Conditions

Question 1

How may dilated cardiomyopathy present (4 signs)?

RAPS

Answer 1

Right ventricular failure
SOB
Pulmonary oedema
AF

Question 2

Describe how atrial myxoma may present

Answer 2

Dizziness
Fainting
Palpitations

(All due to obstruction of the conductive pathway)

Question 3

Hypertrophic cardiomyopathy has a 40% mortality rate within 2 years.

Its signs and symptoms are:

Sudden death
Angina
Dyspnoea
Palpitations
Syncope

The 2 tests that can be done to identify this condition are ECGs and echocardiograms.

What results would you get for each test?
ECG (1)
Echocardiogram (3)

Answer 3

ECG: deep Q waves (due to left ventricular hypertrophy)

Echocardiogram:
MR SAM ASH

MR: Mitral regurgitation

SAM: systolic anterior motion of the anterior mitral valve leaflet

ASH: Asymmetric (so only LV) hypertophy

Question 4

Left ventricular free wall rupture is seen in 3% of people 1-2 weeks post an MI.

A recent history of an MI is one sign for this condition. Name the other 4 signs.

Answer 4

(Cardiac tamponade-) Pulsus paradoxus, raised JVP, diminished heart sounds

Sudden onset of heart failure

Question 5

What is Pulsus paradoxus?

Answer 5

During inspiration there is a larger than normal decrease in systolic blood pressure, stroke volume and pulse wave amplitude.

(Typical decrease in systolic blood pressure should be 10mmHg - anything greater than 10mmHg is pulsus paradoxus)

Question 6

Dressler’s syndrome typically occurs 4-6 weeks post an MI.

Name the 4 signs that would be present and what class of drug is used to treat this syndrome?

Answer 6

Fever, pleuritic pain (so pain present on lateral chest and is worse in inspiration), pericardial effusion + raised ESR

NSAIDs