GP1 Cardiology Case Based Learning Tutorial Flashcards
What are the key differentials for chest pain in general practice?
🔹 Cardiac – MI, angina, pericarditis, aortic dissection
🔹 Respiratory – Pulmonary embolism (PE), pneumonia, pneumothorax
🔹 Gastrointestinal – GERD, esophageal spasm, peptic ulcer disease
🔹 Musculoskeletal – Costochondritis, rib fractures, muscle strain
🔹 Psychogenic – Panic attacks, anxiety
What are the red flags for chest pain in primary care?
🚨 Sudden, severe pain (aortic dissection)
🚨 Radiation to jaw/left arm (MI)
🚨 Associated dyspnea, sweating, nausea (ACS)
🚨 Pain worse when lying down, relieved by sitting up (Pericarditis)
🚨 Pleuritic pain + hemoptysis (PE)
What are the common causes of palpitations in general practice?
🔹 Cardiac – Atrial fibrillation, SVT, ventricular ectopics
🔹 Metabolic – Hyperthyroidism, electrolyte imbalance
🔹 Psychological – Anxiety, panic disorder
🔹 Medications – Caffeine, beta-agonists, cocaine
🔹 Anemia, dehydration
What are the risk factors for Hypertension?
✅ Modifiable: Obesity, high salt diet, smoking, alcohol, stress, sedentary lifestyle
✅ Non-modifiable: Age, family history, ethnicity (Black, South Asian)
What are the first-line investigations for Hypertension?
🩺 Ambulatory blood pressure monitoring (ABPM) – Gold standard
🩸 Blood tests – U&Es (renal function), Lipid profile, HbA1c
🫀 ECG – Left ventricular hypertrophy (LVH)
👀 Fundoscopy – Hypertensive retinopathy
What are the primary care management steps for Hypertension?
🔹 Lifestyle modifications first (Diet, exercise, smoking cessation)
🔹 Drug treatment based on age & ethnicity:
<55 or non-Black: Start with ACE inhibitor
≥55 or Black: Start with Calcium channel blocker
🔹 Second-line: Add Thiazide-like diuretic
🔹 Third-line: Combine all 3 (ACEi + CCB + Thiazide)
What are the clinical features of Myocardial Infarction (MI)?
💔 Central crushing chest pain lasting >20 min
💔 Radiates to left arm/jaw
💔 Dyspnea, sweating, nausea
💔 Silent MI possible in diabetics
How is MI managed in the community?
🚑 Call 999 immediately
💊 Aspirin 300mg STAT
💊 GTN spray (if BP stable)
💊 Oxygen if hypoxic (<94%)
What are the types of Angina and their differences?
✅ Stable Angina – Predictable, relieved by rest/GTN
✅ Unstable Angina – Occurs at rest, high risk of MI
✅ Prinzmetal (Variant) Angina – Coronary spasm, not due to atherosclerosis
What are the treatment options for Angina?
💊 First-line: Beta-blockers OR CCBs
💊 Nitrates (GTN spray) for symptom relief
💊 Aspirin & statins for secondary prevention
💊 Consider PCI (stent) or CABG if refractory
What are the treatment strategies for Atrial Fibrillation (AF) in primary care?
🩺 Rate control first: Beta-blockers OR calcium channel blockers
💊 Anticoagulation (CHA₂DS₂-VASc score)
⚡ Consider rhythm control (Cardioversion) if symptomatic
What are the common side effects of key cardiovascular drugs?
💊 Nitrates → Headache, hypotension
💊 Beta-blockers → Bradycardia, fatigue, bronchospasm
💊 ACE inhibitors → Dry cough, hyperkalemia, angioedema
💊 Statins → Muscle pain, liver dysfunction
💊 Antiplatelets (Aspirin, Clopidogrel) → GI bleeding
How does primary care differ from secondary care in cardiology?
🏥 Primary care: Prevention, risk factor management, long-term follow-up
🏥 Secondary care: Acute management, advanced diagnostics, specialist procedures
Mnemonic for Cardiovascular Drug Side Effects: “BAN-SAC”
Beta-blockers → Bradycardia, Bronchospasm
ACE inhibitors → Angioedema, Cough
Nitrates → Headache, Hypotension
Statins → Muscle pain, Liver dysfunction
Antiplatelets → GI bleeding
Calcium channel blockers → Ankle swelling, Constipation
