Hypertension
An elderly male individual presents with unstable angina. What disease is affecting the coronary vessel?
Atherosclerosis
65yo patient presents with a temporal headache, painless vision loss in one eye and a fever. On questioning, they also reveal a recent history of jaw claudication
Giant cell arteritis
55yo woman presents with acute onset stiffness in the pelvic and shoulder girdles. Associated with this is a low grade fever and some weight loss. On further questioning she has some features of giant cell arteritis
Polymyalgia rheumatica
40yo woman presents with digit discolouration, described pallor, cyanosis and rubor when it is cold
Raynaud’s disease
80yo male with a smoking history presents with sudden onset abdominal pain associated with pre-syncope and a pulsatile abdominal mass
Ruptured AAA
60yo male with long-standing hypertension presents with acute onset severe chest pain radiating to the back. He describes the pain as tearing. On examination the BP in the arms is different
Aortic dissection
55yo female presents with ankle pain associated with pitting oedema, lipodermatosclerosis, venous eczema and varicose veins
Chronic venous disease
A patient presents with a large ulcer with irregular edges and a shallow base in the gaiter area
Venous ulceration
A patient presents with an ulcer over a pressure area that is small and deep with punched out edges
Arterial ulceration
A patient with diabetes mellitus presents with an ulcer over a pressure point. This is associated with hypoaesthesia
Neuropathic ulceration
Following a long flight, a 55yo female complains of unilateral calf pain and swelling
DVT
Other causes: active cancer, recent surgery, pregnancy, obesity, clotting disorders, cardiac failure
Following a lymph node dissection, a patient complains of unilateral painless limb swelling that is non-pitting in nature
Lymphoedema
Other causes: primary (eg/ hypoplastic lymphatic development), radiation therapy, neoplastic infiltration, parasitic nematodes, penetrating trauma
A 55yo male with CVD risk factors presents with leg pain that is brought on after 100m and is relieved by rest. At night he complains of pain in the same leg that is relieved by hanging it off the edge of the bed
PVD
65yo male with long-standing, poorly controlled hypertension. He presents with left ventricular hypertrophy and a diastolic murmur in the aortic region. What is the most likely diagnosis?
Hypertensive heart disease
32yo IVDU presents with fever and chills. On examination a systolic murmur loudest in the mitral region. A set of blood cultures are taken
Infective endocarditis
Common causes: Staphylococci and Streptococci
