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Flashcards in Cardiology Deck (19)
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1

What is an AV nodal re-entry tachycardia?

Supraventricular tachycardia with re-entry is confined to to AV node
ECG= regular, narrow complex with abrupt onset and termination
May occur in healthy, young individuals
associated with= MI, Rheumatoid Heart, pericarditis. Mitral prolapse.
Tx= vagal manoeuvres and adenosine

2

What is AV re-entry tachycardias?

Supraventricular tachycardia where re-entry consists of the AV node and a accessory pathway
accessory pathway may be evident during sinus rhythm

3

What are the signs of Right sided HF?

Congestion fo peripheral tissues:
oedema and ascities
GI tract congestion-

4

What are the signs of Right sided HF?

Congestion fo peripheral tissues:
oedema and ascities
GI tract congestion- anorexia, GI distress and weightloss
Liver congestions (Nutmeg liver)

5

What are the signs of Left sided HF?

Reduced CO= activity intolerance and cyanosis
Pulmonary Congestion= Cynaosis, Paroxysmal Noctornal Dyspnoea, Orthopnea, cough, crackes and wheeze.

6

What is hypertrophic cardiomegaly?

thickened cardiac muscle
as HF progresses the disordered myocardium cannot cope

7

What is hypertrophic obstructive cardiomegaly?

Thickened LV, especially in the intraventricular septum and therefroe obstructs aortic valve
can partially correct surgically with a septal myoectomy.

8

What is arrhythmogenic right ventricular cardiomyopathy?

fatty replacement of cardiac muscle in RV
lose ability to contract
develop very sudden HF
non uncommon cause of sudden death in the young

9

What is dilated cardiomyopathy?

markedly dilated heart chamber
becomes too thin to pump.

10

When could you expect to hear S4 heart sound?

what causes it?

maybe heard in aortic stenosis, HOCM and hypertension
in HOCM a double apical impulse may be felt as a result of a palpable S4.

atrial contraction against a stiff ventricle

11

when could you expect to hear S3?

what causes it?

Normal if under 30 years old
left ventricular failure (eg dialated cardiomyopathy)
constrictive pericarditis (pericardial knock) and mitral regurgitation.

diastolic filling of the ventricles.

12

What is a cause of a continuous murmur heard inferior to the left clavicle?

PDA
washing machine like

13

What is a mid-late diastolic murmur?
where would you hear it?
what does it sound like?

Mitral Stenosis: Apex, low, rumbling, opening snap, louder when pt lying on left side.

Austin-Flint murmur- 2nf LICS severe aortic regurgitation, rumbling.

14

What is the cause of a early diastolic murmur?
where would you hear it?
what does it sound like?
clinical signs?

Aortic regurgitation- 3rd LICS, high pitch, blowing, bounding pulse, wide pulse pressure. Louder on sitting the patient forward.

pulmonary regurgitation- 2nd LICS
high pitch blowing
pulmonary hypertension

15

what is the cause of a late systolic murmur?
where would you hear it?
what does it sound like?

mitral valve prolapse:
apex, crescendo murmur that follows a click.

coarctation of the aorta
harsh murmur intraclavicular/left scapula.

16

What are the cause of a Pan Systolic Murmur?
where would you hear it?
what does it sound like?

Mitral Regurge:Apex, radiated to axilla (high pitch and blowing)

Tricuspid Regurge: Right CM radiated RSB

VSD: LCM harsh murmur doesn't radiate to the axilla.

17

What are the causes of an ejection systolic murmur?

Aortic Stenosis- mid systolic, RSB, 2nd ICS, radiates carotids and apex. Crescendo-decrescendo.

Pulmonary Stenosis LSB, 2nd ICS, radiated to the back.

ASD, Fallots: gets louder at LSB, radiates to the back and splits S2

Hypertrophic cardiomegaly: LSB, harsh increases with reduced venous return.

18

What are the Right to left cardiac shunts?

5 T's:
Trancus arteriosus
Transposition of great vessels
Tricuspid Atresia
Tetralogy of Fallot
Total anomalous pulmonary venous return

19

What are the left to right cardiac shunts?

ASD
VSD
PDA