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Flashcards in Cardiology Deck (62)
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1

ischemic change on ECG

T wave inversion
pathological Q waves

2

atypical presentation of ACS

elderly
diabetic
post op

3

what can ECHO detect

LV
valve disease
RMWA
EF

4

A.fib causes


CARDIAC:
- HTN
- Valvular disase (MS/MR) – rheumatic fever
- HCM
- Ischemic heart disease
PULMONARY CAUSES
- pneumonia
- PE
- Pul HTN
METABOLIC :
- hyperthyroidism
- Hyperkalemia, Mg and Ca
Iatrogenic
- aortic valve replacement
- lidocaine and cocaine
- B-agonst
Others:
- alcohol
- caffeine intake

5

definition for V.T

3 or more conservative ventricular complex occurs at a rate of 100 - 250 bpm

6

treat V.T stable

electrical cardioversion
amiodarone
Lignocaine

7

primary prevention of VT

ICD

8

use of ICD

- LV dysfunction due to presence of MI
LVEF 30-40%
NYHA II and III

9

complication of VT

death
O2 ischemic encephalopathy
acute renal insufficiency
Aspiration pneumonitis
trauma related

10

ECG of hypertrophic Cm

LVH - increase pericardial voltage
non specific ST
T wave abnormality

Deep narrow (dagger like) Q waves

11

Hypertrophic CM

massive hypertrophy in LEFT ventricle due to genetic mutation in sarcomere protein results in
- decrease CO
- sudden cardiac arrest - VT
- syncope with exercise

12

signs of hypertrophic CM

Jerky pulse
JVP LARGE A WAVE
4th heart sounds
Late systolic murmur
- LOUD during valsalva
- soft in Squat

13

definition of Dilated Cm

AD dilation of 4 chambers of heart resulting in systolic dysfunction and biventricular CHF

14

treatment HCM

Sudden cardiac death - ICD
advanced heart failure / non obstructive - TRANSPLANT
AF and stroke - drugs, Anticoagulant, ablation

15

restrictive CM

decrease compliance of ventricle endomyocardium resulting restrictive filling during diastole

16

ABRUPT ANGINA LIKE ONSET in post menopausal women with diffuse T wave inversion

Takostubo Stress CM - transient regional systolic dysfunction lV apex/ or mid - ventricle w/o obstruction coronary arteries and coronary angiogram

17

Diagnostic test for CM

1. ECHO
- left and right ventricle dilation
decrease LV EF
MR and TR
LV thrombus

2. Cardiac MRI

18

Screening for complication test for CM

1. ECG
- sinus tacky
- left atrial abnormalities
- decrease voltage

2. CXR
- CM
- interstitial alveolar edema
- transverse endomyocardial

19

therapeutic test for CM

Cardiac cauterization and ablation

20

treatment CM in general

Avoid (exertion, competitive spots, CCB, NSAIDS )

Family Screen

ICD
HF tx
biventricular pacing / AICD
LVAD (left ventricular atrial device)
Cardiac transplant

21

heart failure definition

abnormality of the cardiac striation or function leading to failure of the heart to deliver 02 at the rate required for tissues

22

sings of Left heart failure

S3
crackles

23

right heart failure

raised JVp
hepatojugular reflex
sacral and lower extremity edema
ascots
parasternal heave
right upper quadrant
hepatosplendomegly

24

diagnostic test heart failure

CXR
T.T.ECHO
BNP or NT-proBNP
Morphology Cardiac MRI imaging (CMR)
- scar burden
- EF
- infiltrative process
Coronary Angiography (Ventriculogram)
- b/c 60% HF pts have CAD
Heart Catheterisation (Left and right)

25

cause of heart failure test

ECHO
ECG
FBC (Anaemia)
TFT’s
Coronary Angiography (CAD)
Urinalysis (looking for proteinuria)
Serology for HIV, Rheumatological Conditions, Viral, Haemochromatosis and Genetic testing.
Iron studies
Fasting lipids
PFT’s

Real causes:
- heart: IHD, HTN, valvular, tachyarrythmia
- OTHER: alcohol, hyperthyroisiam, DM, Acromegly, VIRAl infection, heamochrmatosis, illicit drug

26

Prognostic test for heart failure

BNP / NT-proBNP
LFT’s (Hepatic congestion)
ECG

27

if no response LMNPO

1. invasive BP motor
2. GTN IV infusion
3. Vasoactive agents - Dobutamine and Milirone
4. New agent - Serelaxin

28

drugs that improve prognosis is heart failure

AAAB
ACE ARB ALDEROSTERONE INHIBITOR BB

PLUS mechanical intervention

29

murmurs affected with handgrip

decrease - HOCM
Increase MR. AR. VSD

30

murmurs affected with Squating

increase a. stenosis
decrease HOCM