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CABS2: Cardiology > Syncope > Flashcards

Syncope Flashcards

1
Q

when do coronaries receive blood flow

A

during diastole as the blood come back down the ascending aorta

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2
Q

what supplies the apex of the heart with blood

A

marginal artery off of the right coronary

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3
Q

what does the left main coronary separate into

A

LAD and left circumflex

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4
Q

what feeds the anterior 2/3 of the interventricular septum toward the apex

A

LAD

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5
Q

what is syncope

A

transient loss of consciousness secondary to lack of cerebral blood flow
self-limited with loss of postural tone
typically patients recover rapidly with full return to baseline

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6
Q

what are the rules of 15

A

15% of PE pts will present with syncope
15% of AAA pts present with syncope
15% of ruptured ectopic patients present with syncope
15% of SAH pts present with syncope
15% of ACS pts present with syncope

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7
Q

What is CHESS PIECES

A

C- CHF
H - HCT < 30
E - ECG abnormality
S - SOB
S - SBP < 90

P- Premature SCD (FHx)
I - Ischemic heart disease
E - EF < 35%
C - Cardiomyopathy
E - exertional syncope
S - structural heart disease

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8
Q

what is included in ACS

A

unstable angina, NSTEMI, STEMI

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9
Q

what is the 6 step ECG approach

A

Rate
Rhythm (P waves, regular/irregular, QRS)
Intervals
Dsyrhythmia
ischemia
axis

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10
Q

what is the QT segment

A

time it takes for ventricles to depolarize and repolarize

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11
Q

what is long QT syndrome

A

prolonged if >440ms in men and >460 ms in women

> 500ms has increased risk for badness

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12
Q

what can be causes of acquired long QT syndrome

A

hypokalemia, hypomagnesemia, hypocalcemia, MI, elevated ICP, Meds

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13
Q

what is Wolf Parkinson white

A

pre-excitation syndrome - abnormal conduction pathway along the bundle of Kent directly connecting the atria to ventricles and bypassing the AV node
may be familial

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14
Q

what is WPW pattern

A

seen on ECG but asymptomatic

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15
Q

what is WPW syndrome

A

symptomatic arrhythmia
palpitations, dizzy, syncope, CP, Sudden cardiac death
commonly associated with afib

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16
Q

what is the ECG triad with WPW

A

Delta wave on ECG
short PR < 0.12 sec / no PR seg
Wide QRS > 0.12-0.2

17
Q

what is a sodium channelopathy

A

brugada

18
Q

what occurs with Brugada

A

repolarization issue associated with sodium ion channels which can lead to ventricular strain and fibrillation and sudden cardiac death

19
Q

what is brugada pattern and syndrom

A

pattern: ECG findings with no symptoms
syndrome: ECG + palpitations, syncope, dyspnea (all indicators of vtach)

20
Q

what is the treatment of brugada syndome

A

ICD

21
Q

What is hypertrophic obstructive cardiomyopathy (HOCM)

A

genetic cardiomyopathy that leads to myocyte hypertrophy and myocardial disarray (autosomal dominant)
leads to increased LV thickness which reduces filling and ultimately CO
increased risk of arrhythmias and SCD

22
Q

what is seen on HOCM ECGs

A

‘dagger like” Q wave in lateral leads (1, avl, v5-6), LVH

23
Q

what is tamponade

A

acute or chronic increase in fluid around the heart that can cause pressure on the heart - decreased size of chambers of the heart

24
Q

what is the exam presentation of tamponade

A

tachycardia
hypotension
evelevated JVP
pulsus paradoxus
pericardiual rub
Becks triad

25
Q

what is beck’s triad

A

hypotension
muffled heart sounds
elevated JVP

26
Q

what is a PE

A

venous thromboembolism that blocks the pulmonary vasculature

27
Q

what is a massive PE

A

hemodynamic instability with hypotension, mortality rate 25-52%

28
Q

what is a submassive PE with right heart strain

A

elevated troponin, BNP, strain on imaging (CT or ECG)

29
Q

what are the risks for getting PE

A

time of immobility
surgery
trauma
cancer
estrogen replacement
procoagulant syndromes
hx dvt or pe

30
Q

what is the presentation of PE

A

pleuritic chest pain
SOB, hypoxia
syncope
shock (right side HF)
finding of DVT
cough
hemoptysis
tachycardia

31
Q

what is the workup for PE

A

if low risk - d-dimer
high risk: CTA
- PERC rule

32
Q

what are PERC rule used for

A

rule for PE risk

33
Q

what are the ECG findings for PE

A

s waves in lead 1
Q waves in lead 3
inverted T-waves in lead 3

34
Q

what is severe pulmonary hypertension

A

increase pulmonary vascular resistance which leads to right sided HF
due to HF, COPD, vasculitis, infection
presents with: SOB, CP, effusion, edema

35
Q

what is pulmonary hypertension

A

elevation in the normal pulmonary vascular pressures
increases RV pressure - decrease CO, decrease ability to exert themselves, fluid retention - may lead to death

36
Q

what are common causes of pulmonary arterial hypertension

A

PE, ARDS, COPD, Interstitial lung disease

37
Q

What is aortic dissection

A

separation between layers of the aorta with a false lumen that spreads secondary to pulse and BP

CABS2: Cardiology (11 decks)

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