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Cardiorespiratory > Other Cardiology > Flashcards

Other Cardiology Flashcards

1
Q

What is Beck’s triad for cardiac tamponade?

A

Hypotension, raised JVP, muffled heart sounds.

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2
Q

What ECG changes are suggestive of cardiac tamponade?

A

Electrical alternans

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3
Q

Describe Kussmaul’s sign

A

Increased JVP with inspiration, or a failure in the appropriate fall of the JVP with inspiration.

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4
Q

Describe the features of constrictive pericarditis

A

Dyspnoea, right HF (elevated JVP, ascites, oedema, hepatomegaly), pericardial knock, +ve Kussmaul’s sign.

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5
Q

Why is there a small amount of fluid in the pericardial cavity normally?

A

To provide lubrication between the layers, allowing the heart to beat without much friction.

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6
Q

How is cardiomyopathy diagnosed?

A

Echocardiogram

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7
Q

Can cardiomyopathy occur without any FHx of the disease?

A

Yes if a de novo mutation occurs.

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8
Q

List the causes of pericarditis

A

Idiopathic, viral infection (e.g. coxsackievirus), autoimmune conditions, injury/trauma (MI, surgery), uraemia, cancer, medications (methotrexate).

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9
Q

Describe the clinical features of pericarditis

A

Pleuritic chest pain worse lying flat, relieved by leaning forward.
Fever.
Pericardial rub.

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10
Q

What ECG changes would you see in pericarditis?

A

Saddle-shaped ST elevation, PR depression.

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11
Q

What is the first line medication for pericarditis?

A

NSAIDS for 1-2 weeks

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12
Q

What other medications can be used for pericarditis?

A

Colchicine, steroids.

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13
Q

Pericardial effusion vs pericardial tamponade

A

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.

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14
Q

Transudative vs exudative pericardial effusion

A

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.

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15
Q

Describe the symptoms of pericardial effusion

A

Chest pain, SOB, orthopnoea.

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16
Q

Describe the investigations for pericardial effusion

A

Echocardiogram and pericardial fluid analysis.

17
Q

What is the management for pericardial effusion?

A

Pericardiocentesis or surgical drainage (e.g. pericardial window).

18
Q

Describe the causes of pericardial tamponade

A

Pericarditis, trauma, malignancy, post-MI, aortic dissection.

19
Q

What is pulsus paradoxus?

A

Large decrease in BP during inspiration - suggestive of pericardial effusion or tamponade.

20
Q

What is the management for pericardial tamponade?

A

Urgent needle pericardiocentesis

21
Q

What is hypertrophic obstructive cardiomyopathy?

A

Hypertrophy of LV affects septum causing a left ventricular outflow obstruction.

22
Q

What is hypertrophic obstructive cardiomyopathy associate with?

A

HF, MI, arrhythmias and sudden death.

23
Q

What is the inheritance pattern of hypertrophic obstructive cardiomyopathy and what protein does it affect?

A

Autosomal dominant and sarcomere proteins.

24
Q

Describe the features of hypertrophic obstructive cardiomyopathy

A

Mostly asymptomatic.
Exertional SOB, fatigue, dizziness, syncope, chest pain, palpitations.
Ejection systolic or pan-systolic murmur.

25
Q

How would you diagnose hypertrophic obstructive cardiomyopathy?

A

Echocardiogram or cardiac MRI

26
Q

How is hypertrophic obstructive cardiomyopathy managed?

A

Beta blockers, surgical myectomy, alcohol septal ablation, ICD.

27
Q

Name some other types of cardiomyopathy

A

Dilated cardiomyopathy.
Restrictive cardiomyopathy.
Arrhythmogenic cardiomyopathy.
Takotsubo cardiomyopathy.

28
Q

What is another name for Takotsubo cardiomyopathy?

A

Broken heart syndrome.

29
Q

Which arrhythmia is associated with hypertrophic obstructive cardiomyopathy?

A

Wolff-Parkinson White syndrome.

30
Q

What is the reversal for dabigatran?

A

Idarucizumab

31
Q

What is the reversal for rivaroxaban or apixaban?

A

Andexanet alfa

32
Q

What is the reversal for heparin, enoxaparin or dalteparin?

A

Protamine sulphate

33
Q

A 52-year-old male presents with tearing central chest pain. On examination he has an aortic regurgitation murmur. An ECG shows ST elevation in leads II, III and aVF.

A

Proximal aortic dissection

34
Q

First line management of acute pericarditis

A

A combination of NSAID and colchicine

Cardiorespiratory (15 decks)

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