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Sheff Phase 4 > Cardio > Flashcards

Cardio Flashcards

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1
Q

3 Causes of LBBB

A 
hypertension,
 aortic stenosis,
 acute MI,
 coronary artery disease 
 primary conducting system disease,
infection
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2
Q

Primary heart block findings

A

fixed prolonged PR interval (>200 ms)

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3
Q

Seen in LAD

A

Lead I has the most positive deflection

Leads II and III are negative

[Seen in conduction defects]

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4
Q

RAD?

A

Lead III has the most positive deflection

Lead I should be negative

[This is commonly seen in individuals with right ventricular hypertrophy]

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5
Q

PR interval length?

A

120-200ms [3-5 small squares]

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6
Q

2nd degree heart block type 1 findings?

A

PR interval slowly increases then there is a dropped QRS

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7
Q

2nd degree type 2 heart block findings

A

PR interval is fixed but there are dropped beats

[Make sure you clarify that by the frequency of dropped beats e.g 2:1, 3:1, 4:1]

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8
Q

3rd degree heart block

A

P waves and QRS complexes are completely unrelated

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9
Q

Where do the pathologies causing heart block types occur?

A

1: between the SA node and the AV node (i.e. within the atrium)

2: Mobitz I (Wenckebach) – occurs IN the AV node.
[This is the only piece of conductive tissue in the heart which exhibits the ability to conduct at different speeds]
Mobitz II – occurs AFTER the AV node in the bundle of His or Purkinje fibres

3:Occurs anywhere from the AV node down

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10
Q

2 reasons for a shortened PR?

Seen in the pathological cause on ECG?

A

SA node location can vary / people have small atria

Accessory pathway
Slurred upstroke o= delta wave

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11
Q

2 reasons for a shortened PR?

Seen in the pathological cause on ECG?

A

SA node location can vary / people have small atria

Accessory pathway
Slurred upstroke o= delta wave

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12
Q

What is a narrow / broad QRS

A

NARROW (< 0.12 seconds)

BROAD (> 0.12 seconds)

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13
Q

Why do you get broad QRSs

A

BBB
Ventricular ectopic

Conduction system defects

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14
Q

What should be seen in Anterior chest lead R waves?

A

R wave pregression

small in V1 to large in V6

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15
Q

What is the J pount

A

where S wave joins ST

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16
Q

When is ST elevaiton significant ?

A

greater than 1 mm (1 small square) in 2 or more limb leads

or >2mm in 2 or more chest leads.

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17
Q

When is ST depression significant

A

≥ 0.5 mm in ≥ 2 leads

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18
Q

2 times you get tall T waves

A

Hyperkalaemia (“Tall tented T waves”)

Hyperacute STEMI

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19
Q

Where are T waves normally inverted

A

V1

lead 3

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20
Q

3 causes of T wave inversion

A

Ischaemia
Bundle branch blocks (V4 – 6 in LBBB and V1 – V3 in RBBB)
Pulmonary embolism
Left ventricular hypertrophy (in the lateral leads)
Hypertrophic cardiomyopathy (widespread)
General illness

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21
Q

Biphasic T wave seen in ?

A

Ischaemia and hypokalaemia

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22
Q

When might you see U waves/

A

electrolyte imbalances
hypothermia

antiarrhythmic therapy (such as digoxin, procainamide or amiodarone).

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23
Q

RBBB where is the RsR wave?

A

v6 [2 peaks]

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24
Q

Drugs for rate control of AF

A

β-blockers and calcium-channel antagonists.

[Digoxin]

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25
Prescribe with AF rate control
anticoagulation eg Warfarin
26
name 3 ways/drugs for rhythm control
amiodarone, flecainide, dronedarone | and/or DC cardioversion and/or ablation therapy
27
Name 2 causes of raised troponin T
a. Cardiac ischaemia b. Cardiac arrhythmia c. Pneumonia d. Pulmonary embolism.
28
Drugs used for HTN that can cause heart block
beta-blockers and | the non-dihydropyridine calcium-channel antagonists, EG verapamil
29
3rd-degree heart block - what drug might you use? more permanent fix?
Atropine transcutaneous pacing via a defibrillator
30
2nd degree heart block causes? name 3 Mx if no reversible cause found?
ischaemic heart disease, sarcoidosis, Lyme disease, thyroid disease, strong parasympathetic response, drugs such as digoxin and verapamil. Pacemaker
31
Treatment options for SVT
``` Vagal manoeuvres (blowing hard against closed lips, cold water splashed into face, carotid massage) ``` adenosine BB/CCB/ flecanide/amiodarone (not digoxin) ``` direct current (DC) cardioversion. ```
32
What medication is contraindicated in WPW ? Mx of WPW
Digoxin – this drug will slow AV (atrioventricular) node conduction exclusively and therefore encourage conduction along the accessory pathway. accessory pathway ablation
33
Which leads meaure inferior?
II, III, aVF
34
Which leads are lateral
I, aVL, v5, v6
35
Inferior STEMI - what is likely artery? What else does it supply? 2 other Comps?
Right coronary artery AV node -> complete heart block Other comps: ventricular arrhythmia, reduced left ventricular function leading to acute left ventricular failure, right ventricular failure, ischaemic ventricular septal defect acute mitral regurgitation due to papillary muscle rupture.
36
Why might you get a 'cannon wave' raised JVP in compete heart block?
RA contacts against closed tricusid valve [due to heart block] ->blood shoots up jugular vein
37
Mx of severe AS
TAVI -transcatheter valve implant Open valve repair [Balloon valvuloplasty - usually for palliative / awaiting definitive treatment]
38
2 reasons for a shortened PR? | Seen in the pathological cause on ECG?
SA node location can vary / people have small atria Accessory pathway Slurred upstroke o= delta wave
39
What is a narrow / broad QRS
NARROW (< 0.12 seconds) BROAD (> 0.12 seconds)
40
Why do you get broad QRSs
BBB Ventricular ectopic Conduction system defects
41
What should be seen in Anterior chest lead R waves?
R wave pregression | small in V1 to large in V6
42
What is the J pount
where S wave joins ST
43
When is ST elevaiton significant ?
greater than 1 mm (1 small square) in 2 or more limb leads or >2mm in 2 or more chest leads.
44
When is ST depression significant
≥ 0.5 mm in ≥ 2 leads
45
2 times you get tall T waves
Hyperkalaemia (“Tall tented T waves”) | Hyperacute STEMI
46
Where are T waves normally inverted
V1 | lead 3
47
3 causes of T wave inversion
Ischaemia Bundle branch blocks (V4 – 6 in LBBB and V1 – V3 in RBBB) Pulmonary embolism Left ventricular hypertrophy (in the lateral leads) Hypertrophic cardiomyopathy (widespread) General illness
48
Biphasic T wave seen in ?
Ischaemia and hypokalaemia
49
When might you see U waves/
electrolyte imbalances hypothermia antiarrhythmic therapy (such as digoxin, procainamide or amiodarone).
50
RBBB where is the RsR wave?
v6 [2 peaks]
51
Drugs for rate control of AF
β-blockers and calcium-channel antagonists. [Digoxin]
52
Prescribe with AF rate control
anticoagulation eg Warfarin
53
name 3 ways/drugs for rhythm control
amiodarone, flecainide, dronedarone | and/or DC cardioversion and/or ablation therapy
54
Name 2 causes of raised troponin T
a. Cardiac ischaemia b. Cardiac arrhythmia c. Pneumonia d. Pulmonary embolism.
55
Drugs used for HTN that can cause heart block
beta-blockers and | the non-dihydropyridine calcium-channel antagonists, EG verapamil
56
3rd-degree heart block - what drug might you use? more permanent fix?
Atropine transcutaneous pacing via a defibrillator
57
2nd degree heart block causes? name 3 Mx if no reversible cause found?
ischaemic heart disease, sarcoidosis, Lyme disease, thyroid disease, strong parasympathetic response, drugs such as digoxin and verapamil. Pacemaker
58
Treatment options for SVT
``` Vagal manoeuvres (blowing hard against closed lips, cold water splashed into face, carotid massage) ``` adenosine BB/CCB/ flecanide/amiodarone (not digoxin) ``` direct current (DC) cardioversion. ```
59
What medication is contraindicated in WPW ? Mx of WPW
Digoxin – this drug will slow AV (atrioventricular) node conduction exclusively and therefore encourage conduction along the accessory pathway. accessory pathway ablation
60
Which leads meaure inferior?
II, III, aVF
61
Which leads are lateral
I, aVL, v5, v6
62
Inferior STEMI - what is likely artery? What else does it supply? 2 other Comps?
Right coronary artery AV node -> complete heart block Other comps: ventricular arrhythmia, reduced left ventricular function leading to acute left ventricular failure, right ventricular failure, ischaemic ventricular septal defect acute mitral regurgitation due to papillary muscle rupture.
63
Why might you get a 'cannon wave' raised JVP in compete heart block?
RA contacts against closed tricusid valve [due to heart block] ->blood shoots up jugular vein
64
Mx of severe AS
TAVI -transcatheter valve implant Open valve repair [Balloon valvuloplasty - usually for palliative / awaiting definitive treatment]
65
Pt comes in with central crushing chest pain...Hx HTN | XR shows mediastinal widening .... what is it?
Aortic dissection
66
Type A vs B dissection? Mx?
type A (involves ascending aorta/arch proximal to the origin of the left subclavian artery) REQUIRES SURGERY type B (where the dissection involves the aorta distal to the left subclavian artery origin). Can be managed conservatively
67
In VT what is usual Mx option? | What if they are stable?
DC cardiovert correct electrolytes, amiodarone, beta-blockers [this is uncommon]
68
3 most common bugs for IE
a. Staphylococcus aureus b. Streptococcus viridans c. Enterococcus spp.
69
PE ECG findings
S wave in lead I Q wave in lead III, Inverted T wave in lead III.
70
Becks triad
Muffled heart sounds with hypotension + raised JVP
71
Atrial flutter Mx
DC cardiovert | radiofrequency ablation - for long term
72
Name 3 causes of pericarditis
a. Viral – in particular coxsackie, cytomegalovirus, herpes virus and HIV b. Immune conditions, such as systemic lupus erythematosus c. Myocardial infarction (MI) (Dressler’s syndrome – usually occurring 2 weeks post-MI) d. Trauma to the heart e. Uraemia f. Malignancy (as a paraneoplastic phenomenon)
73
Pericarditis - what positions make it better/worse
The worsening of pain when lying down, | alleviated on sitting forward

Sheff Phase 4 (26 decks)

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