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Block 13 Cardiology

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klau253's version from 2017-06-04 13:30

Section

Coronary arteries on ECG and asso/ MI
Question Answer
LADV1-V6, anteroseptal AMI
Lt circumflexI, AVL, V5-V6, lateral AMI
Rt coronaryII, III, AVF , Inferior AMI
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Treatments
Question Answer
NSTEMIanti-platelets, LMWH, statin, nitrates and beta blocker
Complete vessel occlusionthrombolysis, primary percutaneous coronary intervention
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Acute MI
Question Answer
complicationsarrhythmia, HF, myocardial rupture
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Myocardial rupture types
Question Answer
Inter-ventricular septum rupturedevelops at margin of necrotic and non-necrotic myocardium, presents with shock and new murmur, Lt to Rt shunt
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Papillary muscle rupture: acute hypotension and pulmonary oedema + holosystolic murmur

 

Papillary muscle blood supply
Question Answer
posteromedial papillary musclepost. descending artery
anterolateral papillary muscleLAD + Lt circumflex
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cardiac arrhythmia

Bradycardia
Question Answer
Sinus brady cardiaregular QRS, P wave in front of each QRS
1st degree atrioventricular blockregular QRS, prolonged PR interval, delay in conduction of AV node
2nd degree AV block Type 1 Wenckebachirregular QRS, 3 P waves :2 QRS, diff PR intervals with diff lengths
2nd degree AV block Type 2 Mobitzregular QRS, 2 P waves :1QRS
3rd degree AV block (complete heart block)regular QRS w/o any P wave, wide QRS
Sinus arrestfailure of SA node discharge
Ectopic fociareas in the heart that can initiate and maintain pulses other than SA node
Brady-tachy syndromewhen SAN has alternating periods of firing too slowly and too fast
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Tx of bradycardia
Question Answer
Sinusremove cause such as beta-blockers, CCB or digoxin, hypothyroid
Heart blockremove causerecent inf. MI, digoxin toxicity, bblocker, CCB, atropine, 2nd/3rd degree heart block requires pacing
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Tachycardia
Question Answer
SVTregular QRS and <120ms wide, adenosine slow rate remarkably to differentiate from VT
Sinus tachycardiawith <120 bpm at rest
Pathological>140 bpm at rest
VTregular QRS and >120ms wide
AFirregular QRS, with QRS<120ms (>120ms can still be AF)
Atrial tachycardiareguar QRS, <120ms
Atrial flutteratria beats regularly but faster than usual, 4:1 block = 4 flutter wave to 1 ventri depol
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