cardio

Question 1

murmur infective endocarditis

Answer 1

harsh pansystolic

Question 2

1st degree heart block ECG

Answer 2

fixed prolonged PR (>200ms / 5 small squares)

Question 3

2nd degree heart block (mobitz 1)

Answer 3

progressive PR prolongation until atrial impulse is not conducted and QRS is dropped
after AV nodal conduction resumes + sequence repeats itself with next beat

Question 4

2nd degree heart block (mobitz 2)

Answer 4

consistent prolonged PR intervals with intermittently dropped QRS complexes
dropping typically follows a repeating cycle of every 3rd (3:1 block) or every 4th (4:1) p wave

Question 5

complete heart block ECG

Answer 5

no electrical communication between atria and ventricles - p and QRS have no association
cardiac function maintained by a junctional or ventricular rhythm
junctional (above bifurcation of His bundle): narrow complex QRS (<3 SS / 0.12s)
ventricular (below bifurcation of His bundle): broad complex QRS (>3 SS / 0.12s)

Question 6

when is warfarin used > DOAC

Answer 6

Hx valvular heart disease (e.g. mitral stenosis)

Question 7

assess need for anticoagulation (using what score?) in AF in what groups? (4)

Answer 7

• currently in AF
• (symptomatic/asymptomatic) paroxysmal, persistent or permanent AF (i.e. had 2 or more episodes)
• atrial flutter
• risk of arrhythmia recurrence following cardioversion / catheter ablation