CVS Flashcards
Long QT Syndrome
*Syncope during heightened adrenergic tone or surprise *arrythmia post-partum *syncope at rest *muscle weakness *cold and pale peripheries *dysmorphic features *sensorineural deafness *gene mutation
Myocardial Infarction
*chest pain *dyspnea *pallor *diaphoresis *features of shock or SIRS *ST-segment elevation at least 1mm in 2 contiguous leads (STEMI)
Mitral Stenosis
*dyspnea, orthopneoa, PND *hoarseness *diastolic murmur *opening snap on auscultation *neck vein distension *peripheral oedema *ascites *history of rheumatic fever *investigations reveal enlarged left atrium
Mitral Valve Prolapse
*Mid-systolic click and murmur *Murmur earlier with increase in preload (standing, valsalva) *may present with palpitations or syncope *may have Slim Body Type *Connective tissue disorder
Myocarditis
*chest pain *age <50years *viral prodrome *relative tachycardia, relative hypotension, dyspnea, elevated neck veins, lympadenopathy *S3 gallop *pericardial rub *ST segment and T wave abnormalities
Pericardial Tamponade
*chest pain, abdo pain *distant heart sounds * elevated JVP *low BP *pulsus paradoxus *history of malignancy, trauma, cardiac intervention *enlarged cardiac silhouette on CXR
Pericarditis
*male 20-50yrs *chest pain *assoc with recent infection *eased when sitting up and leaning forward +pain is constant, not related to exertion +high pitched ‘squeaky’ pericardial rub *upwards concave ST-segment elevation globally with PR depressions
Peripheral Vascular Disease
*thigh or buttock pain with walking relieved by rest *poor wound healing or ulcers *erectile dysfunction *diminished or absent peripheral pulse *ABI < 0.90 *cardiovascular risk factors
Phaeochromocytoma
*Headache *Palpitations *Diaphoresis *Episodes that resemble panic attacks *Tachyarryhtmias and MI *family history of endocrine disorders
Angina pectoris
RF: -increased age -family history of condition -hypertension -smoking -diabetes mellitus -hyperlipidaemia -peripheral vascular disease -chronic kidney disease Clinical findings: -retrosternal chest pain radiating to jaw, arm, or neck -dyspnoea -atypical chest discomfort - may present with epigastric pain, recent-onset indigestion, stabbing chest pain, or pleuritic chest pain. -nausea Can be brought on by: - Emotional stress - Exposure to very hot or cold temperatures . - Heavy meals - Smoking - Physical activity Relieved by Rest and/or medications
Abdominal aortic aneurysm
RF: Cigarette smoking, Hereditary/family history, age > 55, M>F for prevalence, F>M for rupture, Congenital/connective tissue disorders Clinical findings: Incidental finding on examination - palpable pulsatile abdominal mass Acute deterioration in renal function Abdominal, Back or Groin pain Hypotension
Aortic (valve) incompetence/Aortic regurgitation
RF: Bicuspid aortic valve, Rheumatic fever, Endocarditis, Marfan’s syndrome, Inflammation of the aorta secondary to systemic diseases such as syphilis, Behcet’s, Takayasu’s, reactive arthritis, and ankylosing spondylitis Symptoms: Dyspnoea, Fatigue, Weakness, Orthopnoea, Paroxysmal nocturnal dyspnoea, pallor - Cardiogenic shock Signs: Diastolic murmur, Soft S1, Soft or absent A2, Collapsing (water hammer or Corrigan’s) pulse, Hyperdynamic apical impulse, Basal lung crepitations
Aortic stenosis
RF: age >60 years, Congenitally bicuspid aortic valve, Rheumatic heart disease, CKD Symptoms: Dyspnoea, Chest pain, Syncope Signs: Ejection systolic murmur, S2 diminished and single, carotid parvus et tardus
Atrial myxoma
1 - RF: Women, 40-60yo, Fam hx 2 - PC: SOB, syncope, fatigue, weight loss, fever, congestive heart failure, embolic disease 3 - Ex: systolic murmur, loud first heart sound, opening snap, Raynaud’s 4- Ix: TTE (atrial mass), CXR, ECG show atrial enlargement
Atrial septal defect
1- RF: F:M = 2:1, maternal alcohol consumption, fam hx 2- Presentation: Systolic Ejection Murmur, split 2nd heart sound. Child usually asymptomatic. 3 – Rare presentation: CHF sx, failure to thrive, cyanosis 4 - Ix: TTE diagnostic, ECG = large P wave from large (R) atria
