Disease Factfiles Flashcards
Aetiology Acute Heart Failure
Ischaemic Heart Disease
Valvular Heart Disease
Hypertension
Acute and Chronic Kidney Disease
Atrial Fibrillation
Acute HF features
Dyspnoea/ PND
Pulmonary oedema
Tachypnoea
Pulmonary Congestion
Low Co output
Acute HF Diagnosis
Gold: Transthoracic Echo
12-lead ECG
CXR
Bloods: creatinine and electrolytes, FBC, glucose, cardiac enzymes, troponin, CRP an D-dimer
BNP
Acute HF Management
Initial
- Oxygen, Diuretic (furosemide), CPAP, vasodilator (GTN)
Morphine
Antithrombin (LMWH)
Acute Mesenteric Ischaemia Aetiology
Thrombus-in situ
Embolis
Non-occlusive
Venous occlusion and congestion
Acute Mesenteric Ischaemia Features
Abdo pain (out of proportion to findings)
Nausea & vomiting
Abdo exam
- Non-specific tenderness
-Late: Global peritoneum
Acute mesenteric Ischaemia Investigations
ABG, Bloods
Imaging: CT scan with IV contrast
Acute mesenteric Ischaemia Management
Surgical emergency
Excision of necrotic or non-viable bowel
Angina Features
Classical
- heavy, tight, gripping
-central/retrosternal
- occurs with exercise/ emotional stress
Stable
- Occurs with activity
Unstable
- angina of recent onset
-occurs at rest
Angina management
Vasodilator: GTN, isosorbide mononitrate
Betablocker
Calcium Channel Blocker (verapamil. dilimiazem, amlodipine)
Other anti-anginals: Ivabradine, nicorandil. ranolazine
Event reducing: Aspirin, clopidogrel, atorvastatin
Thoracic Aortic Aneurysm Aetiology
Connective tissue disease
Bicuspid Aortic valve
Trauma
aortic dissection
aortic arteritis (Takayasu)
Tertiary syphilis
Thoracic Aortic Aneurysm aetiology
Chest pain
back pain
hoarse voice
Features of HF
Thoracic aortic aneurysm investigations
Routine bloods
ECG
Plain CXR
1st Line: CT angiogram
Transoesophageal echo
Acute limb Ischaemia features
Pain
Pallor
Pulseless
Paraesthesia
Perishingly cold
Paralysis
Acute limb Ischaemia investigation
Doppler US
CT angiography
Acute limb Ischaemia management
Surgical emergency
Therapeutic dose heparin
Intervention
-Embolic: Embolectomy via Fogarty catheter
Bypass surgery
-Thrombotic: Local intra-arterial thrombolysis, angioplasty
Acute Aortic Syndrome
Aortic dissection
penetrating aortic ulcer
Intramural haemartoma
Aortic Dissection Classification
Acute <14 days
Chronic >14 days
Stanford
A- involves ascending aorta
B- doesn’t involve ascending aorta
Aortic dissection clinical features
Tearing chest pain (radiates to back)
tachycardia
hypotension
new aortic regurgitation
end organ hypo perfusion
Aortic dissection investigations
First: CT angiogram
Transoesophageal echo
Aortic dissection management
type A: Surgical
Uncomplicated Type B : Labetalol
Narrow Complex Tachycardia Ddx
Sinus tachycardia
SVT
AF
Atrial flutter
SVT management
Vagal Manœuvres
Adenosine
Broad complex tachycardia DDx
QRS >0.12
Ventricular tachycardia
Polymorphic VT
AF with BBB
SVT with BBB
