Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
143 Cards in this Set
- Front
- Back
- 3rd side (hint)
|
Criteria for Brugada Syndrome? |
ECG + 1 or > of 6 : Documented (VF) or polymorphic ventricular tachycardia (VT) FH of sudden cardiac death at <45 y Coved-type ECGs in family members Inducibility of VT with programmed electrical stimulation Syncope Nocturnal agonal respiration |
|
|
|
Most Common Arrythmia Post MI? |
Ventricular Ectopics |
|
|
|
Drugs CI in Cardio? HF: |
AF+IHD,WPW: Flecainide Junctional Tachy: Flecainide AF+ WPW: Digoxin or Verapamil Aortic Dissection: CCB HF: Verapamil and diltiazem |
|
|
|
+ve or -ve qrs concordance? |
كل الفيات ال ار كلهة فوووك او كلهة جوة |
|
|
|
HT a/w which type of HF? |
Diastolic Dysfunction: EF>50% |
|
|
|
Hyer or HypoTHYROID IN DCM? |
Hyper Hypo cause Pericardial Effusion |
التكيكارديا تنيج اخت الهارت فبعدين يهور ويصير ديالاتيد |
|
|
ECG Changes in Pericarditis? 4 stages? |
PR Depression with AVR Elevation ST Elevation in All Leads+ AVR Depress
|
stage I: ST elevation in all leads. PR depression (depression between the end of the P-wave and the beginning of the QRS- complex) stage II: pseudonormalisation (transition) stage III: inverted T-wavess tage IV: normalisation |
|
|
Mx of Acute Pericarditis? |
اللي راح تعبر Anticogulaed if Recurrent: Steroids |
if Infected, Malignancy , Not resolved in 3 months: Surgery Avoid RCU |
|
|
Most Forgotten cause for P.Eff? |
Hypothyroidism |
|
|
|
Mx of Temponade? |
Pericardiocentesis |
CI: in Malignancy, Dissection Go for Surgery |
|
|
Indications of Pericardiectomy in Pericarditis? |
Constrictive pericarditis,
Effusive C pericarditis, or
Recurrent pericarditis + multiple attacks, steroid dependence, and/or intolerance to other medical management. |
|
|
|
Poor Prognosis in HOCM? |
∙ syncope ∙ FH of sudden death ∙ young age ∙ non-sustained VT on 24 or 48-hour Holter monitoring ∙ Abnormal BP changes on exercise
∙ increased septal wall thickness |
|
|
|
CHA2DS2-VASc ? |
C Congestive heart failure 1 H Hypertension (or treated hypertension) 1 A2 Age >= 75 years 2 D Diabetes 1 S2 Prior Stroke or TIA 2 V Vascular disease (including ischaemic heart disease and peripheral arterial disease) 1 A Age 65-74 years 1 S Sex (female) 1 |
Score Anticoagulation In NonV 0 No treatment is preferred to aspirin 1 Oral anticoagulants preferred to aspirin; dabigatran is an alternative 2 or more Oral anticoagulants; dabigatran is an alternative |
|
|
Agents with proven efficacy in the pharmacological cardioversion of atrial fibrillation∙ |
Amiodarone ∙ flecainide (if no structural heart disease) ∙ others (less commonly used in UK): quinidine, dofetilide, ibutilide, propafenone |
Less effective agents ∙ beta-blockers (including sotalol) ∙ calcium channel blockers ∙ digoxin ∙ disopyramide∙ procainamide |
|
|
5 WPW Associations (4 Structural 1systemic) and Mx? |
Associations of WPW ∙ HOCM ∙ mitral valve prolapse ∙ Ebstein's anomaly ∙ thyrotoxicosis ∙ secundum ASD
Management ∙ definitive : radiofrequency ablation of the accessory pathway
∙ medical therapy: sotalol**, amiodarone, flecainide*in the majority of cases, or in a question without qualification, |
بزمن ولاية الذيب : الاسد حكم ابشتاين وهو عندة غدة وترهل **sotalol should be avoided if there is coexistent atrial fibrillation as prolonging the refractory period at the AVnode may increase the rate of transmission through the accessory pathway, increasing the ventricular rate andpotentially deteriorating into ventricular fibrillation syndrome is caused by a congenital accessory conducting pathway between theatria and ventricles leading to a atrioventricular re-entry tachycardia (AVRT). As the accessory pathway does notslow conduction AF can degenerate rapidly to VF |
|
|
Two important updates on mx of Hypertension |
∙ calcium channel blockers are now considered superior to thiazides ∙ bendroflumethiazide is no longer the thiazide of choice |
|
|
|
AHA-ACC-CDC Advisory Bp Mx Recommendation? |
• BP goal of < 139/89 mmHg • Stage I HTN (SBP 140-159 or DBP 90-99 mmHg) • Lifestyle modifications • +/- Thiazide diuretic • Stage II HTN (SBP > 160 or DBP > 100 mmHg) • Thiazide + (ACE-I or ARB) or + Calcium channel blocker • Titrate doses if not at goal or add different drug class |
|
|
|
Bp Classification? |
Stage : Clinic BP >= 140/90 and subsequent ABPM >= 135/85 Stage 2: Clinic BP >= 160/100 and subsequent ABPM >= 150/95 Severe hypertension Clinic systolic BP >= 180 , or clinic diastolic BP >= 110 mmHg |
|
|
|
Direct renin inhibitors∙ e.g. Aliskiren (branded as Rasilez)? |
∙ by inhibiting renin blocks the conversion of angiotensinogen to angiotensin I∙ no trials have looked at mortality data yet. Trials have only investigated fall in blood pressure. Initial trials suggest aliskiren reduces blood pressure to a similar extent as angiotensin converting enzyme (ACE) inhibitors or angiotensin-II receptor antagonists∙ adverse effects were uncommon in trials although diarrhoea was occasionally seen∙ only current role would seem to be in patients who are intolerant of more established antihypertensive drugs |
|
|
|
Bp Targets? |
< 80 years 140/90 135/85 > 80 years 150/90 145/85 |
لا تدوخ نفسك : زيد عشرة علة ال systolic مال ال standard |
|
|
Agents used to maintain sinus rhythm in of atrial fibrillation? |
∙ sotalol ∙ amiodarone ∙ flecainide ∙ others (less commonly used in UK): disopyramide, dofetilide, procainamide, propafenone, quinidine |
|
|
|
Factors favouring rate control |
Older than 65 yearsHistory of ischaemic heart disease |
∙ beta-blockers ∙ calcium channel blockers ∙ digoxin (not considered first-line anymore as they are less effective at controlling the heart rate during exercise. However, they are the preferred choice if the patient has coexistent heart failure) |
|
|
Factors favouring Rhythm control? |
Younger than 65 years Symptomatic First presentation Lone AF or AF secondary to a corrected precipitant (e.g. Alcohol) Congestive heart failure |
|
|
|
Pericarditis Causes? |
∙ viral infections (Coxsackie )∙ tuberculosis ∙ uraemia (causes 'fibrinous' pericarditis) ∙ trauma ∙ post-myocardial infarction, Dressler's syndrome ∙ connective tissue disease ∙ hypothyroidism |
|
|
|
MI: Secondary Prevention? |
All patients: ∙ ACE inhibitor ∙ beta-blocker ∙ aspirin ∙ statin Clopidogre ∙ STEMI: patients treated with a combination of aspirin and clopidogrel: first 24 hours & for at least 4 weeks ∙NTEMI): clopidogrel 12 months if the 6 month mortality risk* is >1.5% |
Aldosterone antagonists∙ patients who have had an acute MI and who have symptoms and/or signs of heart failure and leftventricular systolic dysfunction, treatment with an aldosterone antagonist licensed for post-MI treatment(e.g. eplerenone) should be initiated within 3-14 days of the MI, preferably after ACE inhibitor therapy |
|
|
Mild OLD + HF? BB can be given? |
Yes, beha majal |
|
|
|
Bnp interptetation affected by? |
Obesity ↓ age, women CKD ↑ |
مرة جبيرة عدهة عجز كلة فاكيد يصعد واكيد راح تكون ضعيفة اذا سمينة يجوز يتعادل |
|
|
When to use High sensitive crp? |
Recassify Intermediate risk CAD |
|
|
|
Mx of AV مستحق + bicuspid ? |
ال root بدربك شيلة |
|
|
|
Donedarone on Kidney |
↓ Crcl but not GFR |
|
|
|
Whats eptifebatide MOA? |
GP 2B3A inhibitor |
|
|
|
Indications for GP IIb/IIIa inhibitor ? |
Major ongoing chest pain, dynamic electrocardiographic changes, elevated troponin on presentation, Minor heart failure, and diabetes mellitus. |
|
|
|
Specific Echo/CXR features in Constrictive pericarditis? |
LVH, Ventricular independence with Respiration (Increase Variations) Flow Velocity transMitral Annulus: > restrictive > 12, < 8 respectively. if in bw : nonDx(so but not Sens)
Hepatic venous flow reversal — reverses during expiration in constrictive pericarditis but reverses during inspiration in restrictive cardiomyopathy.
± Ventricular end-diastolic pressures — Right and left ventricular end-diastolic pressures (RVEDP and LVEDP) are equal or nearly equal in constrictive pericarditis, while LVEDP is usually higher than RVEDP in restrictive cardiomyopathy |
Calcification(by CT>> or Echo): Highly specific but not sensitive Absent pul. Congestion |
|
|
Causes of Kussmaul signs? |
Constrictive Preri. Restrictive MyopAthy
Others
RV Infarction in Inf MI Massive pulmonary embolism Partial obstruction of the vena cavae Right atrial and right ventricular tumors Occasionally tricuspid stenosis congestive heart failure Rarely
cardiac tamponade |
tamponade: x descent, absent y constrictive pericarditis: (prominent x and y descent), |
|
|
Rx of chronic cP? |
NYHA 2-3: |
|
|
|
Drugs css cP |
Hydralazine, Procainamide, Doxuribicin |
واحد منهم يوخر المي يبقي بس ال Ca |
|
|
Single drug cause rCMP |
Anthracyclin |
Other idiopathic, infiltrative, Non infiltrative, Fabry, Radiation |
|
|
Pulsus Paradoxus css ? |
|
Have high Negative Predictive value not specificity |
|
|
Af + IHD or structural? MX? |
Amiodarone |
|
|
|
Indication of operative PS mx? |
Annulus Moderate to sever MR Supra/suv valvular PS |
|
|
|
Maze precedure? |
AF mx in PostTOF repair mx |
|
|
|
Preffered CCB IN UA CI BB? |
Diltiazem |
Amlodipine for Associated HT |
|
|
End stage HF + Hypot? |
Ass for Transplant |
|
|
|
Radiation Hx + Murmur? |
AR UPOW |
|
|
|
INR Decrements (Inducers)? RifampIn-ducer INR Increments (Inhibitors)? Iso- Inhibitor |
Rifampin Aprepitant Barbiturates Carbamazepin Cholestyramine Griseofulvin Mercaptopurine Mesalamine Methimazole Nafcillin Rifabutin |
Isoniazid Alcohol Amiodarone Cimetidine Ciprofloxacin Citalopram Clofibrate Diltiazem Erythromycin Fenofibrat Fluconazole, Miconazole, Voriconazole, Metronidazole NSAIDs/COX-2 inhibitors, Omeprazole Quinidines Sulfinpyrazone Tamoxifen TMP-SMZ
Riampicin بين ال ديوس رجلهة ايزو منعهة
|
|
|
3 days post MI, Fever + SOB+ elevated Cardiac enzymes? |
Myopericarditis UPOW |
Akin to MI No JVP distention |
|
|
Features of IE + PR prolongation? |
Aortic Root Abcess |
|
|
|
Restrictive CMP most imp Echo finding? |
Diastolic dysfunction with preserved systolic function NB: PAH PRESENT Note: Also cP have so it is not a feature of Diff. |
Unlike the other cardiomyopathies that are classified according to morphological criteria, i.e. hypertrophic, dilated, right ventricular; Restrictive is a functional classification |
|
|
Echocardiographic features of amyloid infiltration of the heart
|
Increased LV wall thickness Increased RV wall thickness Small, well, or poorly contracting LV Enlarged LA Valve thickening (all valves) Mitral regurgitation (usually mild) Thickened atrial septum E/A ratio >1 Pericardial effusion (advanced disease)
|
|
|
|
Indications for a temporary pacemaker? 3 Tri |
∙ symptomatic/haemodynamically unstable bradycardia, not responding to atropine ∙ q-ANTERIOR MI: Mobits type 2 or complete heart block* ∙ trifascicular block prior to surgery |
|
|
|
BI sphereience Not Alternate Pulse? |
Mixed Aortic Valve disease |
|
|
|
2nd line in Mx of SVT ? |
Verapamil esp if adenosine CI |
|
|
|
Duke Criteria of IE? |
Infective endocarditis diagnosed if ∙ pathological criteria positive, or ∙ 2 major criteria, or ∙ 1 major and 3 minor criteria, or ∙ 5 minor criteria |
|
|
|
Pathological Criteria? |
Positive histology or microbiology of pathological material obtained at autopsy or cardiac surgery (valve tissue,vegetations, embolic fragments or intracardiac abscess content) |
|
|
|
Major Criteria? |
Positive blood cultures ∙ two positive blood cultures showing typical organisms consistent with infective endocarditis, such as Streptococcus viridans and the HACEK group, or ∙ persistent bacteraemia from two blood cultures taken > 12 hours apart or three or more positive bloodcultures where the pathogen is less specific such as Staph aureus and Staph epidermidis, or ∙ positive serology for Coxiella burnetii, Bartonella species or Chlamydia psittaci, o r∙ positive molecular assays for specific gene targets Evidence of endocardial involvement ∙ positive echocardiogram (oscillating structures, abscess formation, new valvular regurgitation ordehiscence of prosthetic valves), or ∙ new valvular regurgitation |
|
|
|
Minor Criteria? 5 |
∙ predisposing heart condition or intravenous drug use ∙ microbiological evidence does not meet major criteria ∙ fever > 38ºC ∙ vascular phenomena: major emboli, splenomegaly, clubbing, splinter haemorrhages, petechiae or purpura ∙ immunological phenomena: glomerulonephritis, Osler's nodes, Roth spots, Janeway lesions |
|
|
|
3 differnces bw Thrombosis and stenosis in post Cath? |
T(1)rombosis: 1 month 1-2 % M1 presentasion |
S(5)tenosis 5 months 25 % Angina Symptoms |
|
|
Myocardial action potential Nemonic? |
الصوديوم سوة هجوم سريع هو دخل وفرغ الشحنات ووكفت ال قنوات جماعة من البوتاسيوم شالو غراضهم وطلعوا اشتغلت القنوات 2 اجة الكالسيوم دخل وكعد علة البليتة صار هدوء بقية البوتاسيوم فنشو وانهزموا كلهم وصار كونتراكشن وبعدين استعدلت الحالة الأيونية
|
0 Rapid depolarisation :Rapid sodium influx These channels automatically deactivate after a few ms 1 Early repolarisation Efflux of potassium 2 Plateau Slow influx of calcium 3 Final repolarisation Efflux of potassium 4 Restoration of ionic concentrations |
|
|
In of ASD closure? |
Rt side enlargement - PAH (absent) |
|
|
|
HOCM + RTA+Shock? MX |
Phenylpherine |
LVOO |
|
|
How to dx ASD L-R shunt? |
Agitated sline echo |
|
|
|
Mechanism of Action of Hydralazin?
|
Direct Vasodilator
|
|
|
|
Mechanism of Action of Nitroprusside?
|
Vascular Smooth muscle Relaxant
|
|
|
|
Mx of IE Cause of Prosthetic Valave |
G+V+R |
|
|
|
• young patient with acute history
•chest pain, SOB + Hx of Toxoplasmosis inf? |
Myocarditis
|
|
|
|
∙ wide pulse pressure ∙ JVP: cannon waves in neck ∙ variable intensity of S1 |
Complete Heart Block |
|
|
|
T wave inversion in leads V1- 3 associated with a notch at the end of the QRS complex |
Arrhythmogenic right ventricular cardiomyopathy / An epsilon wave is found in about 50% MX by Satolol |
Management ∙ drugs: sotalol is the most widely used antiarrhythmic ∙ catheter ablation to prevent ventricular tachycardia ∙ implantable cardioverter-defibrillator |
|
|
triad of ARVC, palmoplantar keratosis, and woolly hair |
Naxos disease variant of ARVC |
|
|
|
∙ left anterior hemiblock ∙ left bundle branch block
∙ Wolff-Parkinson-White syndrome* - right-sided accessory pathway ∙ hyperkalaemia ∙ congenital: ostium primum ASD, tricuspid atresia ∙ minor in obese people |
LAD : تذكر لادا وعلي حيدر (الذيب :سمين اجة من الينمة صعد لان متكفي من ورة LLBBB, LAHB وهو طويل ياكل موز فصار عندة هايبر كاليميا ومن الطبيعي شكلة مشوه خلقيا فصلكوا عندة أسد صف أول |
|
|
|
∙ left anterior hemiblock ∙ left bundle branch block
∙ Wolff-Parkinson-White syndrome* - right-sided accessory pathway ∙ hyperkalaemia ∙ congenital: ostium primum ASD, tricuspid atresia ∙ minor LAD in obese people |
LAD : تذكر لادا وعلي حيدر (سمين اجة من الينمة صعد لان متكفي باب الكراج وهو طويل ياكل موز فصار عندة هايبر كاليميا ومن الطبيعي شكلة مشوه خلقيا فعبالهم أسد من اول شوفة |
|
|
|
Hypertension in DM Mx?
|
ACEI even if Old age
|
|
|
|
Centrally Acting Antihypertensives |
∙ methyldopa ∙ moxonidine NOT Minoxidi ∙ clonidine |
|
|
|
MVP Associations
(Cardio2, Arrythmia2, Rheumato5, Endocrine1, Nepro1) |
∙ congenital heart disease: PDA, ASD ∙ cardiomyopathy ∙ Wolff-Parkinson White syndrome ∙ long-QT syndrome ∙ Turner's syndrome ∙ Ehlers-Danlos Syndrome ∙ Marfan's syndrome, Fragile X ∙ osteogenesis imperfecta ∙ pseudoxanthoma elasticum ∙ polycystic kidney disease No Dawn Syndrome |
|
|
|
In MX of Any Case With AF or Aortic valve Look for? |
Age |
|
|
|
Prinzmetal Anginal Definition & Mx? |
Coronary Vasospasm rather than ischemic Pathology CCB |
Exposure to cold weather Stress Medicines that tighten or narrow blood vessels Smoking Cocaine use |
|
|
1st Line Rx in HF, IHD resp ? |
ACEI, Aspirin Take care |
|
|
|
Anti Hypertensive Drugs may cause lithium toxicity? |
Diuretics, ACE-i
Nephrotoxicity: Verapamil or Deltiazem |
Amlodipine is safe |
|
|
PPH Mx Steps? |
1st : treating underlying conditions, 2nd acute vasodilator testing
A + response: oral CCBs B - response : 1 of 3 1 prostacyclin analogues: treprostinil, iloprost 2 endothelin receptor antagonists: bosentan 3 phosphodiesterase inhibitors: sildenafil |
Endothelin : بوسنتان تكلب الاندوثيليوم علة البطانة |
|
|
Hypertension/NF1 associations? |
1 coexistant essential hypertension 2 phaechromocytoma 3 renal vascular stenosis secondary to fibromuscular dysplasia |
|
|
|
Atrial flutter 2 Mx tricks ? |
|
Flutter waves may be visible following carotid sinus massage or adenosine |
|
|
2 Steps in Mx of MAT |
1 correction of hypoxia and electrolyte disturbances 2 rate-limiting CCB used first-line |
Cardioversion and digoxin are not useful in the management of MAT |
|
|
Who blindly considered High Risk CAD chest painers? |
All men > 70 years who have typical anginal symptoms |
|
|
|
Forgotten Causes of DCMP? |
Iherited (30%) ∙ nutritionale.g. Kwashiorkor, pellagra, B1, selenium deficiency Infections e.g. Coxsackie A and B, HIV, diphtheria, parasitic ∙ Duchenne muscular dystrophy ∙ Doxorubicin
|
Infiltrative causes may also be a cause |
|
|
1st line mx in Stable Angina? |
BB or CCB: Monotherapy: rate-limiting: verapamil or diltiazem Combination: Long Acting DHP (nifedipine or Felodipine) / Risk of CHB long-acting nitrate, ivabradine, nicorandil or ranolazine |
Combination no Benefit: |
|
|
Why to Check electrolytes with Amiodarone? |
Risk of Hypokalemia |
∙ thyroid dysfunction∙ corneal deposits∙ pulmonary fibrosis/pneumonitis∙ liver fibrosis/hepatitis∙ peripheral neuropathy, myopathy∙ photosensitivity∙ 'slate-grey' appearance∙ thrombophlebitis and injection site reactions∙ bradycardia |
|
|
Second heart sound (S2)? ∙ loud: ∙ soft: ∙ fixed split ∙ reversed split: |
∙ loud: hypertension ∙ soft: AS ∙ fixed split: ASD ∙ reversed split: LBBB |
|
|
|
Pregnancy Induced Hypertension? |
2ND half of pregnancy (i.e. after 20 weeks) No proteinuria, no oedema |
Occurs in 3-5% of pregnancies >> in older women |
|
|
How to Prevent recurrence of SVT? |
BB ∙ radio-frequency ablation |
|
|
|
Hepatic Inducers |
******** CRAP GPS induces my rage! St. John's wort Carbamazepine Rifampin Alcohol (chronic) Phenytoin Griseofulvin Phenobarbital Sulfonylureas |
Sulphonylurea anD PHenytoin |
|
|
CYP450 inhibitors VICK'S FACE All Over GQ stops ladies in their tracks. |
Valproate Isoniazid Cimetidine Ketoconazole Sulfonamides Fluconazole Alcohol (acute) Chloramphenicol Erythromycin (macrolides) Amiodarone Omeprazole Grapefruit juice Quinidine |
Quinines: Anti-Malarials Even Qweens in Africa shuold take AntiMalarials Sulphonamide: Antimicrobials Diuretics: Thiazide and Loop Sulphonylurea Sulphasalazine |
|
|
Mx of hyperCa in Sarcoid? |
STEROIDS |
|
|
|
>> presentation of SLE manifestations? |
|
|
|
|
Mx of Sarcoid? |
|
يعني السؤال يجي All of the following used in Mx of Sarcoid except ? كذلك ال Behjet |
|
|
Dx of Whipple? |
|
|
|
|
Post Pharangitis 3 weeks what u suspect? |
|
Pharynx → Heart → Cerebellum, Joints and Skin Rarely |
|
|
Extraglandular Manif. Of Sjogren? |
Arithritis> Reynauds> Lung & Vasculitis> Lymphoma 5 % |
|
|
|
PR Interval interp? |
|
|
|
|
Acetozalamide SE? |
|
|
|
|
VT Triad of Association? / pacemaker Imdication? |
|
|
|
|
S3 Soft S1 + Heave loud, palpable P2, heard best when lying on the left side |
|
|
|
Murmur in Atrial Myxoma |
Mid diastolic (Tumor plop) |
Clubbing, Wt Loss ass |
|
|
3 Ass of Bicuspid Aortic Valve |
Left Coronary Dominence*
Turner COA |
يعني البوستيريور ديسيندنگ من السيركمفلكس مو من ال رايت كوروناري
|
|
|
3 forgotten features of PDA |
Wide pulse pressure Collapsing pulse (Large volume) Heaving Apex beat |
|
|
|
Factors ↓ BNP (F-ve) |
Obesity AntiHT (unless Alpha blockers) |
|
|
|
Forgotten PP in IE |
Low Complements |
STAPH Aureus also |
|
|
2 forgotten F of AS? |
LVF Thrill |
common: Soft S2 S4 Narrow, Slow Pulsd Delayed ESM Duration of, Murmur |
|
|
Ichemic chest pain May be repeoducible by palpations True or False? |
True |
|
|
|
معلومة مهمة |
Verapamil is CI in patient with CI to BBC unlike other CCBs T or F? |
F Nifedipine is |
|
|
Forgotten Changes in Cardiogenic Shock? |
hypokalemia hypomagnesemia acidosis |
Correction is essential |
|
|
Distributive Shock Causes |
Septic + Other causes; SIRS due to noninfectious inflammatory conditions such as burns and pancreatitis; toxic shock syndrome (TSS); anaphylaxis; reactions to drugs or toxins, including insect bites, transfusion reaction, and heavy metal poisoning; addisonian crisis; hepatic insufficiency; and neurogenic shock due to brain or spinal cord injury |
|
|
|
Any cause of LVF may lead to pulmonary hypertension T or F? |
T By pulmonary venous congestion and hence PH |
|
|
|
Frog Sign? |
(prominent venous pulsations in the neck due to cannon A waves seen in AV dissociation) on physical examination is frequently present and suggests simultaneous atrial and ventricular contraction→ AVRT |
|
|
|
Imp MKSAP Question? |
17 even if asymptotic HF → BB unless pulmonary edema or low CO 19 Bicuspid → SURGERY 4 ROOT & VALVE,24bNYHA class 3-4 on Acei & BB → Add Aldactone ,31 Ascending AD → Urgent surgery ,37 CHADS2 <2 no bridging just in RF subtherpetic, > 2 → theraptic 42 Mechanical Valve + Surgery→ no risk factor → 43 PS → SEE VHD DIAG47→ Down → AVSD → ↑ risk of eisenminer / COA: ECG → LVH, O/E→CXR : figure 3 sign + Rib notch sys mrmr in infraclav. Or over back → , E ANOMALY→ TR + RT HEART enlargement → ECG Himalayan P waves+ prolonged QRS , RBBB , preexitation → CXR _→ Rt heart enlarge+ small pul.AsCyanosis in PFO + SEVER TR or ASD with reversed shunt 52 AF ABLATION → 3 months continue warfarin and chk,57 Angina + CI to BB → CCCB → Be 1st Line راجع مخطط ال angina,58 acute HF + ARF → DIURETICS,63 acute MR → Surgery 73 ❎ Trip methoprin DIDNOT cause Long QT ال U wave ما ينحسب وياها اذاىاكثر من ٥٠٠ او ديزداد ٦٠ ورة مياخذ الدوة ,78 see VHD 80 acute edema + discharge → within 1 week hospital check,81, > 5.5 AAA + comorbid condition → Conservative 82 New HF + RF like DM → CAD → CATH ,84 Resolving Constrictive Pericarditis → Continue Mx86 Asymptomatic sever MR + PHT→Repair Surgery ,87 Cardiac allograft VASCULOPATHY >> COMPLICATION OF Transplant 90, exercise test in AS in LV Systolic Dysfunction ➕ low gradient 92 → LBBB, ventricular pacing , st t changes Ventricular preexitation → Stress with IMAGING → Incapable → Pharmacological stress Echo test 95 D(Dilated)oxurubicin induced CMP 96 → Myopericarditis → HF due to MI + pericardiis Post MI syndrome didn't cause HF ,102 → ACE I CI in HF (↑k or ↓ GFR)→ hydralazine + Dinitate ,108, → Sarcoidosis → cmr not Biopsy 111 Marphan + Thoracic AA → SURGERY 113 Cyanotic , Congenital heart disease + HB 15.5 + ↓ Ferritin → Masking of anemia → Rx |
|
|
|
اجاك واحد CHF وعندة PAD مثل حجي لازم محسن(الله يرحمه) ما تكدر تنطي ؟ |
cilastazol |
|
|
|
اجاك مريض HF وعلة ال loop diuretics الزينة وكلب af دير بالك لاتجفت وتنطي ؟ |
amiodarone |
لان هذا يزيد الtoxicity والسبب السبب هو hypokalemia |
|
|
ABCDE Mx of HOCM? CI? |
Amiodarone · Beta-blockers or verapamil for symptoms · Cardioverterdefibrillator · Dualchamber pacemaker · Endocarditis prophylaxis |
NAI Nitrates AceI Inotropes: Digoxin, Milrenone, Insulin |
|
|
+ve Inotropes? |
Amiodaron
Calcium Dopamine Dobutamine Epinephrine (adrenaline) Isoprenaline (isoproterenol) Norepinephrine (noradrenaline) Digoxin Prostaglandins[1] Phosphodiesterase inhibitors Milrinone Theophylline Glucagon Insulin |
Positive: Increase Myocaridal C |
|
|
-ve Inotropes? |
Beta blockers Verapamil Ditiazem Class 1A Procainamide Disopyramide Class 1C Flecainide |
Negative : Decrease Myocardial Contarctility |
|
|
Dental Extraction AB Prophylaxis |
|
|
|
|
ECG changes in ASD? |
PR prolongation Axis Deviation (1 L 2 R) Incomplete RBBB |
|
|
|
main indications for (ASD) closure is ? |
with or without symptoms (eg, exercise intolerance, fatigue, dyspnea, heart failure, paradoxical emboli, arrhythmias) [1].
2. paradoxical embolism or documented orthodeoxia-platypnea |
|
|
|
any patient with an unexplained elevation in JVP, particularly if there is a history of a predisposing condition such as Malignancy, prior cardiac surgery, or prior radiation therapy. |
Pericardial constriction should be considered in |
|
|
|
RCMP due to Amyloid \ which drug should avoid? |
Digoxin as it is thought that digoxin may bind to amyloid fibrils and lead to increased toxicity. There I some suggestion that calcium channel blockers and beta blockers should also be avoided. |
|
|
|
Post MI PW chest pain, shortness of breath, hypotension, biventricular failure, and shock within hours to days. Patients often present with a new, loud, and harsh holosystolic murmur. This murmur is loudest along the lower left sternal border and is associated with a palpable parasternal systolic thrill. |
Ventricular Septal Rupture |
RV and LV S3 gallops are common. |
|
|
Post MI one week pw Arrythmia, and features of Cardiogenic Shock with Recurrent ST elevations ? |
FVWR involve the Anterior wall |
|
|
|
Mx of VSR? |
|
|
|
|
A 62 year old woman undergoes thrombolysis for a myocardial infarction. After 48 hours you are asked to review here as she is complaining of shortness of breath and her saturations have dropped to 92 per cent. Her blood pressure is 100/65 mmHg and is tachycardic 110 bpm. On auscultation she has a systolic murmur, loudest at the apex, and bilateral crackles to mid zone. What is the likely cause for her deterioration? |
Papillary muscle Rupture |
|
|
|
Tall R wave in V1 + Inverted T wave ? |
Post MI |
|
|
|
1st ECG change in MI? |
Hyperacute T wave |
|
|
|
Dxtic Criteria of SLE? |
SOAP BRAIN MD |
S: Serositis P: phtosensitivity B: Blood disorders (1 of 4) M:Malar Rash D: Discoid Rash |
|
|
Classification for CA Indication? |
1 2 3 |
|
|
|
Diff bw segment & interval? |
Interval : begining to End Segment: End to Begining |
|
|
|
Main management of Cholesterol emboli Syndrome |
Supportive :) |
|
|
|
Which cardiac Chamber mostly involved in Radiation toxicity? |
RV → RVF |
|
|
|
At which level Warfarin shod be avoided? |
1st: Emberyopathy 3rd: Risk of ICH of fetus |
|
|
|
3 Novel Drugs used in Mx of Peripartum CMP? |
Immune globulin Pentoxyphilline Bromocriptine |
In addition to anti failure Drugs |
|
|
In women with LV dysfunction below 35%? How to AntiCoagulate? |
Warfarin with INR (2-3) |
|
|
|
Increased Risk of PP CMP? |
من النقطة للنقطة |
|
|
|
When to Prefer Cesarean delivery in CVD pregnant |
Obstetric causes Warfarin Use Sever PHT Dilated Ascending Aorta |
|
|
|
Earliest Feature of Radiation Cardiotoxixity? |
Reduced Contractile Reserve |
Absence of Significant ↑ in EF after stress echo |
|
|
Which type of CMP will occur late after Receiving Cardiotoxic Chemotherapy? |
DCMP Poor prognosis |
|
|
|
Wch type of CMP occur acc Period of Exposure? 1. 2-5 m2. 7 y 3. 10 - 25y 4. Years 5. Years to Decade |
1. Pericarditis (pericardial eff)
2. CAD (may manifest as MI) 3. Valvular fibrosis & Regurgitation 4. Myocardial fibrosis, DD, RCMP 5. Dysrythmia, Bradycardia, HB 6. اخر شي |
|
|
|
Whats the meaning of Ulcerative Plaque? |
It means Irregular Surface → high risk for clot formation
|
|
