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Year 5 > MLA Cardiology > Flashcards

MLA Cardiology Flashcards

1
Q

What is a Q wave on an ECG?

A

A negative deflections before the QRS complex

It’s a sign of present/ old MI

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2
Q

What does ST elevation indicate?

A

A complete occlusion of the epicardial coronary artery

An NSTEMI is a partial occlusion

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3
Q

What is primary percutaneous intervention (PCI)?

A

AKA angioplasty with stent
- It opens up the coronary arteries

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4
Q

What is unstable angina?

A

When there is no evidence of myocardial damage or raised troponin yet the patient will suffer with:
- prolonged (>20 minutes) angina at rest
- new onset of severe angina
angina that is increasing in frequency, longer in duration, or lower in threshold
- angina that occurs after a recent episode of myocardial infarction

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5
Q

What is peripheral arterial disease?

A

A build-up of fatty deposits in the arteries restricts blood supply to leg muscles

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6
Q

When does screening for AAA begin?

A

When the man turns 65

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7
Q

What are key symptoms of an AAA?

A

Pulsing in the stomach
Nausea/vomiting
clammy skin

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8
Q

What are the key symptoms of an aortic dissection?

A

A sudden severe pain felt mostly at the back between the shoulder blades

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9
Q

What is the presentation of aortic stenosis disease on examination?

A

(Left heart disease)

Reduced S2
Ejection systolic murmur, loudest at aortic area
Radiates to the carotids

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10
Q

What is the presentation of mitral regurgitation of examination?

A

(Right heart disease)

Pansystolic murmur, loudest at mitral area
Radiates to the axilla

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11
Q

What is the most common valve disease?

A

Mitral valve regurgitation

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12
Q

What are some causes of aortic valve disease?

A

Rheumatic fever
Endocarditis
Marfan syndrome
Syphilis
Rheumatoid arthritis
Systemic lupus erythematosus, Ankylosing spondylitis
High blood pressure

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13
Q

What are some causes of mitral valve disease?

A

Age
Rheumatic fever
Autoimmune disease like SLE
Endocarditis
MI’s

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14
Q

What are arterial ulcers?

A

Usually occur in legs and feet due to inadequate blood flow

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15
Q

What is the difference between essential and secondary hypertension?

A

Essential: no cause

Secondary: clear, fixable cause

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16
Q

What are some presentations of heart failure?

A

SOB on activity/ laying flat
Fatigue
Oedema

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17
Q

How does haemochromatosis affect the heart?

A

The excess iron can build up and damage the muscles and vessels to cause heart failure and arrhythmias

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18
Q

How is haemochromatosis diagnosed?

A

Iron studies
Abnormal liver enzymes

19
Q

What is the pathophysiology of myocarditis?

A

When the heart muscle becomes inflamed

Caused by common infections

20
Q

What is pericardial disease?

A

Inflammation of the sac that contains the heart
Usually goes away by itself, but can be life threatening

Caused by common infections

21
Q

What is the classic presentation of a PE?

A

Abrupt onset of pleuritis chest pain, SOB, and hypoxia

22
Q

What is pleuritic chest pain?

A

Pain on inspiration

23
Q

What are some causes of pulmonary hypertension?

A

Heart failure
PE
HIV
Autoimmune damage to the lungs

24
Q

What type of stroke is most common?

A

Ischaemic stroke (80%)

25
Q

How does atrial fibrillation present on ECG?

A

Irregularly irregular with no P waves

26
Q

What is atrial flutter?

A

When the atria beat too quickly

Caused by hight bp, congenital, lung disease, thyroid disease, diabetes, alcoholism

27
Q

How does atrial flutter present on an ECG?

A

Flutter lines with no isoelectric lines between QRS complexes

‘saw-tooth’ pattern

28
Q

What is AV node re-entrant tachycardia (AVNRT)?

A

An arrhythmia caused by a re-entry circuit confined to the AV node and perinodal atrial tissue

A type of supraventricular tachycardia

29
Q

What are the different types of supraventricular tachycardia?

A

Focal:
- Sinus
- Atrial
- Multifocal atrial
- functional

Re-entry:
- Atrial flutter
- Atrial fibrillation
- AVNRT
- Atrio-ventricular

30
Q

What is the management of focal tachycardias?

A

Treat with meds like beta-blockers, ivabradine, or calcium channel blockers

Or treat cause like sepsis

31
Q

How are re-entry tachycardias managed?

A

Rate or rhythm control with meds like beta-blockers, calcium channel blockers, digoxin, amiodarone, or flecainide

Offer ablation for cure

32
Q

What is the clinical presentation of a supraventricular tachycardia?

A

Anxiety, palpitations, chest discomfort, light-headedness, syncope, dyspnoea

33
Q

What is a ventricular tachycardia?

A

High HR that prevents blood from circulating to the body and can cause death by cardiac arrest

34
Q

How does ventricular fibrillation present on an ECG?

A

Disorganised electrical activity with no identifiable QRS complexes

It will develop into asystole if not treated

35
Q

What is pulseless ventricular tachycardia?

A

When the contractions of the heart are so rapid that the heart doesn’t have time to fill causing an undetectable pulse

It’s a shockable rhythm

36
Q

What is Torsade de pointes?

A

A type of ventricular tachycardia characterised by long QT interval

Usually caused by electrolyte imbalances

37
Q

What causes heart block?

A

AV node blocking drugs like beta-blockers, calcium channel blockers, and digoxin

Or idiopathic degeneration of the conducting system

38
Q

What are the different types of heart block?

A

1st degree: consistent PR interval >0.20s

2nd degree type 1: progressive PR interval prolongation until a QRS is dropped

2nd degree type 2: consistent PR interval with intermittently dropped QRS

3rd degree: no communication between atria and ventricles

39
Q

What is the clinical presentation of heart block?

A

first degree and 2nd type 1 are usually asymptomatic

second degree and 3rd may present with palpitations, syncope, confusion, SOB, chest pain

40
Q

What is the management of heart block?

A
  • Stop AV node blocking drugs
  • If symptomatic, may require pacemaker insertion

3rd degree urgently requires pacing or permanent pacemaker

41
Q

What is sick sinus syndrome?

A

Causes a slow HR and pauses or irregular beats

Requires a permanent pacemaker

42
Q

What are the different types of heart failure?

A

Systolic (reduced ejection fraction)
- Muscle is too weak to pump enough blood

Diastolic (preserved ejection fraction)
- muscle is too stiff to relax and fill with blood

43
Q

What is the clinical presentation of pericarditis?

A

Pain centrally or on left
Worse on coughing, lying down, or taking a deep breath

44
Q

What are some causes of pericarditis?

A

Infection (normal + HIV,TB)
Autoimmune (lupus, rheumatoid arthritis)
Meds like blood thinners
Cancer
Immune mediated

Year 5 (22 decks)

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