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cardiology > ECG, pericarditis > Flashcards

ECG, pericarditis Flashcards

1
Q

What is each square worth on an ecg

A

40 ms

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2
Q

How to measure heart rate from ecg

A

300/6 or how many boxes between each peak

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3
Q

anatomy of pericardium

A

2 layers
Visceral single cell layer adherent to epicardium
Fibrous parietal layer 2mm thick
Acellular collagen and elastin fibres
50ml of serous fluid

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4
Q

what is acute pericarditis

A

Acute pericarditis is an inflammatory pericardial syndrome with or without effusion

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5
Q

clinical diagnosis of pericarditis is made from

A

Chest Pain (85-90%)
Friction rub (33%)
ECG changes (60%)
Pericardial effusion (up to 60% usually mild)

2 of 4

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6
Q

causes of pericarditid

A

viral
bacterial

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7
Q

specific viruses that cause pericarditis

A

enteroviruses
adenoviruses
paroviruses

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8
Q

non infectious causes of pericarditis

A

auto immune
neoplastic
metabolic

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9
Q

clinical presentation of pericarditis

A

CHEST PAIN
-severe
-sharp and pleuritic
-rapid onset
-left anterior chest or epigastrium

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10
Q

what are you looking for in the clinical examination for pericarditis investigation

A

Pericardial rub – pathognomonic, crunching snow
Sinus tachycardia
Fever
Signs of effusion (pulsus paradoxus, Kussmauls sign)

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11
Q

what woudl ecg show for pericarditis

A

PR DEPRESSION
Diffuse ST elevation
NO reciprocal ST depression

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12
Q

why is there ecg changes

A

pericardium is adjacent to myocardium hence it will show ecg changes due to the inflammation

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13
Q

which ecg leads are inferior

A

2 ,3 , avf

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14
Q

what would a FBC show for pericarditid

A

modest increase in WCC - white cell count
mild lympocytosis

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15
Q

troponin levels in pericarditis ?

A

elevation suggest myopericarditis

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16
Q

differential diagnosis of pericarditis ?

A

MYOCARDIAL ISCHAEMIA
pneumonia
pul embolus

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17
Q

management of pericarditis

A

-sedentary activity until resolution
-nsaid( ibuprofen 600mg)
colchine for three months

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18
Q

prognosis of pericarditis

A

Fever >38°CSubacute onset
Large pericardial effusion
Cardiac tamponade
Lack of response to aspirin or NSAIDs after at least 1 week of therapy

19
Q

what is heart failure

A

inability for the heart to deliver oxygenated blood to tissues at a satisfactory rate for the tissues metabolic requirement
A SYNDROME NOT A DIAGNOSIS

20
Q

What are the causes of heart failure

A

IHD
cardiomyopathy
valvular disease

21
Q

commonest cause of pericarditis

A

viral pericarditis

22
Q

what is cor pulmonalae

A

right sided heart failure cuased by resp disease

23
Q

what does cor pulmonalae cause

A

backlogof blood of right atrium, vena cava and the venous system

24
Q

what causes CP

A

COPD
pul embolism
LUNG DISEASE
cystic fibrosis
pulmonary hypertensions

25
Q

presentation of CP

A

Early CP= asymptomatic
shortness of breath
peripheral oedema
breathlessness on exertion
syncope
chest pain

26
Q

why might a patient with CP have raised JVP

A

Due to a backlog of blood in the jugular vein

27
Q

management for cor pulmonale

A
  • treating the symptoms and underlying cause
    -long term oxygen therapy
28
Q

common presentation for chronic heart failure

A

Breathlessness worsened by exertion
Cough. They may produce frothy white/pink sputum.
Orthopnoea
Paroxysmal Nocturnal Dyspnoea
Peripheral oedema (swollen ankles

29
Q

how would you investigate orthopnea

A

ask patient how many pillows they use

30
Q

what is paroxysmal noctural dyspnoea

A

term used to describe the experience that patients hvae when suddenly waking at night with shortness of breath and cough

31
Q

in what direction does the avr lead go and what does it show

A

from RA to LA
activity of RV and interventricular septem

32
Q

in what direction does the avl lead go and what does it show

A

RA TO LL
high lateral wall of LV

33
Q

in what direction does the avF lead go and what does it show

A

LA TO LL
inferior wall of heart

34
Q

what activity does lead 1 show you

A

high lateral wall of LV

35
Q

WHAT ACTIVITY DOES LEAD 2 AND 3 SHOW YOU

A

inferior portion of the heart

36
Q

how many chest leads are there

A

6

37
Q

leads V1-V3 show you ?

A

RV same as AVR

38
Q

leads v2-v3 show you

A

interventricular septum
same as AVR

39
Q

WHAT do leads v2-v4 show you

A

anterior wall of heart

40
Q

what should leads v5-v6 show you

A

lateral wall of lv

41
Q

What are th signs of hf

A

Tachycardia
n Displaced apex beat
n Raised JVP
n Added heart sounds and murmurs
n Hepatomegaly, especially if pulsatile and tender
n Peripheral and sacral oedema n Ascites

42
Q

What is ejection faction

A

Amount of blood that leaves the heart per beat

43
Q

what is cardiac tamponade

A

Life threatening
accumulation of fluid in the pericardial space– compression of heart chambers= decrease in venous return = decrease in filling in the heart = decrease CO

44
Q

What is the essential blood marker for heart failure

A

Brain natriuretic peptide

cardiology (16 decks)

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