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Phase 2A > CV > Flashcards

CV Flashcards

1
Q

Explain what the different parts of an ECG represent

A

P wave - atrial depolarisation
QRS complex - ventricular depolarisation
T wave - ventricular repolarisation

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2
Q

How long does each part of the ECG last?

A

P-R interval - 0.12-0.2s

QRS -

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3
Q

Quick way of calculating heart rate from ECG

A

300 divided by number of big squares between each QRS

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4
Q

In what condition would you see absent P waves?

A

Atrial fibrillation

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5
Q

What is classed as tachyarrhythmia? and how are they further classified?

A

Heart rate >100bpm
Narrow or broad (QRS120ms)
Supraventricular or ventricular

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6
Q

4 symptoms of atrial fibrillation

A

Breathlessness, chest pain, palpitations, fatigue

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7
Q

Main risk of atrial fibrillation

A

Embolic stroke

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8
Q

Who is most at risk for AF

A

Elderly

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9
Q

What will an ECG in AF look like

A

Absent P waves, irregular QRS

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10
Q

Some causes for AF

A

Heart failure, ischaemic heart disease, hypertension, caffeine, MI, PE, pneumonia

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11
Q

Treatment for acute AF (

A

Cardioversion, drug cardioversion (IV amiodarone)

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12
Q

What score is used to measure the risk of stroke in patients with AF?

A 
CHADS-VASc
(CHA2DS2VASc)
Congestive heart failure
Hypertension
Age >75 (2)
Diabetes
Stroke or TIA in past (2)
Vascular disease
Age 65-74
Sex
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13
Q

2 main goals in AF?

A

Rate control and anticoagulation

B-blocker/CCB first line, add digoxin, then amiodarone

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14
Q

What is atrial flutter

A

Activity 300bpm, sawtooth appearance on ECG - macro reentry around right atrium

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15
Q

What is cor pulmonale?

A

Right sided heart failure secondary to lung disease - pulmonary hypertension, COPD, fibrosis, asthma, sickle cell, PE

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16
Q

Signs and symptoms of cor pulmonale

A

Dyspnoea, fatigue, syncope, cyanosis, tachycardia

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17
Q

When does ischaemic heart disease occur?

A

Increased demand of blood supply or blood supply itself is impaired

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18
Q

4 symptoms of acute MI

A

Crushing band like chest pain may radiate to jaw/back/arm, nausea, vomiting, sweating

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19
Q

Treatment of an acute MI

A 
Morphine
Oxygen
Nitrates
Anticoagulants
Beta blockers if no contraindication
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20
Q

5 differences between STEMI and NSTEMI

A

STEMI - full thickness damage, ST elevation, pathological Q waves, more elevated markers (troponin, CK-MB), PCI to treat, Thrombolysis.
NSTEMI - partial thickness damage, markers only mildly elevated, ST depression, no Q waves, T wave inversion, PCI/CABG, thrombolysis can be harmful

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21
Q

What should patients be prescribed on discharge?

A

ACEI, BB/CCB, statin

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22
Q

Complications of MI

A 
(C PEAR DRoP)
Cardiac arrhythmia/cardiogenic shock
Pericarditis
Emboli
Aneurysm
Rupture of ventricle
Dresslers syndrome
Rupture of free wall
o
Papillary muscle rupture
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23
Q

When does angina occur?

A

Imbalance between oxygen supply and demand

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24
Q

8 risk factors for angina

A

Hypertension, obesity, smoking, diabetes, physical inactivity, family history, stress, age

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25
Q

3 exacerbating factors

A

Excitement, cold weather, exertion, heavy meal

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26
Q

4 components of Tetralogy of Fallot

A

Pulmonary stenosis, ventricular septal defect, over riding aorta, right ventricle hypertrophy

27
Q

Treatment of angina

A

GTN as required, aspirin, beta blockers - contraindicated in asthma and COPD, CABG/PTCA

28
Q

Findings on a CXR of heart failure

A 
Alveolar oedema
Kerly B lines
Cardiomegaly
Dilated prominent upper lobe vessels
pleural Effusion
29
Q

Which classification systems are used for heart failure?

A

New York - symptoms
(1-asymptomatic, 2-dyspnoea on activity, 3-dyspnoea on less than normal activity, 4-dyspnoea present at rest) or Framingham for congestive cardiac failure diagnosis

30
Q

5 symptoms of left sided heart failure

A

Dyspnoea, orthopnoea, fatigue, low exercise tolerance, nocturnal cough, wheeze, +/- pink frothy sputum, weight loss, muscle wasting

31
Q

5 symptoms of right sided heart failure

A

Peripheral oedema, nausea, anorexia, facial engorgement, epistaxis

32
Q

What is the key investigation in heart failure?

A

Echocardiography. Do if either ECG or BNP (b type natriuretic protein) abnormal. Can show dilated cardiomyopathy, systolic/diastolic dysfunction

33
Q

Treatment for chronic heart failure

A

Diuretics (furosemide)
ACEI - ramipril
(if cough is a problem ARB - losartan)
Beta blockers, spiranolactone, digoxin

34
Q

3 causes of aortic stenosis

A

Calcification, congenital bicuspid valve, rheumatic heart disease

35
Q

3 symptoms of aortic stenosis

A

Dyspnoea, syncope, angina

36
Q

Describe the murmur heard in aortic stenosis

A

Crescendo decrescendo ejection systolic murmur radiating to the carotid arteries

37
Q

Possible complications of aortic stenosis

A

Arrhythmias, sudden death infective endocarditis

38
Q

2 features of the pulse in aortic stenosis

A

Narrow pulse pressure, slow rising pulse

39
Q

6 causes of aortic regurgitation

A

Acute - cusp rupture, connective tissue disorders (marfans), aortic dissection
Chronic - Rheumatoid arthritis, ankylosing spondylitis, syphilis

40
Q

3 symptoms of aortic regurgitation

A

Dyspnoea, angina, heart failure

41
Q

2 features of the pulse in aortic regurgitation

A

Waterhammer pulse, wide pulse pressure

42
Q

3 complications of aortic regurgitation

A

Arrhythmias, heart failure, infective endocarditis

43
Q

3 signs of aortic regurgitation

A

De Musset’s sign - head bobbing
Traube’s sign - pistol sound heard over femoral artery
Quincke’s sign - pulse felt in nail

44
Q

Describe the murmur heard in aortic regurgitation

A

Decrescendo early diastolic murmur

45
Q

How is aortic regurgitation treated?

A

Underlying conditions treated, heart failure treated, valve replacement is treatment of choice

46
Q

Which imaging technique is used to confirm a diagnosis of valve disease?

47
Q

5 causes of mitral stenosis

A

Calcification, rheumatic heart disease, rheumatoid arthritis, ankylosing spondylitis, SLE

48
Q

4 symptoms of mitral stenosis

A

Dyspnoea, palpitations if in AF, heart failure, haemoptysis

49
Q

Describe the murmur heard in mitral stenosis

A

Mid diastolic murmur with opening snap

50
Q

4 signs of mitral stenosis

A

Malar flush, irregularly irregular pulse if in AF, Ortner’s syndrome - hoarse voice, tapping apex beat

51
Q

3 complications of mitral stenosis

A

Atrial fibrillation, heart failure, infective endocarditis

52
Q

Treatment of mitral stenosis

A

Manage AF and heart failure, valve replacement

53
Q

4 causes of mitral regurgitation

A

Rheumatic heart disease, papillary muscle rupture, infective endocarditis, prolapse

54
Q

4 symptoms of mitral regurgitation

A

Palpitations if in AF, symptoms of infective endocarditis, heart failure

55
Q

2 signs of mitral regurgitation

A

Irregularly irregular pulse if in AF, displaced apex beat

56
Q

Describe the murmur heard in mitral regurgitation

A

Harsh pansystolic murmur radiating to the axilla

57
Q

4 complications of mitral regurgitation

A

Infective endocarditis, atrial fibrillation, heart failure, pulmonary hypertension

58
Q

Treatment of mitral regurgitation

A

Treat heart failure and atrial fibrillation, valve repair is preferred because valve replacement might damage papillary muscles

59
Q

What are the two layers of the peridcardium?

A

Outer fibrous and inner serous

60
Q

6 causes of acute pericarditis?

A

Viral (cocsackie A+B, herpes simples, influenza), post MI, uraemia, bacterial, tuberculosis, fungal

61
Q

2 causes of chronic pericarditis

A

Connective tissue disease, rheumatoid arthritis

62
Q

How does pericarditis present?

A

Sharp central chest pain, exacerbated by movement, respirating and lying down. Relieved by sitting forward. Fever and dyspnoea.

63
Q

What would be seen on an ECG in a patient with pericarditis?

A

Saddle shaped ST elevation

64
Q

How is pericarditis treated?

A

Cause treated if known, oral NSAIDs, aspirin, colchicine

Phase 2A (9 decks)

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