Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Supporting Life > Chest pain > Flashcards

Chest pain Flashcards

1
Q

What is a differential for ST elevation in inferior ECG leads?

A

Aortic dissection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which syndromes are associated with aortic dissection?

A

Marfan’s
Ehlers-Danlos
Turner’s
Noonan’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Risk factors for aortic dissection?

A 
Hypertension
Trauma
Pregnancy
Bicuspid aortic valve
Syndromes (M, E, T, N)
Syphilis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Features of aortic dissection?

A

Tearing pain
Hyper or hypotensive depending on blood loss
Tachycardia, clammy and cold
Artery specific involvement
No / non-specific ECG changes / ST elevation in inferior leads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Associated symptoms of reflux?

A

Vomiting
High BMI
Positional changes in pain - worse when lying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Presentation of infective endocarditis?

A

Fever
Murmur
IV drug use is a risk factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What organism is most likely to cause infective endocarditis in an IV drug user?

A

S. aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Risk factors for PE?

A 
Immobility / surgery
Previous PE
History of malignancy
Tachycardia
Haemoptysis
Signs of DVT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Dressler’s syndrome is…

A

Auto-immune pericarditis occurring 2-6 weeks after an MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Presentation of Dressler’s syndrome?

A

Pleuritic chest pain
Pyrexia
Rubbing sound on auscultation
Pansystolic murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatments for chronic heart failure?

A

Loop diuretics will reduce the fluid overload

ACE-inhibitors and beta blockers improve the long term prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What commonly follows inferior MI?

A

Atrioventricular block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Most common cause of mitral stenosis?

A

Rheumatic fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Most common cause of cardiac arrest post-MI? (3-5 days)

A

Ventricular fibrillation (extensive coagulative necrosis and neutrophils)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Event 0-24 hours post MI?

early necrosis

A

Ventricular arrhythmia
HF
Cardiogenic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Event 1-3 days post MI?

extensive necrosis + neutrophils

A

Ventricular fibrillation (cardiac arrest)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Event 3-14 days post MI?

macrophages + granulation at margins

A

Free wall rupture
Valve rupture
LV pseudoaneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Event 2 weeks-several months post MI?

contracted scar

A

Dressler’s syndrome
HF
Arrhythmias
Mural thrombus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Causes of cardiogenic shock?

A

Infarcted ventricular wall (reduced stroke volume)

Free wall rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do you improve prognosis of chronic heart failure?

A

Beta blockers

Loop diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Inferior MI commonly can lead to…

A

AV block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Pericarditis chest pain differential?

A

Worse when lying

23
Q

Dressler’s syndrome symptoms?

A

Fever
High ESR
Pleuritic pain
Pericardial effusion

24
Q

What is associated with persistent ST elevation and LV failure?

A

Left ventricular aneurysm

25
Q

How do patients with LV free wall rupture present?

A 
1-2 weeks post-MI
Acute HF secondary to cardiac tamponade
Raised JVP
Pulsus paradoxus
Distant heart sounds
26
Q

Treatment for LV free wall rupture?

A

Urgent pericardiocentesis and thoracotomy are needed

27
Q

Presentation of ventricular septal defect:

A

First week post-MI
Acute HF
Pan-systolic murmur
(Echo will differentiate between atrial mitre regurgitation which presents in a similar way)

28
Q

Consequence of inferior-posterior infarction?

A

Acute mitral regurgitation

29
Q

Cause of acute mitral regurgitation?

A

Ischaemia or rupture of the papillary muscle

30
Q

Presentation of acute mitral regurgitation?

A

Acute hypotension
Pulmonary oedema
Early-to-mid systolic murmur

31
Q

Treatment for acute mitral regurgitation?

A

Vasodilation and often surgical repair

32
Q

Pericarditis postural effects?

A

Worse lying down

Relieved by leaning forward

33
Q

Pericarditis pain profile?

A

Pleuritic

Worse when lying, better leaning forward

34
Q

Global ‘saddle shaped’ ST elevation and PR depression indicated what?

A

Pericarditis (differential to MI as the ECG changes will be regional rather than global)

35
Q

Features of acute pericarditis?

A 
Pleuritic chest pain
Non-productive cough, dyspnoea, flu-like symptoms
Pericardial rub
Tachypnoea
Tachycardia
36
Q

Management for pericarditis?

A

Immediately give all an echo
Treat underlying cause
Colchine and NSAIDs

37
Q

Associated sign of Marfan’s aortic dissection?

A

History of other connective tissue related problems like bilateral inguinal hernias

38
Q

Classic history?

A

Vague constricting sensation at chest, neck, jaw, arms or shoulder lasting 15 mins
Precipitated by exercise/emotional stress
Relieved by rest/nitrates in less than 5 mins

39
Q

1 symptom =

A

Non-anginal chest pain

40
Q

2 symptoms =

A

Atypical angina

41
Q

3 symptoms =

A

Typical angina

42
Q

What do you give adenosine for?

A

Supraventricular tachycardia

43
Q

Exacerbating factor?

A

Anything that raises basal metabolic rate e.g. exercise, cold, post-meal, psychological stress

44
Q

Differentials:

A

COPD and asthma (both have similar SOB, chest pain, inability to expand chest)
ACS = crescendo angina
Oesophageal pain from hot/acidic drink

45
Q

Cardiac work =

A

HR x BP

46
Q

How to differentiate?

A

What relieves symptoms?

GTN and rest relieves angina, not rubbing, cold/warm fluids or antacids

47
Q

Associated symptoms of angina:

A 
Palpitations
SOB
Dizziness
Dysphagia
Fatigue
48
Q

Past medical history?

A

AMI
CABG/PCI
CV Res
Previous cardiac tests

49
Q

Causes of myocardial ischaemia without coronary stenosis?

A

Aortic stenosis
Left ventricular hypertrophy (increased after load)
Microvascular dysfunction
Severe anaemia

50
Q

Tests in angina:

A 
Troponin
CTCA
MRI
Dobutamine stress ECHO
Nuclear perfusion
51
Q

ECG signs of PE?

A

S1Q3T3
Sinus tachycardia
Signs of right heart strain
T wave inversion in the anterior leads

52
Q

What is the murmur in aortic regurgitation?

A

Early diastolic

53
Q

Causes of aortic stenosis?

A 
Degenerative calcification
William's syndrome
Bicuspid aortic valve
Post-rheumatic disease
Subvalvular: HOCM

Supporting Life (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions