CV

Question 1

How do TAAs present?

Answer 1

• dilation of thoracic aorta = asymptomatic
• chest or back pain
• trachea/L bronchus compression > cough, shortness of breath, stridor
• same nerve compressions as pericardial effusion

Question 2

How do ruptured aortic aneurysms present?

Answer 2

• severe chest/back pain (TAA)
• abdo pain radiating to back/groin (AAA)
• shock (hypotension, tachy)
• collapse

Question 3

What is the aetiology of AAAs?

Answer 3

• coarctation of the aorta
• Marfan’s syndrome
• aortic surgery
• 3rd trimester pregnancy

Question 4

How are ruptured aortic aneurysms treated?

Answer 4

• permissive hypotension to decrease blood loss
• immediate vascular review and emergency surgery

Question 5

How does a DVT present?

Answer 5

• unilateral calf pain and tenderness along deep vein line
• swelling >3cm
• erythema
• pitting oedema
• superficial veins distended

Question 6

What are risk factors for DVT?

Answer 6

• immobility
• recent surgery
• long haul travel
• pregnancy
• oestrogen (HRT and cocp)

Question 7

What is syncope?

Answer 7

• transient loss of consciousness
• due to global cerebral hypoperfusion
• rapid onset, short duration, spontaneous complete recovery

Question 8

What are the causes of reflex syncope?

Answer 8

• vasovagal: triggered by emotion, pain, stress (fainting
• situational
• carotid sinus syncope

Question 9

What are the causes of orthostatic syncope?

Answer 9

• primary autonomic failure: Parkinson’s
• 2º autonomic failure: diabetic nephropathy
• drug-induced: diuretics, vasodilators
• volume depletion: haemorrhage, diarrhoea

Question 10

What are the causes of cardiac syncope?

Answer 10

• arrhythmia
• structural
• PE

Question 11

How is syncope investigated?

Answer 11

• CV exam
• postural BP readings
• ECG

Question 12

What BP drop is significant for postural hypotension?

Answer 12

• lying to standing
• fall in systolic >20 or diastolic >10
• systolic falls below 90mmHg after standing

Question 13

What are the 3 acute coronary syndromes?

Answer 13

• STEMI
• NSTEMI
• Unstable angina: prolonged, severe angina, usually at rest possibly with ECG changes

Question 14

How does ACS develop?

Answer 14

• build up of fatty plaques in artery walls
• gradual narrowing > less blood and less oxygen reach heart leading to angina
• plaque rupture leading to occlusion

Question 15

What are non modifiable risk factors for ACS?

Answer 15

• age
• male
• FHx

Question 16

What are modifiable risk factors for ACS?

Answer 16

• smoking
• diabetes
• hypertension
• hypercholesterolaemia
• obesity