Cardiovascular Medicine Flashcards
Helen Taussig
Cardiovascular Health - Part 1
Cardiovascular Health - Part 2
Cardiovascular Health - Part 3
Cardiovascular symptoms- Chest pain
Character
Radiation
Precipitants
Relieving factors
Cardiovascular symptoms- Chest pain
Associations
Pleuritic pain
Chest pain and acutely unwell
Cardiovascular symptoms
Dyspnoea
Palpitations
Syncope
25% of non-cardiac chest pain
Tietze’s syndrome
Chest pain from patient’s perspective
Chest pain from patient’s perspective: Dialogue transformed symptoms
ECG—a methodical approach:
Reading an ECG >>> Rate & Rhythm
ECG—a methodical approach:
Reading an ECG >>> Axis, P wave, PR interval, QRS figure
ECG—a methodical approach:
Reading an ECG >>> QRS complex, QT interval, ST segment, T wave, J wave
ECG—a methodical approach:
Schematic diagram of a normal ECG trace
ECG—a methodical approach
Calculating the heart rate
ECG—a methodical approach:
Determining the ECG axis
ECG—abnormalities:
Sinus bradycardia
Sinus trachycardia
AF
Heart block
ECG—abnormalities
ST elevation
ST depression
T inversion
Myocardial infarction
ECG—abnormalities:
Pulmonary embolism
Metabolic abnormalities
ECG—abnormalities
Diagnosis?
ECG—abnormalities
Location, location, location &
ECG territories
ECG—abnormalities
ECG territories & posterior MI
ECG—additional points
Where to place the chest leads
ECG—additional points
QRS complex: the long and the short
ECG—additional points
RBBB
LBBB
Bifascicular block
Trifascicular block
ECG—additional points
Causes of low voltage QRS complex
Only follow >>> causes of low-voltage QRS complex
ECG— Diagnosis
ECG— Diagnosis
ECG— Diagnosis
ECG— Diagnosis
ECG— Diagnosis
ECG— Diagnosis
ECG— Diagnosis
Cardiac imaging
Intro &
Chest X-ray
Cardiac imaging
Echocardiography &
Cardiac CT
Cardiac imaging
Cardiac MR & Nuclear imaging
Cardiac imaging
changes in the second image > ?
Cardiac imaging
Cardiac CT demostrating > ?
Cardiac MR demonstrating > ?
Echocardiography
Intro
Echocardiography
Types of scan (name only)
Echocardiography
M-mode (motion mode): > ?
Two-dimensional (real time): > ?
Echocardiography
3D echocardiography > ?
Doppler and colour-flow echocardiography > ?
Tissue Doppler imaging: > ?
Echocardiography
Transoesophageal echocardiography (TOE) > ?
Stress echocardiography > ?
Echocardiography
Uses of echocardiography (names)
Only the names
Echocardiography
Use in >>> “Quantification of global LV function”
Echocardiography
Use in >>>
‘estimating right heart haemodynamics’
‘valve disease’
‘congenital heart disease’
Echocardiography
Use in >>>
‘Endocarditis’
‘Pericardial effusion’
‘HCM’
Structures seen in this picture
Echocardiography
Cardiac catheterization
function and indications
Cardiac catheterization
Pre-procedure & post-procedure checks
Cardiac catheterization:
Complications
Cardiac catheterization:
Mortality and intra-cardiac electrophysiology
Coronary artery anatomy
Coronary artery angiography > image
what do the two images show (b & c)?
CVS drugs
Antiplatelet drugs
Anticoagulants
CVS drugs
Beta blockers
ACE inhibitors
CVS drugs
Diuretics
Vasodilators
CVS drugs
Calcium antagonists
CVS drugs
Digoxin
CVS drugs:
Na channel blockers
Amiodarone
Ivabradine
CVS drugs
Statins
Anti-anginal
Anti-HTN
Drugs acting on AV node
Angina pectoris:
Features
Precipitants
Causes
Angina Pectoris:
Types
Tests
Only focus on types and tests
Angina pectoris:
Management
Angina pectoris:
Management > Revascularization
Investigations of IHD
NICE:
Recommended investigations when considering stable angina
CT angiogram data:
white arrow points towards?
Vasospastic/ Prinzmetal angina:
Risks & Triggers
Treatment
Acute Coronary Syndrome (ACS):
Definitions &
Risk factors
Acute Coronary Syndrome (ACS):
Incidence &
Diagnosis
Acute Coronary Syndrome (ACS):
Symptoms &
Signs
Acute Coronary Syndrome (ACS):
Tests
Acute Coronary Syndrome (ACS):
Differentials & mortality
Sequential ECG changes following acute MI
Graph of cardiac enzymes
Troponin:
Introduction &
Rise of troponin > cardiac cause
Troponin:
Rise of troponin > non-cardiac cause
ACS Management:
First step
ACS Management:
Acute STEMI >>> Initial treatment flowchart
ACS Management:
Acute STEMI >>> Initial treatment details
ACS Management:
Acute STEMI > Reperfusion therapy >
criteria
PCI
thrombolysis
ACS Management:
ACS without ST elevation >>> assessment and investigations
ACS management:
ACS without ST elevation >>> Acute/initial management
>>> Flow chart
ACS management:
ACS without ST elevation >>> Acute/initial management
>>> details
ACS management:
ACS without ST elevation >>> prognosis
ACS management:
ACS without ST elevation >>> further measures
ACS management:
what is GRACE ?
ACS management
After immediate actions >> focuses on ?
ACS management:
After initial management >>>
- Symptom control ?
- Modifying CVS risk factors ?
ACS management:
After initial treatment >>>
- Optimize cardioprotective medications ?
- Revascularization ?
ACS management:
After initial treatment >>>
- Discharge and General advice
ECG Diagnosis ?
Complications of MI >>> names
Cardiac arrest
Cardiogenic shock
Left ventricular failure
Bradyarrythmias
Tachyarrythmias
Right ventricular failure/infarction
Pericarditis
Systemic embolism
Cardiac temponade
Mitral regurgitation
Ventricular septal defect (VSD)
Late malignant ventricular arrythmias
Dressler’s syndrome
Left ventricular aneurysm
Bradyarrythmias & their management
Tachyarrythmias & their management
Some MI complications and their management:
Right ventricular failure/infarction
Pericarditis
Systemic embolism
Cardiac temponade
Mitral regurgitation
Ventricular septal defect (VSD)
Some MI complications and their management:
Late malignant ventricular arrythmias
Dressler’s syndrome
Left ventricular aneurysm
ACLS algorithm of cardiac arrest: 2015
Cardiogenic shock:
Intro & causes
Cardiogenic shock:
management flow chart
Cardiogenic shock:
management details
PICCO & LIDCO ?
CABG indications
CABG vs PCI
Procedures of CABG
After CABG
Cardiac temponade:
Causes
Signs
Management
Severe pulmonary oedema:
Causes & differentials
Severe pulmonary oedema:
Symptoms, Signs, & Investigations
Severe pulmonary oedema:
monitoring progress &
once stable & improving
Management of acute heart failure/ severe pulmonary oedema/ heart failure (not chronic)
Arrhythmias:
Introduction &
Causes
Arrhythmias
presentation
history
tests
Arrhythmias:
different arrhythmias, bradycardia, and management
Continuous ECG monitoring:
Telemetry
Exercise ECG
Holter monitors
Continuous ECG monitoring:
Loop recorders
Pace makers & ICDs
Sick sinus syndrome
Narrow complex tachycardia:
Definition & Differentials
Narrow complex tachycardia:
Principles of management
Narrow complex tachycardia:
Differential diagnosis from ‘emergency section’
Management of Narrow complex tachycardia/ SVT > Flow chart
Management of ‘irregular’ Narrow complex tachycardia
Management of narrow complex tachycardia (in brief)
Adenosine in narrow complex tachycardia
Narrow complex tachycardia:
specifics in emergency management
Narrow complex tachycardia:
WPW syndrome (in brief in the emergency section)
Holiday heart syndrome
Normal conduction through heart
Regular rhythm tachycardia:
Sinus tachycardia
Focal atrial tachycardia
Atrial flutter
AVRT
AVNRT
Junctional tachycardia
Bundle branch block
VT
Broad complex tachycardia:
Definition and Principles of management
Broad complex tachycardia:
Differential diagnosis
Broad complex tachycardia:
Differentiating VT from SVT with aberrancy
Ventricular extrasystoles (ectopics)
ECG diagnosis
ECG diagnosis
ECG diagnosis
Broad complex tachycardia:
Differentials in ‘emergency section’
Broad complex tachycardia:
Management (in brief text)
Borad complex tachycardia:
After correction of VT ?
Broad complex tachycardias:
VF
SVT with aberrant conduction
Ventricular extrasystoles (ectopics)
Torsades de pointes
Broad complex tachycardia:
management (flow chart)
Bradycardia:
Intro
Symptoms
Rhythm
Bradycardia:
Causes
Bradycardia:
Management (in flow chart)
Bradycardia:
Management (in text)
