Teaching with Prof Collins Flashcards
Jones criteria is for?
Rheumatic heart disease
Rheumatic heart disease - Jones criteria - what’s part of this?
Carditis, arthritis, chorea, erythema marginatum, and subcutaneous nodules
raised ESR/CRP - look this up
Endocarditis - what is the screening criteria
Duke’s criteria
Can you rule our endocarditis with a normal echo?
No - you can’t see vegetations on this all the time
What is libman-sacks endocarditis
You get this with autoimmune conditions like SLE
What urinary sign do you get in endocarditis and why?
Immune glomerulonephritis secondary to endocarditis - should be resolved upon IE treatment
What would you give in someone with AF if they need rate control but have asthma?
Avoid BB
Give Verapamil instead
Try not to give amiodarone as it might convert her
Then anticoag
Apixaban - twice a day
Edoxaban 60mg once a day
SVT management
If haemodynamically unstable - DC cardioversion
If haemodynamically stable - IV adenosine 6mg
Commonest cause of SVT
AVNRT
Amiodarone SE
Hepatitis
Hypo or hyper thyroidism
Lung fibrosis
How do you treat complete heart block?
If haemodynamically unstable - transcutaneous pacing
If stable - pacemaker
What is a physiological pacemaker?
Physiological pacemaker - dual chamber - one lead in right atrium to sense P wave, which will then send to the lead in the ventricle will see if the wave has been conducted, if not it will contract
VVI
ICD - internal defib
Resynchronised pacemaker to improve synchronisation
Defib - higher shock
DC cardioversion
unsynchronised - for VF/VT????
synchronised - for AF
What is the hear of the MS
The tap in MS is a palpable murmur
Forceful apex - hypertrophy
Displaced apex - dilated
PE ECG changes
S1 Q3 T3
Aortic stenosis
Most common in over 65s
Mitral stenosis
Most commonly caused by rheumatic fever
Tapping S1
Opening snap
You get heart failure
Manage with diuretics, BB/CCB for AF
Anti coag
Mitral regurg - classificaiton and causes
Primary - valve degeneration
Secondary - left ventrcular remodelling causing MR
Acute - after infective endocarditis, rheuamtic fever
Chronic
Barlow’s valve
Mitral valve prolapse - more common in women
More lax tissue
MR heart sound
holosystolic murmur
Pulmonary stenosis
Louder at left upper sternal border - doesn’t radiate into carotids
S2 split - because aortic valve closes first, and then the pulmonary valve closes later
JVP - prominent A waves
RVH - possibly with heave
VSD
Acquired, or after MI
Holosystolic murmur - loudest at left lower sternal edge
Eisenmenger if there is a reversal of the shunt from left to right and right to left
R to L
Tricuspid regurg
Holosystolic murmur - retrograde blood flow during contraction
RHF
Can be caused by
Ebstein anomaly - the valve is pushed down so can’t close as well
Tricuspid repair
