Cardiovascular 2 Flashcards by Erin Timmoney

Risk of Aneurysms…RIPE

Rupture
Infection
Pressure effects on neighbouring structures
Emboli of thrombi to lower limb: causing acute limb ischaemia

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When are left sided and right sided murmurs best heard?

Right in inspiration

Left in expiration

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Sinus Invertis, Chronic sinusitis, bronchiectasis, infertility, dextrocardia

Kartanger’s syndrome

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Small P waves, peaked T waves, widened QRS

Hyperkalaemia

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Cardiac contusion

Bruise caused in trauma

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Systolic murmur grading

Grade 1: just audible
Grade 3: Loud, without a thrill
Grade 4: Loud with a thrill

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Pan systolic heart sound

May obliterate S2

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Opens in the left posterior aortic sinus

Left Coronary Artery

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Opens into the right atrium

Coronary Sinus (in posterior atrioventricular groove)

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Is commonly associated with the atrioventricular groove

Right coronary artery

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Supplies the AVN

Posterior Inter ventricular Artery

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Supplies the SAN

Right coronary artery

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Supplies the apex

Anterior Atrioventricular artery

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Where does the circumflex artery supply?

Oxygenated blood to the lateral walls of the ventricle, the left atrium and the left posterior fasciculus of the left bundle branch (before Purkinje fibres)

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Atrial ‘plop’

Cardiac myoxma

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Ejection systolic murmur

Aortic stenosis

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Pan systolic murmur

Mitral regurgitation

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Early diastolic murmur

Aortic Regurgitation

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What is the diagnostic criteria of an acute MI?

ST elevation of greater than or equal to 1mm in two adjacent limb leads
ST elevation of greater than or equal to 2mm in two adjacent precordial leads
LBBB that is new in the case of an acute history

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Large “a” waves

Tricuspid regurgitation, pulmonary stenosis, pulmonary hypertension
-Are pre systolic and seen in right ventricular hypertrophy

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Large “a” waves

Tricuspid regurgitation, pulmonary stenosis, pulmonary hypertension

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Cannon waves

Complete heart block or ventricular tachycardia

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Boot shaped heart on CXR

Fallot’s tetralogy

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What is the difference between coarse inspiratory crackles and fine inspiratory crepitations?

Study These Flashcards

Coarse inspiratory crackles= heart failure

Fine inspiratory crepitations= pulmonary fibrosis

When is a collapsing pulse found?

High cardiac output states: aortic regurgitation, anaemia, thyroxicosis, fever, patent ductus arteriosus

Assymetrical ventricular hypertrophy, jerky pulse and harsh ejection systolic murmur, autosomal dominant, sudden cardiac death, beta myosin mutation

Hypertrophic cardiomyopathy

Cardio clinical features associated with Turner's Syndrome

Correction of the aorta, aortic dissection, mitral valve prolapse, congenital bicuspid aortic valve

Causes of late systolic murmur

Mitral valve prolapse, coarctation of the aorta and hypertrophic obstructive cardiomyopathy

Why should Ca channel antagonists and beta blockers not be used together?

Can cause severe AV block and hypotension

What is the mechanism of amiodarone?

Prolongs the cardiac action potential

Name some causes of low voltage QRS

Hypothyroidism, COPD and increased haemocrit

Name some ejection systolic murmurs

Aortic stenosis, pulmonary stenosis, atrial septal defect, cardiomyopathy, Fallot's tetralogy and flow murmurs (aortic/pulmonary regurgitation)

Name some pan systolic murmurs

Mitral regurgitation, tricuspid regurgitation, VSD

Name some late systolic murmurs

Hypertrophic cardiomyopathy, mitral valve prolapse

What does the QT interval give an indication of?

Ventricular systole

Blood supply: what opens in the left posterior aortic sinus?

Left coronary artery -lies between the left auricular appendage and the pulmonary trunk, it gives off the anterior inter ventricular artery to become the circumflex artery

Blood supply: what opens into the right atrium?

Coronary sinus -Lies in the posterior atrio-ventricular groove, between the IVC and the right trio-ventricular valve. The sinus is a continuation of the great cardiac vein and receives most of the venous drainage of the heart

Blood supply: is most commonly associated with the atrioventricular groove?

Right Coronary Artery

Blood supply: what is the blood supply to the AVN?

Posterior interventricular artery (in 80%-90% of individuals)

Blood supply: what is the blood supply to the apex

Anterior interventricular artery

Prominence of both X and Y decent in the JVP

Constrictive pericarditis

Give some causes of constrictive pericarditis

Malignancy, TB, bacterial and fungal infections, chronic renal failure

JVP with prominent X decent but no Y decent

Cardiac Tamponade

Rise in JVP with inspiration

Cardiac Tamponade

Management of cardiac tamponade

Pericardial aspiration

Gradual onset fatigue, dysponea and ankle swelling with an apex beat in the mid axillary line, 6th intercostal space. Systolic or diastolic? What is the associated murmur?

- Dilated cardiomyopathy | - Pansystolic murmur, mitral regurgitation

58 year old with malaise, fever, night sweats and exertional dysponea . He has splinter haemmorhages and pulsations visible between the nail beds. Systolic or diastolic? What is the associated murmur?

Aortic regurgitation secondary to endocarditis -Early diastolic murmur

What treatment should be given in a patient with VT due to hyperkalaemia

Calcium Chloride

Harsh pansystolic murmur which is loudest in the lower left sternal edge and inaudible at the apex. The apex is not displaced and does not intensify on inspiration

VSD - If intensified on inspiration: Tricuspid regurgitation - If intensified on expiration, displaced and lower sternal edge: Mitral regurgitation

The pulse is regular and jerky in character, cardiac impulse is hyper dynamic and non displaced. There is a mid-systolic murmur, with no ejection click, loudest at the left sternal edge

Hypertrophic cardiomyopathy

Causes of Atrial fibrillation

Rheumatic mitral valve disease, thyroxitosis, cardiomyopathies

Complications of acute MI

Arrythmias, cardiogenic shock, ventricular septal rupture, ventricular wall aneurysm, papillary muscle rupture, pericarditis

Name some associated causes of aortic regurgitation

UC and rheumatoid arthritis

What are the causes of pulseless electrical activity? 4Hs and 4Ts...

- Hypovolaemia, Hypothermia, Hypoxia, Hypo/hyper kalaemia | - Cardiac Tamponade, Pulmonary thromboembolism, Tension Pneumothorax, Toxic/Therapeutic disturbances

What drug is recommended in the treatment of pulseless electrical activity?

Calcium Chloride

Use of Verapamil

Only in treatment of SVTs

Left ventricle size in mitral stenosis

Normal

Treatment for Acute AF

- If haemodynamically unstable use Cardioversion | - Rate control with Verapamil or Bisoprolol

Treatment for Chronic AF

- Rate control: Beta blocker or Ca channel antagonist | - Anti coagulate

Cardiovascular 2 Flashcards

(59 cards)