General cardiac Q's

Question 1

Classical pain seen in pericarditis

ECG findings for pericarditis

Answer 1

Sharp central chest pain (substernal) relieved by sitting up/ leaning forward

Pain exacerbated when lying flat or inhaling deep breaths (pleuritic pain)

ECG: Saddle shaped ST elevation (other causes: STEMI and LBBB)

Question 2

Autoimmune condition associated with pericarditis

Answer 2

SLE

Question 3

Criteria used to diagnose infective endocarditis

Answer 3

Duke’s criteria

Question 4

Dressler’s syndrome

Answer 4

Type of pericarditis that develops 2-6 weeks following an MI

Characterised by an autoimmune response mounted by the body after injury to myocardium or pericardium

Fever, pericarditis, pleuritic pain +/- pericardial effusion

Question 5

Complete heart block following an MI

Which artery most likely to be affected?

Answer 5

Usually inferior infarct -> RCA

Question 6

Amiodarone use is associated with which respiratory conditions

Answer 6

Pulmonary fibrosis / pneumonitis

Question 7

Cardiac tamponade triad

Answer 7

Beck’s triad

Hypotension
Raised JVP, and
Muffled heart sounds.

Question 8

Inferior myocardial infarction and AR murmur think..

Answer 8

Aortic dissection

Along with
Tearing chest pain
Pericardial effusion, carotid dissection and absent subclavian pulse.

Question 9

Pericardial effusion can lead to…

Answer 9

Cardiac tamponade

Reduced ventricular filling and subsequent hemodynamic compromise due to restriction caused by fluid in pericardium

Question 10

Differentiating between unstable angina or NSTEMI

Answer 10

only see rise in troponin with NSTEMI

Question 11

Brugada syndrome

Answer 11

A form of inherited cardiovascular disease which can disrupt normal rhythm of the heart which may present with sudden cardiac death
Autosomal dominant
Common in Asians

Question 12

The most common cause of death following a myocardial infarction

Answer 12

Ventricular fibrillation

Question 13

Persistent ST elevation and left ventricular failure following an MI might indicate

Answer 13

Left ventricular aneurysm

Question 14

Takayasu’s arteritis

Answer 14

Large vessel vasculitis

Typically causes occlusion of the aorta and an absent limb pulse. It is more common in females and asians

Management: Steroids

Question 15

Transcatheter aortic valve implantation (TAVI) is used for..

Answer 15

Aortic stenosis

Question 16

What happens to JVP in constrictive pericarditis?

Answer 16

JVP increases with inspiration (Kussmaul’s sign)

Question 17

What medication is contraindicated in someone who in a hypotensive patient

Answer 17

Nitrates

Question 18

Which valve problem is commonly found in IVDU

Answer 18

Tricuspid regurgitation (venous system vegetation tends to occur with IVDU)

Question 19

Does infective endocarditis cause valve stenosis or regurgitation

Answer 19

Regurgitation (commonly Aortic regurg)

Question 20

Which murmur?

Mid diastolic, mitral area, radiating to axilla

Answer 20

Mitral stenosis

Question 21

Which murmur?

Pansystolic, mitral area, radiating to axilla

Answer 21

Mitral regurgitation

Question 22

Which murmur?

Pansystolic, tricuspid area, radiating to 4th intercostal space

Answer 22

Tricuspid regurgitation

Question 23

Which murmur?

Ejection systolic, aortic area, radiating to carotids

Answer 23

Aortic stenosis

Question 24

Wellen syndromes is..

Answer 24

Deep T wave inversion or biphasic T waves in V2-V3 on ECG

Indicates critical stenosis of LAD
Patients with Wellen syndrome may be pain-free by the time the ECG is taken

Question 25

Hypertrophic obstructive cardiomyopathy on ECG

Answer 25

Left ventricular hypertrophy (tall QRS complex)

Widespread ST depression and T wave inversion

Question 26

Different cardiomyopathy presentations

Answer 26

HOCM = exertional dyspnoea, angina, syncope seen in YOUNG - ejection systolic murmur

Aortic stenosis (if bicuspid valve) = exertional dyspnoea seen in OLDER pts

Wolff-Parkinson White = palpitations and dizziness with a high heart rate

Friedrich’s ataxia = weakness, poor coordination (gait ataxia) and hearing impairment and hypertrophic cardiomyopathy (Onset is 10-15 years old)

Rheumatic fever = Can develop mitral regurgitation

Question 27

STEMI immediate treatment

Answer 27

Thrombolysis or PCI

Question 28

Young male smoker with symptoms similar to limb ischaemia (extremity ischaemia, raynaud’s, ulcers) think..

Answer 28

Buerger’s disease