The Cardiovascular System Cristina Fernandez FY1 Topics Spot - PowerPoint PPT Presentation

1 / 21
About This Presentation
Title:

The Cardiovascular System Cristina Fernandez FY1 Topics Spot

Description:

The Cardiovascular System Cristina Fernandez FY1 Topics Spot diagnosis Previous OSCEs AF Valvular Heart Disease Chest Pain Hypertension Swollen Ankles Spot Diagnoses ... – PowerPoint PPT presentation

Number of Views:58
Avg rating:3.0/5.0
Slides: 22
Provided by: cmftNhsUk
Category:

less

Transcript and Presenter's Notes

Title: The Cardiovascular System Cristina Fernandez FY1 Topics Spot


1
The Cardiovascular System
  • Cristina Fernandez
  • FY1

2
Topics
  • Spot diagnosis
  • Previous OSCEs
  • AF
  • Valvular Heart Disease
  • Chest Pain
  • Hypertension
  • Swollen Ankles

3
Spot Diagnoses
  • Open heart surgery
  • Always examine the legs!

4
  • Xanthelasma
  • Where else do you look?
  • What do you ask?
  • Corneal Arcus
  • What are the causes?

5
Previous OSCEs
  • 10 Minute Stations
  • Explain stroke/MI to relative
  • CVS exam
  • Intermittent claudication
  • ECG Perform interpret
  • Basic Life Support Defib
  • Counsel Smoking and Pregnancy
  • Interpret results ? trigs, chol
  • Chest pain Hx, Mx, ECG, Angina
  • 5 Minute Stations
  • Ankle swelling
  • MI ECG and Mx
  • AF ECG and Mx
  • AS / MR murmur
  • Prosthetic heart valve
  • Xanthelasma
  • AF
  • Sternotomy scar

6
Atrial Fibrillation
  • Presentation in OSCEs
  • Causes be systematic!
  • Symptoms (if any)
  • Clinical Assessment
  • Exclude treatable causes
  • Need for treatment

7
And dont forget Paroxysmal AF !
8
Valvular Heart Disease MR / AS
  • Usually in the 5 minute stations
  • Diastolic murmurs never come up
  • Know your land marks
  • MRS ASS
  • Remember prosthetic valves!

A
P
T
M
9
Chest Pain
  • History aimed to rule out differentials
  • Risk Factors
  • Examination
  • ECG
  • Differentials
  • Management

10
ALWAYS ask
  • Age and Gender
  • Duration of chest pain
  • Previous angina / MI
  • Palpitations
  • Family history
  • Hypertension
  • Hyperlipidaemia
  • Smoking
  • Diabetes

11
ECG
12
Acute Cardiac Chest Pain
13
Management of Angina
14
MI Acute Mx
  • GTN (X2)
  • ?
  • High Flow Oxygen (15L)
  • ?
  • ECG
  • ?
  • 300mg Aspirin
  • ?
  • Analgesia Morphine Metaclopramide
  • ?
  • Reperfusion PCI / Fibrinolysis
  • ?
  • Heparin 24-48 hours
  • Clopidogrel for stent insertion

15
Secondary Prevention
  • Immediately
  • ACEi- if intolerant give ARB
  • Statin
  • Aspirin PPI
  • Clopidogrel if given acutely (STEMI 4 weeks,
    High risk NSTEMI 12 months)
  • When Stable
  • B Blocker
  • Lifestyle
  • Diet
  • Physical Activity
  • Stop Smoking
  • Cardiac Rehab

16
Hypertension in OSCEs
  • Take BP
  • Know targets 140/90 Non DM
  • 130/80 DM
  • Repeat in other arm and X3
  • Investigate- exclude secondary causes
  • Complications
  • Management

17
Hypertension
18
Complications End Organ Damage
  • Cerebrovascular Disease strokes
  • Vascular Disease Eyes, Kidneys, Heart
  • L Ventricular Hypertrophy independent predictor
    of early death
  • Renal Failure
  • Malignant HTNgt 220/120
  • gt 180/110 papilloedema

19
HTN Mx
A ACEi B B Blockers C Calcium Channel
Blockers D Diuretics
20
Swollen Ankles
  • Examine
  • Differentials Heart (!)
  • Liver
  • Pelvic mass
  • Previous injury
  • Nephrotic Syndrome
  • History Examination
  • Investigations
  • Plan

21
Questions ?Good luck!
Write a Comment
User Comments (0)
About PowerShow.com