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Systems revision > CARDIOVASCULAR > Flashcards

CARDIOVASCULAR Flashcards

1
Q

What is the different stages of hypertension

A

Stage 1: 140/90mmHg

Under 80 and 135/85mmHg
with
risk factors:
diabetic/renal disease/CVD/end organ damage

Stage 2: 160/100mmHg

SEVERE

Stage3: 180/110mmHg

Stage 4:
Persistent

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2
Q

What increases the risk of hypertension

A 
Smoking 
Diabetes 
Hyperlipidaemia 
Previous MI or stroke 
Family history

Increased age - decreases arteriole compliance

Alcohol

High sodium diet (<6mg)

Obesity (activates SNS)

Low birth weight

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3
Q

What is the aetiology of hypertension

A

Primary - idiopathic

Secondary 
Drug induced: oral contraceptive, NSAIDS, Steriods 
Endocrine disorder: cushions, chronns 
Co-arctation of aorta 
Sleep apnoea 
Renal disease: renal artery stenosis
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4
Q

What is the investigations for hypertension

A

ABPM - Ambulatory Blood pressure Monitoring

HBPM - Home Blood pressure Monitoring

For end organ damage:

ECG + ECHO

Renal ultrasound
asses GFR

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5
Q

What is the treatment plan for hypertension

A

TARGET BP
< 135/80mmHg
Over 80 years
<145/85mmHg

STAGE 1:
-CBB if over 55 or pregnant
or
-ACEI/ARB if under 55

STAGE 2:
-add thiazide diuretic with either CBB or ACEI

STAGE 3
- CBB+ACEI +Thiazide

STAGE 4:
- Further diuretic therapy

low K+ levels

  • low does spironolactone
  • further diuretic therapy

High K+ levels
-higher dose thiazide

PREGNANT 
Before:
- CBB: nifiedipine 
- beta blocker: atenelol
- Centrally acting agent: methydopa

During:

  • add thiazide diuretic
  • CBB: amlodipine
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6
Q

What is the symptoms of angina

A

pain or discomfort radiating from your retrosternal chest into your neck and jaw and down your left arm

Tight band pressure and heaviness on the chest

Stable - aggravates with exercise
Unstable - happens are rest

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7
Q

What is the investigations for stable angina

A 
Bloods:
FBC
Lipid profile 
Electrolytes
Liver/thyroid test

CXR

ECG
QRS- LVH
ST segment depression
Evidence of myocardial ischaemia

Exercise tolerance test/ETT

Myocardial perfusion imaging

Computed tomography (CT) coronary angiography

Cardiac catheterisation/coronary angiography

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8
Q

What is the medical treatment for stable angina

A

FIRST LINE TREATMENT:

Short acting nitrates - GTN
Beta blockers - bisoprolol/atenolol

SECOND LINE TREATMENT:

IK channel blockers (Ranolazin/Ivabradine)

Long-acting nitrates

K channel blockers (Nicorandil)

Fatty acid oxidation inhibitor -Trimetazidine

Angioplasty:
PCI- stenting or CABG

General measures to stop disease progression:
Statins
ACE inhibitors
Aspirin (or clopidogrel if allergic)

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9
Q

What is acute coronary syndrome

A

Spontaneous plaque rupture & local thrombosis, with
degrees of occlusion resulting in unstable angina, NSTEMI, STEMI, and sudden cardiac death

Potentially leading to myocardial necrosis

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10
Q

What is the risk factors of stable angina and ACS

A

Smoking

Lifestyle- exercise & diet

Diabetes mellitus

Hypertension

Hyperlipidaemia

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11
Q

What is the investigations for ACS

A

ECG

  • ST elevation or depression?
  • is Irregular/ Ventricular fibrillation /multiple wavelets?

ECHO

  • Overall contractility
  • MR
  • abnormality
  • LV ejection: LV dysfunction

Troponin test

Blood test

CXR

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12
Q

What is the medical treatment for ACS

A 
IMMEDIATE 
Morphine (or diamorphine) 
Oxygen 
Nitroglycerine (GTN spray or tablet) 
Aspirin 300 mg orally (crush/chew) 
Fibrinolysis /thrombrolysis 
Primary PCI
Defibrillation

LATER TREATMENT
Dual anti-platelet therapy Aspirin + ADP receptor (clopidogrel) for one year following ACS event

SECONDARY PREVENTION: REDUCE RISK 
ADP receptor blocker: clopidogrel
antithromboytic therapy: Heparin + Fondaprinux
Intravenous nitrate 
Statin 
Beta blockers - no other contradictions 
ACE inhibitors - LV dysfunction present 
Coronary revascularisation treatment:  CABG or PCI
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13
Q

Define aneurysm

A

Weakened blood vessel wall, which is pushed outwards due to blood pressure causing excessive localised swelling in the wall of an artery

True: involving all 3 layers

False: thin adventitial layer or by the surrounding soft tissue

Dissecting: An aneurysm in which the inner wall of an artery rips longitudinally, the blood forces the wall apart creating two lumen passages

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14
Q

What is the aetiology of THORASIC AORTIC DISSECTING ANEURYSM

A

Hypertension

Atherosclerosis

Trauma

Smoking

Marfan’s syndrome

co-arctation

Bicuspid valve

Syphilis/mycotic infection

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15
Q

What is the signs and symptoms of an aortic aneurysm

A 
SOB 
Heart Failure: pulmonary oedema
Hypotension 
Pulsatile mass, tender 
Back pain

In the Ascending aorta
Dysphagia (difficult swallowing)
Hoarseness

Sharp chest pain radiating to back and between shoulder blades

Collapse
- due to rupture or dilation

ST elevation

soft early diastolic murmur - AR

Reduced or absent peripheral pulses
(BP mismatch between sides)

Hypotension/ hypertension

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16
Q

What is the treatment of aneurysm

A

TYPE A - ascending aorta : Surgery
Open
Endovascular

TYPE B descending aorta : BP control
(sodium nitroprusside plus beta blocker)

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17
Q

What is the investigations for aneurysm

A

Screening
Ultrasound
- easy, cant plan from

CT /MRA

  • detailed anatomy,
  • bad for contrast + radiation

ECHO

Test for fitness for surgery
Lung function
ECG
Bloods

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18
Q

What is the investigations for chronic/ acutelimb ischaemia

A

Exercise tolerance test
Ankel brachial pressur index
Bruegers test - thombosis

Ascultation of peripheral pulses

CT/MRA

  • First line
  • allows treatment planning

Duplex

Digital subtraction angiogram
- visualise blood vessels

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19
Q

What is the treatment of chronic/ acutelimb ischaemia

A

Anti-coagulation:
Antiplatelte therapy
Statin therapy

Analgesia

Embolectomy/ thromectomy
Thrombolysis

Angioplasty and stent

Surgical bypass
- new route for blood

Non-Salvageable
Amputation

Smoking cessation
Diabetic control
BP control
Exercise

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20
Q

What is the cause of chronic and acute limb ischaemia

A 
Chronic
 -Atheosclerotic, Vasculitis 
 Buergers disease - thrombosis 
(linked to smoking)
 Diabetes mellitus

Acute: thrombosis or embolus

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21
Q

What is the symptoms and staging of chronic limb ischemai

A 
Ulceration, Pallor 
Feet slow to regain colour - then dark red appears 
 (Decreases capillary refill time)
Hair loss
decreased peripheral pulses 
Diabetes

STAGE 1: Asymptomatic

STAGE 2: Mid claudication (cramping) pain in limb
{IIA- walking >200m}
{IIB - walking <200m}

STAGE 3: Rest pain, mostly in the feet

STAGE 4: Necrosis, gangrene of the limb

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22
Q

What is the symptoms for acute limb ischaemia

A 
Pain 
Pallor 
Perishingly cold 
Paraesthesia 
Paralysis 
Pulseless 
(compared in both legs)
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23
Q

Definition of varicose veins and aetiology

A

Dilated swollen superficial veins in the lower limbs

if the valves become weaked or damaged then blood can back up and pool in the veins; causing them to swell

long saphenous; 80-87%
short sapnhenous; 21-30%

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24
Q

Risk factors of varicose veins

A

Standing occupation

Pregnancy - twins

previous DVT

Previous major trauma

Family history - can be hereditary

Female

Lack of exercise

Obesity

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25
Q

Symptoms and signs of varicose veins

A 
localised / generalised discomfort in the leg
nocturnal cramps
swelling
acute haemorrhage
pruritis (itching)

Superficial thrombophlebitis (inflammation of the wall of a vein associated with thrombosis)

Skin changes:
spider
discolouration

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26
Q

What is the investigations and treatment for vaircose veins

A

Duplex ultrasound

MANAGMENT
exercising, losing weight
elevation, loose clothing
compression hosiery (stockings)

Superficial venous Surgery:

Minimally invasive procedures involving thermal ablation:
Endovenous Laser removal
Radio frequency ablation
Injection - sclerotherapy

Compression

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27
Q

What is the definition of chronic venous insufficiency

and the aeitiology

A

a condition where veins cannot pump enough blood back to the heart

Venous hypertension
Varicose veins 
Failure of muscle pumps 
 -Superficial /deep venous reflux
  Venous obstruction 
  Neuromuscular  
  Obesity 
   Inactivity
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28
Q

What is the signs and symptoms of chronic venous insufficiency

A

Ankle oedema
Telangectasia - spider veins
Venous eczema
Haemosiderin pigmentation - orangey colour in the lower limbs
Hypopigmentation “atrophie blanche” - white patches
Lipodermatosclerosis - inflammation of subcutaneous fat in the legs
Venous ulceration

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29
Q

What is the investigations and management of chronic venous insufficency

A

Ambulatory venous pressure:
Fall in pressure from standing motionless to active movements
ABPI (Ankle Brachial Pressure Index)
Duplex ultrasound

compression therapy;
systemic / topical therapy; most ulcers colonised rather than infected
exercise; calf muscle pump

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30
Q

What is Deep vein thrombosis and its aetiology

A

Venous thromboembolism
in the legs

Venous thrombus due to disruption of virchos triad
- more due to stasis + hypercoagubility

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31
Q

What is the risk factors to DVT

A

Increasing age

  • Tissue trauma
  • Immobility
  • Obesity
  • Smoking
  • Some systemic diseases e.g. cancer - Inheritance

Heritable thrombophilia – an inherited predisposition to venous thrombosis -

Pregnancy

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32
Q

What is the sign and symptoms of DVT

A 
Unilateral limb swelling
Persisting discomfort
Calf tenderness
Warmth
Redness- erythema
Pigmentation 
pittin oedema 
May be clinically silent - asymptomatic

If not treated
Ulceration

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33
Q

What is the investigation and management of DVT

A

Use Wells score in clinical assessment for pre test probability
Blood test: D dimer
Ultrasound

Anticoagulation:
Warfarin
Heparin

Thrombolysis

34
Q

What Mitral stenosis and its aetiology

A

Narrowing of mitral valve to less than 2cm
(from 4-6cm)

Rheumatic Heart disease
(strep. infections) 
Congenital MS
Infective endocarditis 
systemic lupus erythematous (autoimmune disease affecting tissue)
35
Q

What is the symptoms and signs of mitral stenosis

A 
Dyspnoea 
Heamoptisis 
Chest pain 
Hoarsness - due to compression of laryngeal nerve 
Palpitations (due to AF)
Tachycardia 
Mitral facies
(discolouration of nose and cheeks)
JVP - prominent a wave 
Diastolic thrill 
tapping apex beat 
RV heave
(Normal pulse due to normal systole) 
Diastolic murmur - s3
36
Q

What is mitral regurgitation and the aetiology

A

Valves become incompetent and leaky either chronic or acute

Rheumatic Heart Disease 
Mitral valve prolapse - acute 
Infective endocarditis
Degenerative
Previous MI causing
LV dilation / annulus dilation
37
Q

What is the signs and symptoms of MR

A

Acute - dysnopea / pulmonary oedema
Chronic - fatigue

Palpitations - Afib

RV heave

Brisk and hyperdynamic apex beat

Signs of right heart failure:

  • prominent JVP
  • reduced pulse rate

Loud systolic murmor between s1-s2 radiates to mid axillary

38
Q

What is aortic stenosis and what is the aetiology

A

Narrowing of the aorta to less than 1.5-2cm
(from 3-4cm)

Degenerative
(athlersclerosis)
Rheumatic heart disease
Bicuspid stenosis

39
Q

What is the signs and symptoms of aortic stenosis

A

Usualy asymptomatic

Chest pain
On exertion: Syncope + dizzines
Breathlessness

Pulse - small volume and slow rising
RH failure present:
JVP prominent
Low BP

Vigorous and sustained apex beat
RV heave
Systolic murmur - radiates to carotid
S1 = less audible S2 = Harsh ejection sound

40
Q

What is aortic regurgitation and what is the aetiology

A

Dysfunctional leaflets aortic leaflet or Dilation of aorta

Bicuspid aortic vale
 Rheumatic heart disease 
Infective endocarditis
 Connective tissue disorder:  marfans 
Hypertension
41
Q

What is the signs and symptoms of aortic regurgitation

A

Asymptomatic: Exertional Dyspnoea

Pulse

  • large volume
  • retracting/ collapsing
  • wide pulse pressure e.g 170/40mmHg

Hyper-dynamic and displaced apex beat (due to overloaded heart)

Diastoli murmur heard on expiration

42
Q

What is the investigations for valvular diseases

A

ECG:
Bigger P or R wave?
ST elevation?

CXR
-cardiomegaly, calcification

ECHO

  • AV cusp anatomy
  • LV function/dilation/hypertrophy
  • annular disease
  • shows the backflow of blood
  • Pressure gradient

MRI

  • valves open or shut
  • pressure gradient

Cardiac catherisation

  • LV angiography
  • pressure gradient
43
Q

What is the treatment for valvular diseases

A

Afib present - anticoagulation

Improve ventricle contractility/reduce BP:
Diuretics
Vasodilators - prolong till surgery

Valve replacement or repair
Mechanical/prosthetic - need warfarin
Biologival/ native - will wear out

44
Q

Define endocarditis

A

Infection of the inner layer of the hearts

  • endocardium
  • Heart valves (native/prosthetic)
  • Inter-ventricular septum,
  • Chordae tendinae,
  • Intra cardiac devices

Invasive procedures: prothetics, cardiac surgery
brushing teeth

45
Q

What is the risk factors for endocarditis

A 
CARDIAC 
Native/ prosthetic valve disease 
Congenital heart disease 
Rheumatic heart disease 
Cardiac surgery 
Prior native IE 
Cardiac hypertrophy 
NON CARDIAC 
IVDA
immunocompromised eg elderly/AIDS
diabetes mellitus 
trauma (burns) 
indwelling medial devises 
health care association
46
Q

What is the microbiology of endocarditis

A
  • staph.aureas
  • strep viridans
Pseudomonase
aerguginosa
HACEK organisms 
Fungi
Enterocci
47
Q

What is the signs and symptoms

A

Weight loss
Headache

F- fever 
R - roth spots 
O  - oslers nodes
m - murmur 
J - jane way lesions 
a - anemia 
n- Nail haemorrhage 
e - embolism
48
Q

What is the tests for endocarditis

A

Blood tests
FBC
C -reactive protein (CPR)
erythrocyte sedimentation rate (ESR)

Blood cultures 
(if negative can be due to intracellular bacteria/previous antibiotics/fastidious organisms)

urea + electrolytes
-asses kidney function

ECG
- shows conducting delay

CXR
- Heart failure

ECHO
1st line = TTE
2nd line = TOE
- High clinical suspicion + TTE normal
- See complications + asses/measure vegetation
-prosthetic/ intra-cardiac device present

Intracellular bacteria
Serological
PCR
Cell culture

49
Q

What is the treatment for endocarditis

A

prolonged antibiotic therapy + removal of prosthetic material

Native - Gentamicin + IV amoxycillin
vancomycin (sepsis or allergic)

Prosthetic - Gentamicin + IV vancomycin + rifampicin

Good oral dental care

50
Q

What is the definition of heart failure

A

A clinical syndrome compromising of dysnopea, fatigue, or fluid retention due to cardiac dysfunction either at rest or on exertion with accompanying neurohormonal activation RAAS + Sympathetic

Caused by LV dysfunction or injury

51
Q

What is the signs and symptoms

A

Breathlessness
Fatigue -reduced exercise capacity

tachycardia 
raised JVP 
hepatomegaly 
(microscopically see nutmeg appearance)
Oedema 
- pitting 
-chest creptiations or effusions 
Displaced or abnormal apex beat
Obstructive sleep orthnopea?

Auscultation
Third systolic heart sound S3

52
Q

What is the two forms of heart failure

A

Systolic HF - decreased pumping function of the heart

  • Reduced CO
  • activates increased in Central venous pressure due to RAAS
  • increase in pressure result in further dilation

Diastolic HF - thickening and stiff heart muscle

  • same CO due to greater EDV
  • smaller ejection fraction
53
Q

What is the investigations for Heart failure

A

Investigate underlying cause

ECHO

  • LV systolic function/thickness/LV ejection fraction (severe = <30%)
  • Diastolic function
  • pericardial effusion
  • valvular disease
  • pressure pulmonary/aortic valve

MRI

CXR

MUGA (IV-radionucleide)

  • pumping ability of ventricles
  • LVEF

Screening tests
ECG
(normal = no LV systolic disfunction)

BNP (elevated in HF)

54
Q

What is the treatment for heart failure

A

Loop Diuretics

Diuretic

ACE inhibitors

ARB

Beta blockers

aldosterone antagonists

Positive ionotropes - digoxin

Warfarin

ANP/BNP enhancements

55
Q

Define marfan syndrome

A

Autosomal dominant Multisystem Connective tissue disease due Mutation of Fibriliin 1 gene on chromosome 15q21 mutation

56
Q

What is the presentation of marfans

A 
skeletal
 tall stature
 arm width longer than height 
pectus carinatum 
 dural ectasia 
scoliosis / kyphosis 
thumb ankle foot wrist issues reduced ankle extension arachnodactyly (long digits)

chest
pneumothorax
protrusio acetabuli - abnormal hip bone
pectus carinatum - pigeon chest

abnormal facies

eye
lens subluxation
(aka ectopia lentis)

57
Q

How do you diagnose Marfans

A

Ghent 2010 criteria
2+ findings of:

Cardiovascular - aortic dilation/dissection/ MV prolapse 
Eyes – ectopia lentis
Family history
Fibrillin 1 mutation
Systemic score ≥ 7
 - Skeletal 
 - Respiratory 
 - Myopia 
 - dural ectasia 
 - Mitral valve prolapse 
 - Skin
58
Q

What is the investigations for Marfans

A

Echocardiography - MANDATORY
-AORTIC ROOT DIAMETER

MRI of lumbar spine
- dural ectasia

Pelvic xray - protrusio acetabuli

Chest x ray - look for blebs

Genetic testing - Fibrillin 1 mutation
- when only a few features are present

FAMILTY TESTING - ECHO + BLOOD SAMPLE FOR FIBRLIN GENE MUTATION

59
Q

What is the treatment for Marfans syndrome

A

ANTIHYPERTENSIVES
B blockers

Angiotenin 11 Receptor blockers

Prophyllactic aortic root surgery
(if sinus valsalva exceeds 5.5cm growth)

(warfarin needed if mechanical valve inserted)

60
Q

Down syndrome

A

atrio-ventricular septal defect

Hypotonic

61
Q

Turners syndrome 45X

-single nucleotide

A

Co- arctation of the aorta

Short stature
neck webbing
Puffy hands
gonadal dysgenesis

62
Q

Noonan syndrome PTPN11

- single nucleotide

A

Pulmonary stenosis

Short stature
Neck webbing
Cryptochordism
Characteristic face

63
Q

22q11 deletion syndrome

-Microdeletion

A 
C - cardiac malformation of Outflow tract
A - abnormal facies 
T - thymic hypoplase 
C - cleft palate 
H - hypoparathyrodism 
22
64
Q

Williams syndrome

- microdeltion of elastin on chromosome 7

A

Aortic stenosis

Hypercalceimia
cocktail party manner
characteristic face
5th finger clinodactyly

65
Q

Tetarogens

A

Fetal alcohol syndrome
anti epileptic drugs
rubella - affects back and lower limbs
maternal diabetes mellitus

AtrioVentricular septal defect

Characteristic face
ADHD
hearing loss
Motor difficulties

66
Q

What is dilated cardiomyopathy

A

Can be one but more often all chambers dilated and functionally impaired SYSTOLIC DISFUNCTION ejection problem resulting in heart failure

67
Q

What is the aetiology of dilated cardiomyopathy

A

Ischaemia

Valvular disease

Endocrine/thyroid problems

Genetics and familial DCM
muscular dystrophy

Inflammatory/infectious

toxic exposure 
(alcohol, drugs, endocrine)

Post child birth

tropical disease

Injury, cell loss, scar replacement (sarcoid)

68
Q

What is the signs and symptoms of dilated cardiomyopathy

A 
dyspnoea
fatigue
orthopnoea,
 PND, 
ankle swelling, 
weight gain of fluid overload, 
cough
Poor superficial perfusion
pulse - irreg if in AF,
SOB at rest,
narrow pulse pressure,
JVP elevated+/- TR waves,
displaced apex,
S3 and S4,
MR murmur often,
pulmonary oedema,
pleural effusions,
ankle oedema/ sacral oedema,
acites, (the accumulation of fluid in the peritoneal cavity)
hepatomegally (liver enlargement)
69
Q

What is the investigations for cariomyopathies

A

Mandatory:
Repeated ECG noting left bundle branch block if present

Cardiovascular magnetic resonance imaging MRI

ECHO

Further:
CXR

N termial pro Brain Natriuetic Peptide
- secreted due to excessive stretching

Basic bloods Full; Blood Count, urea and electrolytes

Coronary angiogram

For restrictive cariomyopathy specifically:
Biopsy (amyloid non cardiac)
antibodies testing
(for sclerotic CT diseases)
Test for Fabry
(low plasma alpha galactosidase A activity)

70
Q

What is the management for cardiomyopathies

A 
Avoid heavy exercise
Avoid dehydration
Explore FH and first degree relatives,
ECGs and echoes may be required
Consider genetic testing

avoid NSAID

71
Q

What is the management and treatment for dilated cardiomyopathy

A

Correct any endocrine disturbance
advice on fluid and salt intake
advise on managing wight to identify fluid overload
Correct anemia

Lower BP:
ACEI
Angiotensin II blockers,
diuretics

Lower HR:
Beta blockers

Spironolactone - steroid drug promotes sodium excretion

Anticoagulants as required

Cardiac transplant

72
Q

What is restrictive cardiomyopathy and what is its aeitiology

A

Ventricle walls are rigid, and the heart is restricted from stretching and filling with blood properly.
there is a reduced compliance DIATOLIC DISFUNCITON
ACTIVE PROCESS due to relaxation of ventricle wall

Clinical disorders;
Scleroderma - hardening and contraction of skin
Diabetic
Sarcoid/amyloid

Endomyocardial;
Fibrosis 
Radiation 
Drug effects 
Carcinoid - tumour in glands

Diseases;
Haemochromatosis
Fabry

73
Q

What is hypertrophic cardiomyopathy and what is its aetiology

A

a disease in which a portion of the myocardium (heart muscle) is hypertrophic (enlarged) without any obvious cause = Impaired relaxation

Inherited Autosomal dominant sarcomere gene defect
- Changes the genes in the heart muscle protein
Thyroid problems
Diabetes

74
Q

What is the symptoms and signs of hypertrophic cardiomyopathy

A 
Asymptomatic for many, 
fatigue, 
dyspnoea, 
anginal like chest pain, 
exertional pre syncope, 
syncope related to arrhythmias or LV

Notched pulse pattern
Irreg pulse if in AF or ectopy
Double impulse over apex, thrills and murmurs, often dynamic
LVOT murmur will increase with valsalve and decrease with squatting
JVP can be raised in very restrictive filling

75
Q

What is the treatment for hypertrophic cardiomyopathy

A

enhance relaxation:,
beta blockers,
CBB -verapamil,
Anti arrhythmic - disopyrimide

AF - anticoagulate

Obstructive - surgical / alcohol septal ablation

High risk - implantable cardioverter defibrillator

76
Q

Define myocarditis and whats it aetiology

A

Acute or chronic inflammation of the myocardium reducing function and resulting in heart failure

Virus 
bacterial 
 HIV
lymes disease
drugs 
Toxic exposure
77
Q

What is the signs and symptoms of myocarditis

A 
Heart failure 
fatigue 
SOB 
Potential fever
arrhythmias
78
Q

What is the investigations for myocarditis

A 
ECHO
MRI
Viral DNA PCR
Biopsy
Test for autoantibodies, strep antibodies, HIV, lymes disease
Troponin testing
79
Q

Define Pericarditis and its aetiology

A

Inflammation of the pericardial layers with or without myocardial involvement that can result in pericardial effusion causing cardiac tamponade

diopathic 
viral 
bacterial, 
post MI, 
perforation, 
dissection of proximal aorta, 
neoplasia
80
Q

What is the sign and symptoms of pericarditis

A

chest pain with pleuritic features
lying back makes it worse - Orthnopea
Fever
If effusion present: fatigue, SOB, chest pain, low BP/dizzyHigh fever (with no effusion = bacterial)

pericardial rub LSE,
Raised JVP - Effusion present
low BP,
muffled Heart Sounds

81
Q

Signs and treatment to Long QT syndrome

A

Syncope
seizure
sudden death
arrhythmias precipitated by emotion, exercise and drugs

Beta blockers
Nicrorandil
NA channel openers-
Lidocaine

Systems revision (3 decks)

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