Cardiovascular Medicine

Question 1

What do narrow complex tachycardias indicate?

Answer 1

Tachycardia is originating in the atria or AV node

Question 2

Possible causes of a narrow complex tachy?

Answer 2

AF
Sinus tachy

Supraventricular:
Atrial tachycardia
AVNRT
AVRT (eg WPW syndrome)

Question 3

What maneuver can exacerbate aortic stenosis?

Answer 3

Squatting down

Question 4

What artery would be effected in a patient with a MI and BRADYcardia?

Answer 4

Inferior MI most likely caused by RCA suppling the SA node

Question 5

What is the treatment for a broad complex tachycardia?

Answer 5

Amioderone - if patient is stable

Cardioversion - if patient is compromised (chest pain, signs of heart failure, decreased BP, decreased GCS)

Question 6

What are NOACs?

Answer 6

Novel oral anticoagulants: inhibit thrombin directly (e.g. dabigatran)

Question 7

Camplete heart block - what do you need to know from the ECG?

Answer 7

QRS width:
Narrow = escape rhythm from above the budle of His
Wide = below BoH and slow HR. Increase likelihood of heamodynamic instability

Question 8

Heavy periods - what of it?

Answer 8

Anaemia (could this lead to HF??)

Question 9

What does a narrow complex tachycardia tell you?

Answer 9

Narrow complex tachycardias originate in the atria or AVN - causes include AF, sinus tachycardia, or supraventricular (atrial tachycardia, AVNRT, AVRT)

Question 10

`Which valvular heart defect is made worse by squatting down?

Answer 10

AS

Question 11

What is the commonest artery affected by MI that causes bradycardia?

Answer 11

RCA - pullies the SA node

Question 12

What is the best drug in management of broad complex tachy?

Answer 12

Amioderone however if the patient is compromised (chest pain, HF, low BP, low GCS) then cardioversion