Differential Diagnosis PAIN Onset: PAIN Characteristic Provocative Factors definitions NEW YORK HEART ASSOCIATION FUNCTIONAL CLASSIFICATION OF ANGINA Class 1 Patients with cardiac disease but without…
Complications Post-AMI First 2-3 Days: Later Complications: Other Late Complications: Pain Management Left Ventricular Failure Cardiogenic Shock Right Ventricular Infarction Pericarditis Arrhythmias Thromboembolic Disease Cardiac…
Goal: Recommendations Smoking Complete cessation No exposure to environmental/ passive tobacco smoke – ceasing ↓ %Y mortality by half– Patients should be asked about tobacco…
Most pt’s will present with prolonged or recurrent central chest discomfort but others (elderly, DM, women) may present with atypical sx. Risk = DM &…
Drug Indications Mechanism Adverse effects Precautions Nitrates (short- and long-acting) Relief of acute or anticipated pain (short-acting)Prevention of angina (long-acting) Systemic and coronary vasodilation HeadacheHypotensionSyncopeReflex…
Definition: clinical sx consistent w ACS w ECG features including any of: Reperfusion Critera: Qwaves Area of Infarction Posterior Infarcts: https://lifeinthefastlane.com/ecg-library/basics/inferior-stemi Posterior Circulation: Posterior Infarction:…
STATINS Effectiveness Administration Timing Factors to Consider When Selecting a Statin Avoid drug interactions Statin Metabolised by Statin concentration may be increased by Statin concentration…
Not all palpitations are due to arrhythmia Investigations usually occur between episodes due to palpitations’ transient nature. Diagnosis begins with patient history, physical examination, and…
TOO FAST TOO SLOW NARROW COMPLEX BROAD COMPLEX NARROW COMPLEX BROAD COMPLEX REGUALR IRREGULAR REGULAR IRREGULAR SVTFlutterSinus Tachy AFA-flutter with variable block VTConduction abN VFAF…
NOTE: Diabetes mellitus is associated with a substantially increased CVD risk, meaning patients are generally excluded from primary prevention trials. In Australia (https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/national-guide/chapter-11-cardiovascular-disease-prevention) In USA…
Intro Risk factors, disease associations and potentially reversible precipitants for atrial fibrillation Risk factors and disease associations Potentially reversible precipitants ObesityHypertensionType 2 diabetes/impaired glucose toleranceSmokingObstructive…
Evaluation Differential Diagnosis Prognosis
Troponins High-sensitive Troponin (hs-Trop T and hs-Trop I) Purpose: Kinetics: Advantages: Disadvantages: Causes of Elevated Troponin in Absence of Acute Coronary Syndrome (ACS): Clinical Practice:…
Signs of Tamponade
Hypertrophic Cardiomyopathy (HCM) Structural changes Processes responsible for clinical manifestations of HCM: Clinical features Apical HCM Narrow, “dagger-like” Q waves in inferior and lateral leads…
Conducting a comprehensive risk assessment Absolute cardiovascular disease (CVD) risk assessment Risk category Estimated 5‑year CVD riska Management Reassessment interval High ≥10% Encourage, support and advise a…
Causes of chest pains presenting in general practice, compared with emergency departments Percentage in general practice (%) Percentage in emergency departments (%) Musculoskeletal conditions 29…
4. AXIS Lead I Lead aVF differential Normal axis (0 to +90 degrees) Positive Positive Left axis deviation (-30 to -90) Positive Also check lead…
Summary of inherited lipid disorders Type Heterozygous (Homozygous familial hypercholesterolaemia) Lipoprotein(a) Familial combined hyperlipidaemia Familial hypertri-glyceridaemia Type III familial dysbetalipo-proteinaemia Familial chylomicronaemia syndrome…
Delayed conduction of electrical current as it passes through the conducting system May occur at any level in the conducting system (AV node, Bundle of…
Symptoms and signs of heart failure More typical symptoms More specific signs Dyspnoea (usually with exertion)OrthopnoeaParoxysmal nocturnal dyspnoeaFatigue Elevated jugular venous pressureHepatojugular refluxThird heart soundLaterally…
Causes of acute decompensation of chronic heart failure Acute myocardial ischaemia or infarctionHypoxia (e.g., pneumonia, pulmonary embolism)Arrhythmia (e.g., atrial fibrillation, ventricular tachycardia/ectopy)Noncompliance with medications, fluid…
FROM: National Heart Foundation of Australia and Cardiac Society of Australia andNew Zealand: Guidelines for the Prevention, Detection, and Management of Heart Failure in Australia…
Medications indicated Drugs used in heart failure with reduced left ventricular ejection fraction Drug Indications Mechanism Adverse effects Precautions ACE inhibitors First-line therapy when LVEF…
There are five major classes of lipoprotein Chylomicrons Triglyceride rich Atherogenic VLDL – Very low density lipoprotein IDL – Intermediate density lipoprotein LDL – Low…
Risk Factors Causes/History In history identify Category Systolic Diastolic Grade 1 140-159 90-99 Grade 2 160-179 100-109 Grade 3 >180 >110 Isolated systolic >140 <90…
Disease Characteristic: Inflammation of the endocardium, typically affecting heart valves Causes and Organisms Risk Factors Pathophysiology Diagnosis History Signs Clinical Features Embolic Manifestations Cutaneous Findings…
Smoking cessation Nutrition weight control smoking alcohol exercise
Waist circumference thresholds for abdominal obesity Recommended threshold in waist circumference for abdominal obesity (high risk) Population Men Women European/North American ≥102 cm ≥88…
CAUSES (HIGAAP) ASSESSMENT HISTORY EXAMINATION INVESTIGATIONS MANAGEMENT
mRNA vaccines Symptoms and outcomes Myocarditis Pericarditis Symptoms Chest pain, pressure or discomfortPalpitationsShortness of breathNon-specific symptoms e.g. fatigue Chest pain which may be sharp, worse…
Two main categories: AV NODE INDEPENDENT AV NODE DEPENDENT MANAGEMENT Undifferentiated Narrow Complex Tachycardia Ventricular stand-still post Adenosine AV NODE INDEPENDENT AV NODE DEPENDENT
- Direct thrombin inhibitors: Dabigatran - Factor Xa inhibitors: Rivaroxaban, Apixaban Indications: NOAC dosing and PBS listings for prevention of stroke and SE in patients…
Aetiology Palpitations: Associated Symptoms and Causes Cardiac:Arrhythmias Cardiac: Nonarrhythmic cardiac causes Serious Indicators: Symptom Characteristics: Orthostatic Intolerance: Psychiatric causes Drugs and medications Extracardiac causes History…
Causes: Signs/Symptoms
Causes: Common Causes of pericarditis and pericardial effusions Cause Prevalence Investigation Idiopathic Most common Diagnosis of exclusion Viral Most common cause of infectious pericardial diseaseAdenovirusCoxsackievirus…
Wolff-Parkinson-White (WPW) Syndrome ECG features of WPW in sinus rhythm Tachyarrhythmias associated with WPW syndrome Atrioventricular reentrant tachycardia (AVRT) WPW with AF – FBI =…
Pathophysiology: High-Risk Groups for Acute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD): High-Risk Groups for Rheumatic Fever: Reasons for Increased Risk of Rheumatic Fever:…
DIAGNOSIS ECG Inappropriate sinus tachycardia (IST) Postural orthostatic tachycardia syndrome (POTS)
most common: birth to 13 years aged 14 to 24 years causes:
Case: Jane is a 42 yr old women who teachers at the local primary school. She attends your surgery at lunch time complaining of feeling…
Causes of tachyarrhythmias and differentiating clinical features Rate P-waves Variability Most common demographic Sinus Tachycardia <220 Present, normal morphology Variable Typically unwell children or…
Risk factors Causes of prolonged QT Antipsychotics Antiarrhythmics Tricyclics Other antidepressants Antihistamines Others Chlorpromazine Quinidine Amitriptyline Citalopram Diphenhydramine Erythromycin Haloperidol Procainamide Doxepin Escitalopram Loratadine Clarithromycin…
Features: always associated with absent pulse and loss of consciousness ECG Differential diagnosis Management: Electrical cardioversion Management: Drug therapy Special circumstances
Monomorphic Polymorphic complex of normal duration. (the first of the narrower complexes is a fusion beat (the next two are capture beats) Brugada Criteria:: RS…
Contraindications to warfarin therapy Factors that influence the INR Advice on Managing Bleeding Risk Specific Situations