ZTF Cardio not covered Flashcards
what are the main side effects of statins
myopathy (check CK in patients with muscle pain or weakness)
type 2 diabetes
what are the ECG changes in a STEMI
ST elevation
new LBBB
what are the ECG changes in an NSTEMI
ST depression
deep T wave inversion
pathological Q waves
give some examples of the main thrombotic agents
streptokinase, alteplase and tenecteplase.
what score is used in an NSTEMI to assess for PCI in an NSTEMI
GRACE score
what kind of respiratory failure does LVF cause
type 1 respiratory failure
what findings could you see in someone with right sided heart failure
raised JVP
peripheral odema
what is the management of LVF
mnemonic ‘pour SOD’
Pour away (stop) their IV fluids
Sit up
Oxygen
Diuretics
what is cor pulmonale
Cor pulmonale is right sided heart failure caused by respiratory disease.
what is the most common cause of cor pulmonale
COPD is the most common cause
name a potassium sparing diuretic
Spironolactone
name a type of diuretic that may cause hypokalaemia
thiazide diuretics
what is S1 caused by
closing of the atrioventricular valves (the tricuspid and mitral valves) at the start of the systolic contraction of the ventricles.
what is S2 caused by
closing of the semilunar valves (the pulmonary and aortic valves) once the systolic contraction is complete.
what is S3
heard roughly 0.1 seconds after the second heart sound. I think of it as rapid ventricular filling causing the chordae tendineae to pull to their full length and twang like a guitar string.
normal in a young patient
indicates heart failure in older patient as chordae and ventricles are stiff and weak
when is a 4th heart sound normally heard
direct before S1 and indicates a stiff or hypertrophic ventricle caused by turbulent flow from an atria contracting against a non-compliant ventricle
which side of the stethoscope is used to hear low pitched sounds and which is used for high pitched sound
childs high-pitched screaming from their diaphragm
vs a church bell giving a deep “bong”.
valvular heart disease can cause hypertrophy or dilation
what is the difference between the 2
hypertrophy is thickening both outwards and into then chamber
dilatation is thinning and expanding (think of it like blowing up a balloon)
what valve pathology causes the following
a) left atrial hypertrophy
b) left ventricular hypertrophy
c) left atrial dilatation
d) left ventricular dilation
A) MS
B) AS
C) MR
D) AR
what are the main causes of mitral stenosis and what do you hear
rheumatic heart disease
infective endocarditis
causing mid-diastolic rumbling murmur
what is mitral stenosis associated with
mallar flush due to back pressure of blood into the pulmonary system causing a rise in CO2 and vasodilation
AF
what medical condition does MR cause and what do you hear when you listen
HF
pan-systolic murmur
what are the main causes of MR
Idiopathic weakening of the valve with age
Ischaemic heart disease
Infective Endocarditis
Rheumatic Heart Disease
Connective tissue disorders such as Ehlers Danlos syndrome or Marfan syndrome
what is the most common valve disease
AS
what sound do you hear with AS
ejection systolic murmur
what are the main causes of AS
Idiopathic age related calcification
Rheumatic Heart Disease
what are the other signs of AS
The murmur radiates to the carotids as the turbulence continues up into the neck
Slow rising pulse and narrow pulse pressure
Patients may complain of exertional syncope (light headedness and fainting when exercising) due to difficulty maintaining good flow of blood to the brain
what sound does AR make and what is it associated with
early diastolic murmur
associated with corrigans pulse which is a collapsing pulse
what are the causes of AR
Idiopathic age related weakness
Connective tissue disorders such as Ehlers Danlos syndrome or Marfan syndrome
out of the following, which are the 2 shockable rhythms
Ventricular tachycardia
Ventricular fibrillation
Pulseless electrical activity (all electrical activity except VF/VT, including sinus rhythm without a pulse)
Asystole (no significant electrical activity)
