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Core Conditions > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What are some causes of secondary hypertension?

A

Renal parenchymal diease (e.g. GN, reflux nephropathy)
Renal artery stenosis
Adrenal tumours (hyperaldosteronism, hypercortisolism, phaeochromocytoma)
Sleep apnoea
Aortic coarctation

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2
Q

What questions should you ask when taking a history of patient with hypertension?

A 
Family history of CVD
Past coronary or cerebrovascular events
Heart failure symptoms
Renal disease symptoms
Smoking
Diabetes
High cholesterol
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3
Q

What examinations should you perform on a patient with hypertension?

A

BP and pulse rate/rhythm
BMI and waist circumference
Full cardio exam
Fundal inspection
Renal mass (polycystic) and bruits (renal artery stenosis)
Stigmata of secondary causes (e.g. cortisol excess)

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4
Q

What tests should you perform on a patient with hypertension?

A

Plasma potassium (low in hyperaldosteronism)
Plasma creatinine (high in renal disease)
Fasting glucose
Fasting lipids
FBE
LFTs
Urine albumin/creatining ratio (renal damage)
MSU (renal disease)
ECG and echocardiogram (coronary disease and cardiac hypertrophy)

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5
Q

When do you treat hypertension?

A
  1. SBP >180 mmHg
  2. DBP > 110 mmHg
  3. BP >160/70 mmHg
  4. BP >140/90 mmHg + associated conditions OR high CV risk
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6
Q

How do we manage hypertension?

A 
Non-pharmacological:
- lose weight
- improve fitness
- avoid excess salt
- moderate alcohol
- stop smoking
Pharmacological:
- ACE inhibitors
- beta blockers
- Ca channel blockers
- Diuretics
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7
Q

What are the risk factors for ischaemic heart disease?

A
  1. Dyslipidaemia
  2. Hypertension
  3. Diabetes
  4. Smoking
  5. Family history
  6. Age
  7. Physical inactivity
  8. Obesity
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8
Q

What are common presenting symptoms of an AMI?

A
  • Chest pain described as a pressure sensation, fullness, or squeezing in the midportion of the thorax
  • Radiation of chest pain into the jaw or teeth, shoulder, arm, and/or back
  • Associated dyspnea or shortness of breath
  • Associated epigastric discomfort with or without nausea and vomiting
  • Associated diaphoresis or sweating
  • Syncope or near syncope without other cause
  • Impairment of cognitive function without other cause
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9
Q

How do we diagnose an AMI?

A
  1. ECG changes

2. Elevated troponin levels

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10
Q

How do we manage an initial presentation of AMI?

A 
Remember MONA =
Morphine
Oxygen
Nitrates
Aspirin
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11
Q

What are the complications of an AMI?

A
  1. Ischaemic: angina, reinfarction, infarct extension
  2. Mechanical: heart failure, cardiogenic shock, mitral valve dysfunction, cardiac rupture
  3. Arrhythmic: atrial or ventricular arrhythmias, sinus or atrioventricular node dysfunction
  4. Embolic: central nervous system or peripheral embolisation
  5. Inflammatoy: pericarditis
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12
Q

What are the consequences of uncontrolled hypertension?

A
  1. Coronary artery disease
  2. Stroke
  3. Cardiac hypertrophy
  4. Heart failure
  5. Kidney failure
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13
Q

How is pericardial pain typically described?

A
  • central or left side
  • sharp, stabbing pain
  • worse on movement
  • worse on breathing
  • relieved by sitting up and leaning forward
  • worse when lying down
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14
Q

How is pleuritic chest pain typically described?

A
  • sharp, stabbing pain
  • localised
  • worse on inspiration or coughing
  • may be worse on sitting up or leaning forward
  • not related to exertion
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15
Q

How is oesophageal pain typically described?

A
  • usually “burning” but may be dull ache
  • worse after meals
  • worse on lying down
  • relieved by antacids
  • oesophageal spasm may be releaved by GTN
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16
Q

How is a dissecting aortic aneurysm typically described?

A
  • severe chest pain

- radiation to the back

17
Q

What are the causes of acute chest pain?

A 
Cardiac
- AMI
- unstable angina
- pericarditis
Vascular
- dissecting aortic aneurysm
Respiratory
- pulmonary embolus
- pneumonia
- pleurisy
- pneumothorax
Oesophageal
- oesophagitis
- oesophageal spasm
Musculoskeletal
- muscle injury, spasm
- costochondral joint inflammation
Skin
- Herpes Zoster (shingles)
18
Q

What are typical examination findings in a patient with dissecting aortic aneurysm?

A
  1. BP different in each arm

2. Early diastolic murmur of aortic regurgitation

Core Conditions (13 decks)

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