heart failure and ischaemia

Question 1

dilated cardiomyopahty drug treatment

Answer 1

Different types of drugs may be used to lower blood pressure, improve blood flow and reduce the strain on the heart. Such medications include beta-blockers, angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs). Sacubitril/valsartan (Entresto).

Question 2

4 signs of dilated cardiomyopathy

Answer 2

Displaced apex beat
S3 gallop rhythm (rapid ventricular filling)
Murmur of mitral regurgitation (due to displacement of the valve leaflets)
Signs of heart failure (such as oedema, hepatomegaly, ascites, raised JVP).

Question 3

myocardial ischaemic casues what

Answer 3

LBBBB and ventricualr tachycardia

Question 4

what electrolyte imbalance can cause a shortened QT interval

Answer 4

Hypercalcaemia can cause a shortened QT interval and can occur in patients with end-stage renal failure and tertiary hyperparathyroidism.

Question 5

becks triad for cardiac tamponade

Answer 5

triad: muffled heart sounds, raised JVP and hypotension.

Question 6

aortic dissection gold and first line if stable

Answer 6

If he were stable, an urgent CT angiogram of the chest, abdomen and pelvis would be the first-line imaging test.

Echocardiogram

The patient is presenting with a suspected aortic dissection. He has a diastolic murmur (suggesting aortic regurgitation) and a widened mediastinum on his chest x-ray. As the patient is haemodynamically unstable, an immediate echocardiogram is required to provide the diagnosis. This can be done at the bedside.

Question 7

indications for a permanent pacemaker

Answer 7

Indications for a permanent pacemaker are severe heart failure (ejection fraction <35%) not responding to medication, complete AV block, Mobitz type 2 AV block, symptomatic bradycardia, symptomatic sick sinus syndrome and drug-resistant tachyarrhythmias.

Question 8

BB overdose casuing bradycadia so atropine does not work what should you do

Answer 8

try glucagon

Question 9

how long can you not drive after ICD insertion

Answer 9

6 months

This is the length of time that a patient should not drive if they have had an implantable cardiac defibrillator inserted for secondary prevention as was the case in this scenario

Question 10

on exertuon collapse thinj

Answer 10

arrhymia cause