From QNs

Question 1

What valve is most commonly affected in valvular heart disease?

Answer 1

Aortic Valve

Question 2

What is an Ejection systolic murmur in eight 2nd intercostal space

Answer 2

Aortic Stenosis

Question 3

What murmur is heard with mitral stenosis?

Answer 3

Mid-diastolic with opening snap
5th intercostal space

Question 4

What 3 meds to control mitral valve disease?

Answer 4

Ca channel blockers
Beta Blockers
Anticoag if CHAD-VASC score is high enough

Question 5

Raised JVP & Murmur radiating to left axilla

Answer 5

Mitral Reguritation

Question 6

What bacteria should be expected in IE after a dentist appointment?

Answer 6

Strep Viridans

Question 7

What criteria is used to diagnose Infective endocarditis?

Answer 7

Dukes criteria

Question 8

What microorganism should be expected in IE of an IV drug user?

Answer 8

Staph aureus

Question 9

What microorganism should be expected in IE of a patient with a prosethic valve?

Answer 9

Staph epidermidis

Question 10

What is the most common cause of heart failure?

Answer 10

Ischaemic Heart Disease

Question 11

Describe the pathological difference between Left and Right sided heart failure

Question 12

What symptoms occur with left sided heart failure

Question 13

What symptoms occur with right sided heart failure

Question 14

What are the indications for DC Cardioversion?

Answer 14

HISS
Heart Failure
Ischemia
Syncope
Shock (Tachy & hypotension)

Question 15

What does coved ST elevation with negative T waves suggest? And what are they at risk of? So what is definitive treatment

Answer 15

1. Brugada syndrome
2. Sudden Cardiac Death
3. Implantable Cardiac Defib

Question 16

What is an ECG for LBBB

Answer 16

WILLIAM
Deep S waves followed by sloping high take off to T

Question 17

What is an ECG for RBBB

Answer 17

MARROW
‘bunny ears’

Question 18

What is a complication of an MI

Answer 18

ischemia leading to papillary muscle dysfunction causing acute mitral regurgitation

Question 19

What does no correlation between P waves and QRS mean?

Answer 19

Complete heart block/ 3rd degree AV block

Question 20

What must not be given with beta-blockers?

Answer 20

Beta-blockers and non-dihydropyridine Ca channel blockers (e.g. verapamil) should not be given together as they are both negatively inotropic and their effects are additive. This can lead to marked bradycardia and increase the risk of atrioventricular block

Question 21

How does Digoxin toxicity present

Answer 21

Yellow-green visual discolouration
nausea, vomiting and confusion
Causes hypokalaemia

Question 22

What is the indication for CABG over PCI?

Answer 22

CABG has a survival advantage over PCI in patients who: are over 65 years old, have diabetes, or have complex 3 vessel disease

Question 23

How does Amyloidosis present in the heart?

Answer 23

It can lead to a restrictive cardiomyopathy that appears “sparkling” on an echocardiogram. This man has presented with symptoms of heart failure with a preserved ejection fraction (HFpEF). Amyloid deposition also causes arrhythmias and conduction disturbances.

Question 24

What is suggestive of Cardiac tamponade?

Answer 24

Beck’s triad - hypotension, muffled heart sounds, raised JVP
suggests external constriction on the heart

Question 25

What does a pulsatile liver signify?

Answer 25

Seen in cases of severe tricuspid regurgitation due to backflow of blood into the liver during systole. It may be associated with hepatomegaly. The patient may also have other features of right-sided heart failure including peripheral oedema and ascites.

Question 26

What are the triad of symptoms in aortic stenosis

Answer 26

Heart failure, syncope, angina

Question 27

What is an emergent complication of aortic valve infective endocarditis?

Answer 27

Aortic root abscess formation

Question 28

What is Dresslers Syndrome?

Answer 28

A form of pericarditis tends to occur weeks to months after myocardial infarction. It is an autoimmune response triggering systemic inflammation, affecting other serous membranes as well such as the pleura.