Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular > General Cardio > Flashcards

General Cardio Flashcards

1
Q

Indications for Transvenous pacing?

A

Symptomatic arrhythmia with cardiovascular compromise + pharmacotherapy has failed + transcutaneous pacing has failed or contraindicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Contraindications to transvenous pacing?

A

All relative
- Appropriate site CVC contraindications present
- Prosthetic tricuspid valve
- Severe hypothermia causing arrhythmia (unlikely to succeed, likely to cause VF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Arrhythmias requiring pacing?

A

All are + cardiovascular compromise
- Sick sinus syndrome
- Sinus arrest
- Symptomatic sinus bradycardia
- AF with slow vent response
- 3rd degree heart block
- 2nd degree block Mobitz II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the best sites for transvenous pacing in order?

A

1- R) IJ
2- L) subclavian
3- LIJ + R) subclavian
4- any other site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are reasonable initial settings for transvenous pacing?

A

Rate 70-80
Current 15-20mA
Sensitivity 1-2V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are reasonable initial settings for transcutaneous pacing?

A

Rate 70-80 or 20 above intrinsic
Current 70mA
Once capture turn current down to 5-10 above threshold
If no capture at current up to 130 then resite electrodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How should defibrillation be performed in conscious VT?

A

If QRS and T waves are distinguishable then an attempt at synchronisation should be done

Synchronised shock biphasic 100-200J
Unsynchronised shock biphasic 200j
Unsynchronised monophasic 360j

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some of the causes of cardiac sounding syncope in a patient who is now stable?

A

Severe aortic stenosis
ARVD
WPW +/- AF
Brugada syndrome
Long Qt with TdP
High grade heart block (although usually still asymptomatic)
Short Qt syndrome
HOCM
VT (ie ischaemic cardiomyopathy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some relatively benign causes of syncope that can be managed as an outpatient?

A

Cough syncope
Micturition syncope
Vasovagal syncope
Orthostatic hypotension (autonomic dysfunction, drugs, dehydration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the routine medical treatments for a STEMI?

A
  • Aspirin 300mg
  • Nitrates (S/L, patch, infusion) as long as BP can take it
  • Clopidogrel/Ticagrelor/Prasugrel
  • Analgesia (Morphine, fent etc)
  • Aim sats >94% (02 only if needed)
  • Heparin infusion/bolus prior to PCI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When should fibrinolysis be done over PCI?

A
  • > 120 mins from first contact to availability of PCI (aim <90mins from ED arrival to cath lab)
  • Ischaemic symptoms present for less than 12hrs
  • No contraindications to fibrinolysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the potential causes for an acute bradycardia?

A

Acute ischaemia
Chronic cardiomyopathy
Drug overdose
Hypothermia
Hypoxia
Hypothyroidism
Electrolyte disturbance (Hyper K)
Raised ICP
Inflammatory/infiltrative (Sarcoid, SLE, TB, amyloid)
Typhoid fever (relative bradycardia)
Vagal stimuli
Normal variant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In those without access to immediate PCI, what are the indications for thrombolysis?

A
  • ECG meets STEMI criteria for >20mins
  • Chest pain >20mins within the last 12hrs (may have resolved)
  • No contraindication to thrombolysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the high and low risk features for someone with chest pain having ACS?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some of the causes of a troponin rise other than ACS?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the principle causes of a dilated cardiomyopathy?

A
17
Q

What are the main drugs causing dilated cardiomyopathy?

A

Clozapine
Phenothiazines
Chloroquine
Antiretroviral
- Zidovudine, Zalcitabine
Chemotherapeutics
- Cyclophosphamide, Anthracyclines, Trastuzumab

18
Q

What are statistics of syncope ED presentations?

A
  • 1-1.5% of all ED presentations
  • Approx 20% of people will have an episode in their lifetime
  • 35% of patients presenting to ED with syncope go on to be admitted
  • Men have higher risk of arrhythmias
19
Q

What are the typical clinical and historical features of burgada syndrome?

A
  • Autosomal dominant
  • 2 year death rate after 1st ED presentation if not treated is 30%
  • SE asian descent is risk factor
  • Na+ channel defect
  • Average age at presentation 30yo
  • Causes 60% idiopathic VF
  • Avoid Na+ channel blockers including class 1a and 1c
20
Q

What are the clinical features of silent AMI’s?

A
  • Twice the mortality of those presenting with chest pain
  • Higher risk in females, diabetics, CCF previous stroke and the elderly
  • 1% per annum for people aged 45-65
21
Q

What is the Framingham Criteria for CCF?

A

At least 2 major or 1major and 2 minor critiera

Major
- PND/Orthopnoea
- Raised JVP
- APO
- Cardiomegaly on CXR
- S3 gallop

Minor
- Ankle oedema
- Nocturnal cough
- tachycardia >120
- SOB on exertion
- pleural effusions

22
Q

What are the indications for overdrive pacing?

A

Any regular tachycardia with a re-entrant circuit, as it short circuits the re-entrant circuit
- Ie SVT, VT, A flutter
- Also to prevent TdP in patients with prolonged QTc and relative bradycardia

Does not work on VF/AF

23
Q

How is overdrive pacing performed to terminate regular tachyarrythmias ?

A

Accelerate to about 10-15% greater rate than the intrinsic rate for 8-10secs then cease
Requires transvenous (temporary or permanent) pacing, transcutaneous cannot fire fast enough

24
Q

What are the factors favouring a rhythm controlled approach to AF?

A
  • Haemodynamically unstable
  • Young
  • First presentation
  • Onset <24hrs
  • No structural/valvular HD
  • No/corrected precipitant cause
  • Normal/corrected electrolytes
  • Normal TFT’s
  • Intolerable symptoms
25
Q

What are the factors favouring rate control in AF?

A
  • Age >80 yrs
  • Low HASBLED score
  • Failure of rhythm control
  • Minimal to no symptoms
  • Haemodynamically stable
  • Patient preference
  • Structural/valvular heart disease
  • Long term AF
  • Underlying precipitant has not/can not be fixed
  • intolerable side effects from pharmacological rhythm control
26
Q

What are the goals of management in AF?

A
  • Reverse haemodynamic instability
  • Prevent thromboembolism
  • Alleviation of symptoms
  • Reduce CVS disease and mortality
  • Prevent adverse cardiac remodelling
27
Q

What is the ADAPT protocol for chest pain rule out?

A

TIMI score
+
2 -ve troponins
+
no ischaemic changes on ECG

= discharge

28
Q

What is the TIMI score for chest pain?

A

Used for risk stratification in chest pain, but originally derived from unstable angina/NSTEMI patients 30 day mortality

  • Age >65
  • 3 or more CAD risk factors
  • Known CAD 50% or more
  • Aspirin use in last 7 days
  • Symptoms typical of severe angina >2 episodes in 24hrs
  • ECG ST changes >0.5mm
  • Positive cardiac marker
29
Q

What is the HEART score for chest pain?

A

Used in adult chest pain patients being considered for ACS workup
- Divides into risk categories based on likelihood of major adverse cardiac events (MACE)

H- History (slightly, moderate, very suspicious) 0-2 points
E- ECG (normal, non-specific, sepcific ST changes) 0-2
A- <45, 45-65, >65, 0-2 points
R- Risk factors (0, 1-2, 3 or more) 0-2
T- Troponin (normal, 1-3x limit, >3x limit) 0-2 points

Low score
- 0-3 points, <0.3% risk MACE
Moderate score
- 4-6 points, 12-16% MACE
- High 7 or more, 50-65% MACE

Cardiovascular (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions