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Y6 Senior Med > Laz Cardio > Flashcards

Laz Cardio Flashcards

1
Q

what valve connects the RA to the RV

A

TRICUSPID

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2
Q

What valve connects LA to LV

A

MITRAL

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3
Q

Explain pathway of deoxy blood from systemic circulation

A

systemic circulation > RA > Tricuspid > RV > Pulm artery > lungs

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4
Q

explain pathway of oxy blood from lungs

A

lungs > LA > Mitral > LV > Aorta > systemic circulation

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5
Q

what is the formula for EF

A

EF = stroke volume / end diastolic volume

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6
Q

explain in your own words what EF measures

A

how much of the blood in the ventricle at the end of diastole is squeezed out during ventricular contraction

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7
Q

what is normal EF

A

ABOVE 50%

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8
Q

What are the two types of HF and what are their expected EFs

A

preserved EF: EF>50

reduced EF: EF<40

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9
Q

explain HFpEF

A

inadequate filling of the ventricle but normal ventricular contraction

the ventricle contracts normally but is too stiff to fill sufficiently

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10
Q

explain causes of HFpEF

A

anything that causes stiffening of the ventricle and prevents it from distending appropriately

  • REDUCED DISTENSIBILITY e.g. constrictive pericarditis
  • PRESSURE OVERLAOD e.g. HTN
  • volume overload e.g valve regurg
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11
Q

Explain causes of HFrEF

A

outflow obstruction OR impaired contractility

e.g. MI, cardiomyopathy, arrythmia

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12
Q

what are key ix for suspected HF

A

Bedside: ECG (ischaemia?)
Bloods: ABG (LHF > pulm oedema), Trops (ischaemia), BNP
Imaging: CXR (pulm oedema), Echo (EF?)

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13
Q

what is the definition of AF

A

rapid chaotic ineffective atrial electrical conduction, with electical impulses being generated abnormally

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14
Q

what is AF on an ECG

A

irreg irreg rhythm with absent P waves

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15
Q

What does AF management depend on ? i.e. explain what underlies the choice of rate vs rhytm control

A

how likely is the patient to maintain sinus rhythm after cardioversion? i.e. if AF is permanent / no identifiable cause, it is unlikely that cardioverting them will help

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16
Q

what is the first thing you need to look at in a pt with AF when deciding what type of management is appropriatew?

A

if haemodynamically stable / unstable

if unstable, immediate cardioversion

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17
Q

What are the two key types of antithrombotics

A

anticoagulants

antiplatelets

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18
Q

what kinds of clots do you use anticoagulants for and why

A

for risk of clotting due to STASIS
usually VENOUS
because when blood is static (e.g. immobility in the deep veins of the legs or in the atria) the coag factors bounce off each other and are likely to cause a clot

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19
Q

give examples of anticoagulants

A

warfarin

antiXa or antiIIa e.g. rivaroxaban

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20
Q

what kinds of clots do you use antiplatelets for and why

A

for risk of clotting due to VESSEL WALL INJURY
usually ARTERIAL e.g. in atherosclerosis
vessel is damaged > subendothelial prothrombotic agents exposed > platelets aggregate > arterial clot

21
Q

how do you manage an SVT

A

if haemodynamically unstable > DC cardiovert

If stable: vagal maneuvres >adenosine 6mg > adenosine 12mg > adenosine 12mg > seek specialist advice

22
Q

whom must you not give adenosine to for SVT?why

A

asthmatics
because it can cause bronchoconstriction
give verapamil instead

23
Q

what are the three classes of anticoagulants \

A

heparins
DOACs
Vit K antagonist (warfarin)

24
Q

what are the two types of heparin and how are they administered

A

LMWH - SC

unfractionated heparin - SC/IV

25
Q

what is LMWH used for

A

VTE treatment or prophylaxis

26
Q

what is a disadvantage of LMWH

A

reduces renal function > so dont use if significant renal impairment

27
Q

give an example of LMWH

A

enoxaparin

28
Q

what are advantages of unfractionated heparin

A
  • do not affect renal function> can be used if renally impaired
  • rapid onset of action and rapid reversal
29
Q

what are disadvantages of unfractionated heparin

A

risk of HIT

APTT moniroting

30
Q

What is an advantage and disadvantage of doac?

A

advantage: no monitoring required, oral
disadvantage: not good in pts with poor renal function

31
Q

What is warfarin still used for

A

AF + moderate or severe MS (as high stroke risk)

mechanical valve

32
Q

what are disadvantages of warfarin

A

repeated INR monitoring

drug interactions

33
Q

what classifies JVP as being elevated

A

JVP is elevated if the vertical distance between the sternal angle and the highest point of the pulse is greater than 4cm.

34
Q

how do you elicit the JVP and what does that do?

A

How to Elicit: press over the right upper quadrant for 10-15 seconds while inspecting the JVP.

Significance: The reflex temporarily increases venous return to the right atrium, making the jugular venous pulsation more pronounced.

35
Q

causes of raised JVP

A

Fluid overload - excessive IV fluids, renal disease, heart failure
Right ventricular systolic failure - cor pulmonale, left ventricular failure
Right ventricular diastolic failure - constrictive pericarditis, tamponade
Pulmonary hypertension

36
Q

what do you do with AF if patient is ACUTELY UNSTABLE, but they have had AF for >48h?

A

TOE to check for thrombi

then DC cardiovert immediately

37
Q

what causes pulsus alternans, and why=?

A

severe LV dysfunction causes PULSUS ALTERNANS (1 strong and 1 weak beat)

due to compromised ventricular filling

38
Q

what drug causes very good long term benefit in mild-mod HF

A

CARVEDILOL (beta blocker)

39
Q

what drug causes benefit in severe HF

A

spironolactone

40
Q

why does HF cause syncope or eventually death????

A

Due to ARRHYTMIAS (rhythm disturbances)

41
Q

how does pulmonary HTN present on exam on palpation

A

LEFT PARASTERNAL HEAVE (of right ventricle)

42
Q

what is normal but may look abnormal on ECG

A

T wave inversion in V1

43
Q

what comes up on ECG in a paced rrhytm

A

RSR pattern in V6

44
Q

what is the technical term for fast AF

A

AF with rapid ventricular respone

45
Q

what is the rate in fast AF

A

> 100

46
Q

What are causes of fast AAF

A

infection
dehydration
electrolyte imbalance

47
Q

what is the rate in slow AF

A

<60

48
Q

what are causes of slow AF

A

hypothermia
digoxin toxicity
meds

Y6 Senior Med (29 decks)

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