Flashcards in Clinical very good :) :) Deck (34):
Harsh pan-systolic murmur, loudest at the lower left sternal edge and inaudible at the apex. The apex is not displaced. It does not intensify on inspiration
Ventricular septal defect
Soft late systolic murmur at the apex, radiating to the axilla
Mitral valve prolapse
(late systolic murmurs resemble mitral incompetence)
There may also be a systolic click
Possible reason for systolic click?
Slow-rising pulse and heaving apex (apex not displaced)
Ejection systolic murmur best hears at the right second interspace that does not radiate
The pulse is regular and jerky in character. The cardiac impulse is hyperdynamic and not displaced.
There is a mid-systolic murmur with no ejection click, loudest at the left sternal edge
Constant "machinery-like" murmur throughout systole and diastole
Patent ductus arteriosus
Tented T waves on ECG?
(hyperkaelemia impairs cardiac conduction)
You can investigate arrhythmias with an electrophysiological study, what is this?
This is when you induce a clinical arrhythmia to study mechanism and map pathway
-Also gives the opportunity to treat the arrhythmia by radiofrequency ablation
Why would you carry out an exercise ECG?
To assess for ischemia
Exercise induced arrhythmia
How would you check for paroxysmal arrhythmia?
To assess for paroxysmal arrhythmia
Side effects of statins?
Myalgias, myositis and deranged liver function tests
Side effects of amiodarone?
Blue-grey photosensitivity rash
Side effects of GTN?
Headaches and hypotension
Loud S1 with opening snap
Rumbling low pitched diastolic murmur
A 72 year old woman with an acute ischaemic stroke has ST elevation on her electrocardiogram. There is a past medical history of MI
Left ventricular aneurysm
Retinal haemorrhages that are usually caused by an immune complex vasculitis and are most commonly seen in bacterial endocarditis
ECG yellow electrode
Which ECG electrode should be put on bony prominence on left side of abdomen or left leg?
Which ECG electrode should be placed on bony prominence on the right arm/shoulder?
Risks of RIPE aneurysm
Infection (of thrombus)
Pressure effects on neighbouring structures
Emboli of thrombi to lower limb
Raised J waves
Congenital rubella syndrome is associated with
Atrial septal defect
Marfan syndrome is associated with
Aortic root dilaration (causing aortic regurgitation)
Mitral valve proplapse
Turner syndrome is associated with
Coarction of the aorta
When and how does Tetralogy of Fallot usually present?
Prevents with cyanotic episodes usually at 1-2 months
Why should you not use rate-limiting Ca channel blockers and beta blockers together?
May cause severe AV block and hypotension
Opens into the left posterior aortic sinus
Left coronary artery
Opens into the right atrium
Commonly associated with the atrioventricular groove
Right coronary artery
Supplies the AV node
Posterior interventricular artery
Supplies the apex of the heart
Anterior interventricular artery