Cardio Flashcards
(27 cards)
Management of AAA
> 5.5cm: offer elective repair
5.5cm has 10% annual risk of rupture, risk increases as gets larger
Atrial myxoma presentation
Symptoms are due to local mechanical effects + constitutional:
- Eg. Dyspnoea, palpitations, syncope, heart failure, fever, w/l, arthralgia
80% on left
75% females
NB. Familial myxoma may be associated with CARNEY syndrome (myxoma in breast, skin, thyroid, neural tissue, endo dysfunction, pigmented naevi)
Dukes Criteria for IE
2 major / 1 major + 2 minor / 5 minor
Major:
- micro evidence on 2 separate BCs of typical organism
- positive echo
Minor
- Predisposition eg. Valve abnormality
- Vascular phenomena
- Elevated CRP
- Immunological phenomena
- BCs not fitting major criteria
Amiodarone SEs
3 Hs, 3Ps, cornea and skin
Hypo/hyperthyroidism Hepatotoxic Hypotension - NOT hypertension Photosensitivity Peripheral neuropathy Pulmonary fibrosis Grey skin Corneal microdeposits
Px of VSD as a complication of MI
Tends to be post anterior MI
Pansystolic murmer at LSE (unlike MR)
Signs of heart failure
Contraindications for Exercise ECG
UA HF/Pulmonary oedema Recent MI (last 7 days) AS Electrolyte imbalance
Pharm options for thrombolysis for STEMI
Streptokinase vs Reteplase? Reteplase~better outcomes and fewer deaths
Features and management of Digoxin toxicity
GI: anorexia, N+V, diarrhoea
ECG: bradycardia, 1st degree HB, other arrhythmias (eg ST and TW changes)
Rx: Check potassium (low K can potential toxicity) Correct electrolyte abnormalities Treat arrhythmias DIGIBIND
Issues with Exercise tolerance test to diagnose stable angina?
High sensitivity but only moderate specificity
A normal test does not exclude CAD
I.E. Exercise ECG and MRCA NOT used to diagnose or exclude stable angina in people without known CAD
Diagnostic tests for Aortic Dissection
TransOESOPHAGEAL Echocardiography (as the aorta is posterior to heart (CTA and MRA can also be diagnostic)
Sick sinus syndrome presentation and pathology
Px: fatigue and pre/syncope
ECG: sinus brady
Path: idiopathic fibrosis of sinus node -> inappropriate atrial rate for normal requirements
Holiday heart syndrome
Px: palpitations, narrow complex tachycardia
Often results from binge drinking, dehydration, stress
Sx and arrythmia tends to resolve following rehydration, no follow up
Polymorphic VT vs TdP
Polymorphic VT = beat to beat variability in morphology
TdP = Polymorphic VT + Prolonged QT
Staging and Management of HTN
Stage 1: 140/90 clinic or 135/85 ABPM
Stage 2: 160/100 clinic or 150/95 ABPM
Stage 3/Severe: 180/100
Malignant: Stage 3 + papilloedema/retinal haemorrhages
Malignant Rx:
- immediately treat
- immediate specialist care
Causes and features of High Output Heart Failure
Causes: ~hyper dynamic circulation
- Anaemia, pregnancy, thyrotoxicosis, beriberi, Pagets
Px:
- palpitations + heart failure Sx
- venous hum over RIJ
- wide pulse pressure
PDA presentation and management
DA should close after 48 hours
Px: loud, constant machinery murmur heard at 6 week newborn check
Rx: indomethacin
Tricuspid stenosis features
Large “a” waves ~increased R to right atrial emptying
Right sided diastolic murmur, louder on inspiration (can be EDM)
Graham Steel murmur?
High pitched early diastolic murmur over pulmonary area, louder in inspiration ie. pulmonary regurgitation
Often in context of pulmonary hypertension eg. Cor pulmonale, mitral stenosis
(S2 can be split)
Peripartum cardiomyopathy presentation
HF developing in last month of pregnancy, or within 5 months of delivery
With no other cause of reduced EF found
AAA and DVLA
> 6cm: notify DVLA and annual review
>6.5cm: notify DVLA and NO DRIVING
Features of Tetralogy of Fallot
Clubbed infant, often cyanotic during feeding. Has a habit of squatting.
- RVOT
- RVH
- VSD
- Overriding aorta
(Squatting reduces RVOT)
Definition of features of Coarctation of Aorta
Definition: narrowing of aorta at or distal to origin of Subclavian A ie. can compromise distal circulation
Features:
- Cold feet, claudication, radiofemoral delay
- Associated with Turner’s syndrome (5-10%)
Management of aortic stenosis in child
First line: balloon angioplasty of AV
If fails, surgical AVR
Rheumatic fever scoring criteria, eponymous name
Jones’ criteria
