Other Cardiology Flashcards
What is Beck’s triad for cardiac tamponade?
Hypotension, raised JVP, muffled heart sounds.
What ECG changes are suggestive of cardiac tamponade?
Electrical alternans
Describe Kussmaul’s sign
Increased JVP with inspiration, or a failure in the appropriate fall of the JVP with inspiration.
Describe the features of constrictive pericarditis
Dyspnoea, right HF (elevated JVP, ascites, oedema, hepatomegaly), pericardial knock, +ve Kussmaul’s sign.
Why is there a small amount of fluid in the pericardial cavity normally?
To provide lubrication between the layers, allowing the heart to beat without much friction.
How is cardiomyopathy diagnosed?
Echocardiogram
Can cardiomyopathy occur without any FHx of the disease?
Yes if a de novo mutation occurs.
List the causes of pericarditis
Idiopathic, viral infection (e.g. coxsackievirus), autoimmune conditions, injury/trauma (MI, surgery), uraemia, cancer, medications (methotrexate).
Describe the clinical features of pericarditis
Pleuritic chest pain worse lying flat, relieved by leaning forward.
Fever.
Pericardial rub.
What ECG changes would you see in pericarditis?
Saddle-shaped ST elevation, PR depression.
What is the first line medication for pericarditis?
NSAIDS for 1-2 weeks
What other medications can be used for pericarditis?
Colchicine, steroids.
Pericardial effusion vs pericardial tamponade
Effusion - excess fluid within pericardial cavity.
Tamponade - pericardial effusion is large enough to increase intra-pericardial pressure, compressing the heart, affecting its ability to function, decreasing CO.
Transudative vs exudative pericardial effusion
Transudative - due to increase venous pressure e.g. congestive HF, pulmonary hypertension.
Exudative - due to inflammation e.g. infection, autoimmune, injury/trauma, uraemia, cancer, medications.
Describe the symptoms of pericardial effusion
Chest pain, SOB, orthopnoea.
Describe the investigations for pericardial effusion
Echocardiogram and pericardial fluid analysis.
What is the management for pericardial effusion?
Pericardiocentesis or surgical drainage (e.g. pericardial window).
Describe the causes of pericardial tamponade
Pericarditis, trauma, malignancy, post-MI, aortic dissection.
What is pulsus paradoxus?
Large decrease in BP during inspiration - suggestive of pericardial effusion or tamponade.
What is the management for pericardial tamponade?
Urgent needle pericardiocentesis
What is hypertrophic obstructive cardiomyopathy?
Hypertrophy of LV affects septum causing a left ventricular outflow obstruction.
What is hypertrophic obstructive cardiomyopathy associate with?
HF, MI, arrhythmias and sudden death.
What is the inheritance pattern of hypertrophic obstructive cardiomyopathy and what protein does it affect?
Autosomal dominant and sarcomere proteins.
Describe the features of hypertrophic obstructive cardiomyopathy
Mostly asymptomatic.
Exertional SOB, fatigue, dizziness, syncope, chest pain, palpitations.
Ejection systolic or pan-systolic murmur.
