Flashcards in 4th Year Cardio Deck (84):
Mitral regurgitation - systolic or diastolic?
Aortic stenosis - systolic or diastolic?
Systolic - ejection systolic
BNP is marker of?
First line drug treatment for heart failure?
ACE inhibitor and Beta blocker
Second line drug treatment for heart failure?
Spironolactone, ARB or hydralazine
Third line treatment for heart failure?
Slurred upstroke on ECG?
Wolff Parkinson white syndrome (delta wave)
When should a bradycardia be treated?
If <40 or symptomatic
What is the drug treatment for a bradycardia?
What kind of arrhythmia does sick sinus syndrome cause?
SVT - what kind of tachycardia? What is the treatment?
Narrow complex tachycardia
IV adenosine or Verapamil (asthma)
VT - what kind of tachycardia cardia and treatment?
IV amiodarone or IV lidocaine
DC shock if no response or unstable
What is 1st degree heart block?
Fixed prolongation of the PR interval
What is 2nd degree heart block - mobitz 1?
Progressive PR prolongation followed by missing QRS
What is 2nd degree heart block - mobitz 2?
P wave without QRS
What is complete heart block?
No relationship between P and QRS waves
What is the rate of atrial flutter usually?
A division of 300
Which type of arrhythmias are always pathological?
Which is rhythm is always shockable?
What is bruggada syndrome?
QRS goes into T wave inversion - risk of sudden cardiac death
Which leads are lateral territory?
I, aVL, V5, V6
Which leads are inferior territory?
II, III, aVF
Which leads are anterior territory?
V1, V2, V3, V4
Name 2 ECG markers of ischaemia?
T wave -tall, biphasic, inverted
What are the criteria for thrombosis in ischaemia?
>1mm in 2 contiguous limb leads
>2mm in 2 contiguous chest leads
3 features of RBBB?
Broad M shaped V1
QRS >0.12 seconds
RSR complex in V1
Delayed S wave
Name the 4 heart valves in order?
What causes the P wave on ECG?
What causes the QRS complex on ECG?
Contraction of L and R ventricles
What causes the 1st heart sound?
Closure of mitral and tricuspid valves
What causes the second heart sound?
Closure of the aortic and pulmonary valve
What is the ejection fraction?
Proportion of end diastolic volume ejected in each cardiac cycle
What is the after load?
Resistance against which heart is pumping
What causes wollf Parkinson white syndrome?
Congenital accessory pathway between atria and ventricle
treatment of WPW syndrome?
Radio frequency ablation of accessory pathway
Drugs for cardio version in AF?
Amiodarone or Flecainide
When should DC cardioversion be used in AF?
If the patient is unstable
Two signs of aortic stenosis?
Narrow pulse pressure
Slow rising pulse
Most common causes of aortic stenosis in older and younger patients?
>65 - degenerative calcification
<65 - bi cuspid aortic valve
When should you replace a the valve in a patient with aortic stenosis?
If they are symptomatic or valvular gradient is >40mmHg
What two cardiac drugs should you never prescribe together and why?
Verapamil and a beta blocker - risk of complete heart block
Drug management of angina?
Statin and aspirin for all
GTN for symptoms
B blocker or Ca channel blocker - first line - both if uncontrolled
If uncontrolled or cannot tolerate - long acting nitrate (ivabradine, nicorandil)
Which anti biotic should you avoid in long QT syndrome?
What ECG sign is seen in hypokalaemia?
In what condition will a patient with VF be?
Unconscious - not compatible with cardiac output
What drugs are used for rate control in AF?
Bisoprolol or Ca channel blockers (diltiazem)
If BP between 135/85 and 150/95 when should you treat?
If <80 or 10 year risk >20%
First line hypertensive for someone under 55?
First line hypertensive for someone over 55?
Calcium channel blocker
Step 2 of hypertension management?
ACE and Ca blocker
3rd drug to add in hypertension?
Which 3 drugs can be added if control is not achieved on first line treatment?
Spironolactone if K <4.5
Splitting of which heart sound is normal?
S2 during inspiration
When is S3 normal?
If under 30
Causes of a 4th heart sound?
What type of arrhythmia is torsades des points?
What kind of drug is diltiazem?
Calcium channel blocker
Anti coagulation in actue AF?
What is systolic heart failure?
Failure of the ventricles to contract
What is diastolic heart failure?
Failure of the ventricles of relax
Symptoms of left ventricular failure?
Dyspnora, paroxysmal bought, nocturnal dyspnoea, pink frothy sputum
Symptoms of right ventricular failure?
Peripheral oedema, ascities
CXR features of LVF?
A - alveolar oedema
B - Kelley B lines
C - cardiomegaly
D - dilated prominent upper lobe vessels
E - effusion
First line management of heart failure?
ACE inhibitor and beta blocker
2nd line treatment for heart failure?
Spironolactone, ARB, hydralazine
3rd line treatment for heart failure?
Diuretics used in heart failure and when?
Furosemide and bumetenide
When signs of fluid overload
In what time frame should PCI be performed for an MI?
Within 120 minutes, if not possible then thrombolyse
W and M in LBBB and RBBB?
Left - W in V1, M in V6
Right - M in V1, W in V6
Which type of BBB can be a normal variant?
Acute drug management of anaphylaxis?
0.5mg IM adrenaline
10mg IV chlorphenamine
When should you treat AF according to CHADVASC score?
1 - for males
2 - for everyone
What arrhythmia has absent P waves?
Typical symptoms of pericarditis?
Chest pain relieved on sitting forward, non productive cought
ECG changes in pericarditis?
Saddle shaped ST elevation
What is the commonest ECG change in PE?
Treatment of torsades des points?
What other arrhytmia is torsades des points associated with and what drugs can cause this?
Long QT syndrome
Anti psychotics and anti depressants
What type of murmur Is head in hypertrophic obstructive cardiomyopathy?
What ECG changes are seen in a recovering MI?
Inverted T waves, Q waves
What is a complication of pericarditis?
Name 3 causes of pericarditis?
Virus - coxsackie
Post MI -dressler syndrome
Uraemic pericarditis - renal
Risk in pericardial effusion?