Medicine: Cardio Flashcards
How would you present a murmur?
HS 1+2+Added
When, where, insp/exp, radiation, at least grade three
Indicates, ddx, ECG/echo
Which murmurs get louder on insp/exp?
RILE
Right sided w Insp + Left sided w Exp
List the four classic murmurs you hear
AS - ESM - lub whoosh dub
AR - EDM - lub durrr
MS - MDM - rrrlub dub
MR - PSM - lub oof dub
NB: HOCM also ESM + ASD also MDM
Which is worse a longer or louder murmur?
Longer > Louder
What are the differentials of aortic stenosis? (2)
Aortic Sclerosis
Pulmonary Stenosis
NB: if it radiates to the carotids stenosis > sclerosis
If the pt has aortic sten what should you advise?
Any chest pain, feeling faint, SOB come back to us
NB: also in order of worsening risk of mortality angina, syncope, dyspnoea
How would you present an ECG?
Pt details, date and time, calibration, rate, rhythm, axis, pqrst, overall impression
How many seconds are the small and large squares?
Small - 0.04s
Large - 0.2s
How can you calculate rate from the rhythm strip?
- Number of complexes in 10s x6
2. Divide 300 by number of big squares b/w R waves
How can the rhythm be described? (3)
Sinus, AF, Block
The quick method of testing for axis deviation
Use leads I+II and if the R waves:
Point away - leaving - LEFT
Point together - reaching - RIGHT
And if lead III is more neg think left vs more pos think right
Which p wave shows which atrial hypertrophy?
Bifid P mitrale - left atrial hypertrophy eg mitral stenosis/regurg
Peaked P pulmonale - right atrial hypertrophy eg tricuspid stenosis/regurg
How long should the PR interval be?
0.12-0.2s ie 3-5 small squares
Outline the different degrees of AV heart block
1st: prolong PR interval
2nd: Mobitz 1 - prolongation then dropped QRS + Mobitz 2 - constant PR and often wide QRS w occ dropped QRS
3rd: complete dissociation b/w p waves and QRS complexes
Which heart block is also called Wenckebach?
2nd Degree Mobitz I
Which heart block is also called Hay?
2nd Degree Mobitz II
Which Mobitz type is more likely to degenerate into 3rd degree?
Type 1
How long should the QRS complex be?
<0.12s ie <3 small squares
What does a narrow QRS suggest?
SVT
What does a broad QRS suggest?
BBB, VT, VF, WPW
Which BBB is more concerning?
A new LBBB is always pathological whereas RBBB could be a normal variant
S1Q3T3
Rare sign of PE w deep S in I, pathological Q in III, inverted T in III
Anteroseptal MI Leads
V1-V4
Anteroseptal MI Artery
LAD