Amir Sam 1 - Cardio Flashcards

1
Q

List the investigations (in order!!) you would do for chest pain suggesting MI?

A

ECG Troponin Echocardiogram

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2
Q

What are the 4 categories for DDx in chest pain?

A

Cardio Resp GI Musculoskeletal

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3
Q

List DDx for chest pain

A

Cardio - IHD, aortic dissection, pericarditis Resp - PE, pneumothorax, pneumonia GI - oesophageal spasm, oesophagitis, gastritis Musculoskeletal - costochondritis

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4
Q

How would you differentiate between cardiac causes of chest pain?

A

IHD - risk factors Aortic dissection - sudden pain radiating to back with difference of BP between 2 arms Pericarditis - flu like Sx, better leaning forward

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5
Q

ST elevation is seen in leads II, III and aVF. Which artery is affected and therefore which type of MI is this?

A

RCA Inferior

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6
Q

ST elevation is seen in leads V1-4. Which artery is affected and therefore which type of MI is this?

A

LAD Anterior

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7
Q

ST elevation is seen in leads V5, V6, I and aVL. Which artery is affected and therefore which type of MI is this?

A

Circumflex Lateral

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8
Q

What 3 questions do you ask in a LOC history?

A

What happened before / during / after ?

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9
Q

List DDx of collapse

A

Hypoglycaemia Vasovagal Arrhythmia Outflow obstruction (PE or aortic stenosis) Postural hypotension Seizure

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10
Q

List causes of R and L outflow obstruction

A

R = PE L = AS or HOCM

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11
Q

What is the relevance of long QT syndrome?

A

Predisposes to tachyarrhythmias

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12
Q

List 4 causes / associations of long QT syndrome

A

FH sudden death Low K or MG Drugs K channel malformation

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13
Q

If a murmur is louder on INspiration, it is …

A

Right sided

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14
Q

Pansystolic murmurs and raised JVP indicate what?

A

Tricuspid regurgitation

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15
Q

IV drug use leading to infective endocarditis leads to what?

A

R sided murmurs

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16
Q

What is DDx of raised JVP?

A

R heart failure

Tricuspid regurg

Constrictive pericarditis - due to TB / inflam / cancer

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17
Q

What is DDx of systolic murmur?

A

Aortic stenosis Mitral regurg Tricuspid regurg VSD

18
Q

How do you differentiate between the 3 main causes of a systolic murmur?

A

Aortic stenosis - loudest in aortic area, radiating to neck

Mitral regurg - loudest in apex, radiating to axilla

Tricuspid regurg - loudest in tricuspid area, with raised JVP VSD

19
Q

List 3 causes of sinus tachycardia

A

Sepsis Hypovolaemia Endocrine eg thyrotoxicosis or phaeochromocytoma

20
Q

What is supra ventricular tachycardia?

A

No p waves before QRS

21
Q

What causes SVT?

A

Re entry circuit - accessory pathway of blood around heart

22
Q

How can you tell an SVT on ECG?

A

Regular but fast rhythm No p waves Delta waves (short PR intervals and slurred upstroke)

23
Q

Describe AF on ECG

A

Irregular rhythm with no p waves

24
Q

List causes of AF

A

Thyrotoxicosis, alcohol, heart (valve, muscle, pericardium) and lungs (pneumothorax, PE, cancer)

25
Q

What does ventricular tachycardia look like on ECG?

A

Broad QRS complex

26
Q

Describe Mx of SVT with normal BP

A

Vagal manoeuvres eg valsalva Adenosine and cardiac monitor DC cardioversion

27
Q

Describe Mx of fast AF

A

Rhythm control Rate control - beta blockers, digoxin Anticoagulate to reduce complications

28
Q

Describe Mx of VT

A

IV amiodarone (if no haemodynamic compromise) Look for and treat cause No pulse = defibrillation and CPR

29
Q

Describe LVH on ECG

A

Deep S in V1 and V2 Tall R in V5 and V6

30
Q

Explain the difference between the 3 types of heart block

A

1st degree = long PR interval 2nd degree = p waves not followed by QRS 3rd degree = bradycardia, brand QRS, no relationship between P and QRS

31
Q

What is the Tx for 3rd degree heart block?

A

Pacemaker

32
Q

What does S1 represent?

A

Closure of mitral valve

33
Q

What does S2 represent?

A

Closure of aortic valve

34
Q

What does S3 represent?

A

Ventricular filling

35
Q

What does S4 represent?

A

Ventricular hypertrophy

36
Q

What does fixed splitting of S2 represent?

A

Atrial septal defect

37
Q

What is the immediate management of heart failure?

A

Sit pt up Give high flow O2

38
Q

List signs of heart failure

A

High JVP Peripheral oedema Fine crepitations in lungs

39
Q

What does fluffy airspace shadowing show on CXR?

A

Pulmonary oedema

40
Q

What is RBBB?

A

Activation of the right ventricle is delayed as depolarisation has to spread across the septum from the left ventricle

41
Q

What does RBBB look like on ECG?

A

MARROW M shaped QRS in V1 -3 W shaped QRS in I, aVL, V5-6 (wide slurred S wave) Broad QRS

42
Q

How do you determine axis deviation?

A

Look at I & II - is either overall negative? Yes = deviation Is aVL more + or - ? + = L axis deviation, - = R axis deviation