OTHERS Flashcards
What is brugada syndrome?
a form of inherited cardiovascular disease with may present with sudden cardiac death
It’s rare
It affects the heart’s electrical systemic leading to abnormal heart rhythms and an icnreased risk of sudden cardiac arrest
What is Brugada sign on ECG?
incomplete/partial right bundle-branch block and convex ST elevations in the anterior precordial leads
How is brugada syndrome inherited?
In an autosomal dominant fashion
Who is Brugada syndrome more common in?
Asians
Whats the pathophysiology of Brugada syndrome?
20-40% of cases are caused by a mutation in the SCN5A gene which encodes the myocardial Na+ channel protein
What are symptoms of Brugada syndrome?
Palpitations
Syncope
Sudden cardiac arrest
Whats the investigation of choice for suspected Brugada syndrome?
Administration of flecainide or ajmaline as these make the ECG changes more apparent
How is Brugada syndrome managed?
With an implantable Cardioverter-defibrillator
What is Buerger’s disease?
Aka thomboangiitis obliterans
a small and medium vessel vasculitis
Characterised by inflammation and clotting which can ultimately lead to obstruction of blood flow and tissue damage
What is Buerger’s disease strongly associated with?
Smoking
What are the features of Buerger’s disease?
extremity ischaemia - intermittent claudication and ischaemic ulcers
superficial thrombophlebitis
Raynaud’s phenomenon
What are the specific rules for driving with hypertension?
can drive unless treatment causes unacceptable side effects, no need to notify DVLA
You must stop driving if you have malignant hypertension and you can drive again when Dr says its well controlled and BP is consistently <180/110mmHg
Bus, coach or lorry - you must tell DVLA if you have hypertension
What are the rules of driving after an elective angioplasty?
1 week off
What are the rules of driving following a CABG?
4 weeks off
What are the rules of driving after acute coronary syndrome?
4 weeks off (1 week if successfully managed with angioplasty)
If you have angina what are the rules with driving?
You can drive unless you get symptoms at rest
What are the rules of driving after having an ICD in?
if implanted for sustained ventricular arrhythmia: cease driving for 6 months
if implanted prophylactically then cease driving for 1 month. Having an ICD results in a permanent bar for Group 2 drivers
What are the DVLA rules for an aortic aneurysm of >/=6cm
Notify DVLA
Licensing will be permitted subject to annual review
An aortic diameter of =/>6.5cm disqualifies you from driving
What are the rules of driving following a heart transplant?
Do not drive for 6 weeks
No need to notify DVLA
What is Wellen’s syndrome?
An ECG pattern that is typically caused by high-grade stenosis in the LAD coronary artery
ECG features includ biphasic or deep T wave inversion in V2-3, minimal ST elevation and no Q waves
What is mild hypothermia?
32-35°C
What is moderate or severe hypothermia?
<32 degrees
What are signs of hypothermia?
shivering
cold and pale skin
slurred speech
tachypnoea, tachycardia and hypertension (mild)
respiratory depression, bradycardia and hypothermia (if moderate)
confusion/ impaired mental state
What ECG changes may you see in hypothermia?
Acute ST elevation
J waves
