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Rahul's Basics > DPD Deck - CARDIO > Flashcards

DPD Deck - CARDIO Flashcards

1
Q

An anterolateral STEMI will show ST elevation in which leads?

A

1, aVL and V1-V6

aVL - AnteroLateral

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2
Q

An inferior STEMI will show ST elevation in which leads?

A

2, 3, aVF (basically everything NOT in anterolateral) - which also has L in it so aVR is irrelevant

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3
Q

Left main stem coronary artery is made up of which two vessels?

A

The LEFT ANTERIOR DESCENDING CORONARY ARTERY and the CIRCUMFLEX ARTERY

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4
Q

An anterior MI involves which coronary artery and would show changes on which leads?

A

ARTERY: LEFT ANTERIOR DESCENDING
LEADS: V1, V2, V3, V4

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5
Q

A lateral MI involves which coronary artery and would show changes on which leads?

A

ARTERY: CIRCUMFLEX
LEADS: 1, aVL, V5, V6

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6
Q

An inferior MI involves which coronary artery and would show changes on which leads?

A

ARTERY: RIGHT CORONARY ARTERY
LEADS: 2, 3, aVF

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7
Q

Which CK is used in relation to MIs and UA?

A

CK-MB isoform

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8
Q

Describe the time course of CK-MB

A

CK-MB rises 3-12 hours after the MI
It then peaks at 24 hours
Returns to normal by 48-72 hours

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9
Q

Why is the trajectory of Troponin important?

A

Because a single measurement is useless, you want to know if it is rising or falling

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10
Q

List the conditions in which Troponin may be raised

A 
MI
Sepsis
Pneumonia
Falls 
Renal Impairment
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11
Q

List situations in which CK-MB may be raised

A

MI
cardiac surgery
myocarditis
electrical cardioversion

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12
Q

Vasovagal syncope is associated with what?

A

The 3P’s:
Precipitating factor (e.g DEHYDRATION)
Posture
Prodromal aura

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13
Q

What are the CARDIAC causes of falls?

A

Postural hypotension
Arrhythmia (family history of sudden death)
Outflow obstruction: Aortic stenosis or PE (Would be heard)
Ruptured aortic aneursym
Vasovagal syncope (benign)

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14
Q

List the DDx of falls

A
  1. HYPOGLYCAEMIA
  2. Vasovagal syncope
  3. Arrhythmia
  4. Outflow Obstruction
  5. Postural hypotension
  6. Seizure
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15
Q

What are the Ix for an arrhythmia?

A

ECG (looking for long QT syndrome)
Cardiac monitor in a monitor bed
24 hour tape

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16
Q

What are the Ix for outflow obstruction/finding on examination?

A

Low volume/slow rising pulse
An ejection systolic murmur will be heard
Echocardiogram can be performed

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17
Q

What are the Ix for postural hypotension

A

Take standing/lying BP
SBP will fall >20 mmHg after 3 minutes
DBP will fall >10 mmHg after 3 minutes

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18
Q

What is long QT syndrome?

A

An arrhythmia where there is ABNORMAL VENTRICULAR REPOLARISATION

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19
Q

What is one sign that might indicate long QT syndrome?

A

A family history of sudden death

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20
Q

What are the causes of long QT syndrome?

A

Causes of long QT syndrome can be classified as CONGENITAL or ACQUIRED
CONGENTIAL: Mutations in K channels
ACQUIRED: Drugs or Low K+/Mg2+

21
Q

Symptoms of Heart Failure

A

Fatigue
Dyspnea
Orthopnea
Paroxysmal Noctural Dyspnea

22
Q

Signs of Heart Failure

A 
Cardiomegaly
S3/S4
Tachycardia
Bi-basal crackles
Pleural effusion
Peripheral oedema
Smooth, tender enlarged liver
23
Q

What are 3 causes of a raised JVP?

A

Right heart failure
Tricuspid Regurgitation
Constrictive pericarditis

24
Q

Name the causes of constrictive pericarditis

A

Infection: TB
Inflammation: Connective tissue disease
Malignancy

25
Q

Name the 4 differentials for PALPITATIONS

A
  1. Sinus tachycardia
  2. Supraventricular tachycardia (SVT)
  3. Atrial fibrillation
  4. Ventricular tachycardia
26
Q

Describe SINUS TACHYCARDIA and list its causes

A

Everything is normal but the QRS may be narrow and the rhythm is regular
Causes of sinus tachycarida:
Physiological
Sepsis
Hypovolaemia
Enodcine causes: thyrotoxicosis and phaeochromocytoma

27
Q

Describe SVT

A

It is a re-entry circuit that involves a normal and accessory pathway
In SVT you will see no p waves before the QRS
However, the rhythm (Which can be determined by measuring distance between complexes) will be regular

28
Q

What is the difference between AVNRT and AVRT?

A

AVNRT: The re-entry circuit is at the lvel of the AV node as a result you have constant electrical signals sent which causes rapid contraction
AVRT: (eg. Wolff-Parkinson White syndrome): The re-entry circuit is not at the level of the ventricles

29
Q

Describe AVRT

A

Short PR interval and a slurred QRS complex called a delta wave which is seen at rest or after treatment

30
Q

Describe ATRIAL FIBRILLATION as it appears on an ECG

A

Irregular rhythm

no p-waves

31
Q

What are some of the causes of AF

A 
Thyrotoxicosis, Alcohol
Heart causes: muscle affected - IHD
Valve affected: Mitral stenosis
Pericardium affected
Lungs: Pneumonia or PE
32
Q

Describe Ventricular tachycardia as it appears on an ECG

A

Fast, broad QRS

33
Q

List causes of Ventricular tachycardia

A

Ischaemia
Electrolyte abnormality
Long QT

34
Q

What is the management of SVT?

A

Vagal manouevers: Valsalva (or carotid sinus massage)
Give adenosine (use cardiac monitor)
If there is haemodynamic compromise - give DC cardioversion

35
Q

What is the management of AF?

A 
Rhythm control
Note: If onsent >48 hours, anticoagulate for 3-4 weeks before cardioversion to avoid clots
Control rate:
Beta-blockers
Digoxin
36
Q

What is the management of VT?

A

If there is no haemodynamic compromise give IV amiodraone (which prolongs the heart refractory period)
ICD
If pulseless: Defibrillate

37
Q

How do you detect hypertension on an ECG?

A

Deep S waves in V1/V2

Tall R waves in V5/V6

38
Q

How do you detect LVH?

A

If requires an echocardiogram
LVH by voltage criteria can be determined by:
S waves in V1 AND R waves in v5 or v6 greater than/equal to 7 large boxes

39
Q

What are the differential diagnoses for PLEURITIC CHEST PAIN?

A 
Pericarditis
PE
Pneumonia
Pneumothorax
Pleural pathology
40
Q

What is the difference between DC cardioversion and defibrillation?

A

Cardioversion is synchronised while defibrillation is not, it just ‘shocking’ the patient

41
Q

What is S1 associated with?

A

Mitral valve closure

42
Q

What is S2 associated with?

A

Aortic valve closure

43
Q

What is S3 associated with and when does it appear?

A

S3 appears after S1 and S2 and is associated with VENTRICULAR FILLING

44
Q

What is S4 associated with and when does it appear?

A

S4 appears before S1 and is associated with VENTRICULAR HYPERTROPHY

45
Q

Describe the management for acute heart failure

A
  1. Sit up and give oxygen (60%-100%)
  2. IV Furosemide
  3. GTN may be given in SPECIAL CIRCUMSTANCES - angina and heart failure
  4. Treat underlying cause of heart failure
46
Q

What is the management plan for someone with VF/pulseless VT?

A 
o	Shock
o	CPR (2 min)
o	Assess rhythm
o	Adrenaline every 3-5 minutes
o	Amiodarone after 3 shocks 
o	Correct reversible causes
47
Q

What is the management plan for someone in asystole/with PEA?

A

o CPR (2 min)
o Adrenaline every 3-5 min
o Correct reversible causes

48
Q

List the cardiovascular causes of clubbing

A 
Infective endocarditis
Congenital cyanotic heart disease
Atrial myoxma (tumour on the atrial septum)
Axillary artery aneurysm
Brachial arteriovenous fistula

Rahul's Basics (11 decks)

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