Cardio.txt

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Author:
laureng
ID:
277069
Filename:
Cardio.txt
Updated:
2014-06-17 18:07:12
Tags:
MS AR MR PS HOCM ESM PSM systolic diastolic
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Description:
Cardio SC
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  1. MR Causes
    • Degenerative
    • MVP
    • RHD
    • Papillary muscle dysfunction
    • CT disease (RA, AS)
    • Congenital
    • IE
    • Ischaemic
    • Surgery
    • Trauma
  2. MR - Signs of severity
    • Enlarged LV
    • Pul. HTN
    • HS 3
    • Soft HS 1
    • LVF
    • Small volume pulse
  3. MR ECG
    • P mitrale
    • AF
    • RAD
  4. MR CXR
    • LAE - loss of convexity distal to aortic knuckle, double heart shadow and splaying main bronchi
    • Increased LV size
    • MV calcification
  5. MR - Indications for surgery
    • NYHA 3/4
    • LV dysfunction
    • Progressive LV dilatation
  6. MVP - clinical findings
    • Mid-systolic click
    • Mid- to late-systolic murmur
    • Increased with Valsalva (decreases preload)
    • Handgrip (Inc. afterload)/ Squatting (Inc. preload) reduce the duration of the murmur
  7. MVP - Clinical associations
    • Marfans
    • ASD secundum
    • Anorexia nervosa
  8. MVP - Complications
    • MR
    • IE
  9. AR - Causes
    • RHD
    • Congenital - Bicuspid AV, VSD
    • Seronegative arthropathy - AS
    • Marfans
    • Aortitis (Seronegative arthropathies/RA/tertiary syphilis)
    • Dissecting aneurysm
    • Degenerative
    • Functional
  10. AR - Signs of severity
    • Collapsing pulse
    • Wide PP
    • Length of murmur
    • HS 3
    • Soft HS A2
    • Austin Flint murmur
    • LVF
  11. AR - ECG
    LVH
  12. AR - CXR
    • LV dilatation
    • Valve calcification
  13. AR - Indications for surgery
    • Symptoms - SOBOE
    • Worsening LV Fx
    • Progressive LV dilatation (LV-ESD > 55mm)
  14. AS - Causes
    • Degenerative senile calcific aortic stenosis
    • RHD (rarely isolated)
    • Calcific bicuspid AV
  15. AS - Signs of severity
    • Plateau pulse
    • Aortic thrill
    • Length, harshness, and lateness of the peak of the murmur
    • Paradoxical splitting of HS 2
    • LV failure
  16. AS - ECG
    LVH
  17. AS - CXR
    • LVH
    • Valve calcification
  18. AS - indications for surgery
    • Exertional angina, sob or syncope
    • Critical obstruction
  19. TR - Clinical signs
    • JVP - V waves
    • RV heave
    • PSM LLSE
    • *** multiple systolic clicks = Ebsteins abnormality
    • Enlarged pulsatile and tender liver
  20. TR - Causes
    • Functional - RVF
    • RHD
    • IE
    • Congenital - Ebsteins anomaly
    • RV papillary muscle infarction
    • Trauma (steering wheel)
  21. PS - Clinically
    • Peripheral cyanosis
    • Low volume pulse
    • Giant a waves in JVP
    • RV heave
    • Thrill over pulmonary area
    • Harsh ESM - maximal over pulmonary area on inspiration
    • Pre-systolic pulsation of liver
  22. PS - Signs of severity
    • ESM late peaking
    • Absence of systolic click
    • S4
    • RVF
  23. PS - Causes
    • Congenital
    • Carcinoid syndrome
  24. Chronic constrictive pericarditis - Clinically
    • Cachectic
    • Low BP
    • Pulsus paradoxus
    • Raised JVP +/- Kaussmauls sign
    • Distant HS
    • Hepatosplenomegaly, ascites and oedema
  25. Chronic constrictive pericarditis - Causes
    • XRT
    • Tumours
    • TB
    • CT disease
    • CRF
    • trauma
  26. HOCM - Clinically
    • Sharp, rising and jerky pulse
    • JVP - prominent a wave
    • Double apex beat
    • Late ESM on LSE + PSM from MR + S4
    • *** No diastolic murmurs
    • Louder with Valsalva, standing and isotonic exercise (jogging)
    • Softer with squatting, raising the legs isometric exercise (forceful handgrip)
  27. HOCM - ECG
    • LVH with strain
    • Deep q waves
    • Conduction defects

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