RBBB is normal - s wave in V6 Flashcards
Signs on examination include a “jerky” pulse, along a displaced apex beat, apical thrill and an ejection systolic murmur. ECG shows left ventricular hypertrophy( touch peaks with each other)
HOCM
defintive tx of brugada ( sodium channelopathies) - weird V1 and V2 with st elevation adn then t wave negative
ICD
absent p waves
AF
aortic slclerosis uncomon under the age of
60
Aortic sclerosis occurs due to age related degeneration and calcification. It is usually best heard in the aortic area (as opposed to left sternal edge) and is uncommon in patients under the age of 60
Ejection systolic murmur, loudest between lower left sternal edge and apex, louder with exercise/standing/performing valsalva, quieter when supine/squatting. Due to left ventricular outflow tract obstruction (LVOTO).
Pansystolic murmur may be heard- loudest at the apex and radiating to the axilla (mitral regurgitation) due to systolic anterior motion (SAM) of the mitral valve. If heard all over the praecordium can be combination LVOTO and SAM.
Rarely, a diastolic murmur from aortic regurgitatio
can all be seen in
HOCM
target INR for aortic metallic valve
2.5
target INR for mitral metallic vave
3
innocent murmurs loudest where
pulmonary areas
noonan syndrome and pulmonary stenosis what characteristic murmur heard
Noonan syndrome is most commonly associated with pulmonary stenosis. This patient’s murmur is characteristic (ejection systolic, loudest at the pulmonary area and radiating to the shoulder rather than the carotids)
first line mangement in someone with heart fialure with preserved ejectionfrction
First line management in a patient with heart failure and preserved ejection fraction (HFPEF) would be lifestyle advice for risk factor reduction, low dose diuretic in patients with signs of fluid overload and ACE- inhibitor/ARB if the patient is hypertensive
59%
Auscultation of his chest reveals a late systolic murmur preceded by a mid-systolic click.
mitral valve prolapse
dypnoea
poor exercise tolerance
palpitations to af - marfan
what drugs can cause long QT
Drugs: Amiodarone, Tricyclic Antidepressents, Antibiotics, Fluconazole, Erythromycin, Metoclopramide, Quinidine, Haloperidol, Ondansetron, SSRIs
Genetic (Sodium or potassium channel mutations):
Jervell and Lange-Nielson syndrome (associated with deafness)
Romano Ward Syndrome
Myocardial disease
Electrolyte abnornality: Hypocalcaemia, Hypokalaemia, Hypomagnasaemia
poor ejection fraction and heart failure - what should you consider
ICD - risk of ventricualr tachys etc which will kill
bundle branch block is not like we know
what features of both LBBB and RBBB should we see
V1 and V6 both need to have wide complexes
V1 down and V6 upwards in LBBB
V1 up and V6 down in RBBB
