Cardio ECG and murmurs

Question 1

ECG Findings for stable angina

Answer 1

Normal or ST depression

Question 2

ECG findings for unstable angina

Answer 2

Normal or ST depression/T wave inversion

Question 3

ECG findings for an NSTEMI

Answer 3

ST depression
T wave inversion

Question 4

ECG findings for STEMI

Answer 4

ST elevation
Pathological Q eaves after a few days

Question 5

First line investigation for heart failure

Answer 5

BNP-released from ventricles n response to mechanic stress

Question 6

CXR findings for heart failure

Answer 6

ABCDE
Alveolar bat wing oedema
B Kerley B lines
Cardiomegaly
Dilated upper lobe vessels
E pleural effusion

Question 7

Which valve disorders have systolic murmurs and which have diastolic

Answer 7

Systolic-ASMR (aortic stenosis, mitral regurg)
Diastolic-ARMS(Aortic regurg, mitral stenosis

Question 8

Causes of stenosis

Answer 8

RHD
Congenital issues
Calcification

Question 9

Causes of regurgitation

Answer 9

Connective tissue-Marfans, EDS
Infection: IE

Question 10

Murmur of aortic stenosis

Answer 10

Ejection systolic crescendo-decrescendo murmur

Question 11

Murmur indicative of mitral regurgitation

Answer 11

pansystolic murmur at the apex radiating to the axilla

Question 12

Signs of Mitral stenosis

Answer 12

Malar flush
Diastolic murmur heard when patient lying on left side in held expiration

Question 13

Signs of aortic regurgitation

Answer 13

Diastolic murmur at the left sternal border 4th intercostal space
Collapsing water hammer pulse

Question 14

Treatment pathway for heart failure

Answer 14

ABAL
ACE-i and beta blocker
Aldosterone antagonist-spironolactone
Loop diuretic-furosemide
Digoxin as last resort

Question 15

ECG findings first-degree AV block

Answer 15

Prolonged PR interval(>0.12s)

Question 16

ECG findings Mobitz 1

Answer 16

PR intervals become progressively longer until a P wave and QRS complex is dropped

Question 17

ECG findings Mobitz 2

Answer 17

Consistently prolonged PR intervals randomly not followed by a QRS complex

Question 18

ECG findings 3rd degree AV block

Answer 18

P waves completely independent of QRS complexes

Question 19

ECG findings AFib

Answer 19

No P waves
Irregular and rapid QRS complexes

Question 20

ECG findings Aflutter

Answer 20

Regular sawtooth like atrial flutter between QRS complexes

Question 21

HASBLED score

Answer 21

Risk of major blees in AF patients on antiocoags

Question 22

CHADSVASC score

Answer 22

Stroke risk on AF patients-> need for anticoagulation

Question 23

2:1 block

Answer 23

2 p waves for every QRS complex

Question 24

ECG findings in RBBB

Answer 24

MaRRoW
V1: M shAPED QRS complex
V6: W shaped QRS COMPLEX

Question 25

ECG findings in LBBB

Answer 25

WiLLiaM V1: W shaped QRS complex V6: M shaped QRS compelx

Question 26

Pathophysiology of AVRT

Answer 26

Accessory pathway exists for impulse conduction-> not re-entry through AVN WPW-Accessory pathway-bundle of kent-> excited ventricles earlier than typical pathway

Question 27

ECG findings WPW

Answer 27

Slurred delta waves Short PR intervals Wide QRS

Question 28

What is long QT syndrome

Answer 28

Ventricular tachyarrhythmia Typically congenital QT interval >480ms

Question 29

ECG findings Torsades de Pointes

Answer 29

Looks like ventricular tachycardia QRS complexes twisting around the baseline Height of QRS complex gets progressively smaller then large

Question 30

Ventricular fibrillation

Answer 30

Shapeless rapid oscillation on ECG

Question 31

What can Torsades de Pointes lead to?

Answer 31

Can terminate spontaneously or progress to ventricular tachycardia-> cardiac arrest

Question 32

Causes of prolonged QT

Answer 32

Long QT syndrome (inherited condition) Medications: antipsychotics, flecainide, amiodarone Electrolyte imbalances: hypokalaemia, hypocalcaemia

Question 33

ECG findings ventricular ectopics

Answer 33

Isolated random, abnormal broad QRS complexes on otherwise normal ECG

Question 34

ECG findings AVNRT

Answer 34

Retrograde P waves with prolonged PR interval

Question 35

ECG changes infective endocarditis

Answer 35

Long PR interval

Question 36

ECG changes pericarditis

Answer 36

PR depression Saddle shaped ST elevation OR widespread ST elevation

Question 37

ECG changes pericardial effusion

Answer 37

Low voltage QRS complexes, electrical alternans

Question 38

ECG changes cardiac tamponade

Answer 38

Low voltage QRS complexes, electrical alternans