Cardiology

prostacyclin analogues:
treprostinil, iloprost
endothelin receptor

antagonists: bosentan,
ambrisentan

phosphodiesterase
inhibitors: sildenafil

In most people, which
coronary artery supplies

the AV node?

Right

Bleeding on dabigatran?

Idarucizumab can
reverse

First line investigation
for stable chest pain of

suspected coronary
artery disease
aetiology?

Contrast-enhanced CT
coronary angiogram

Drug eluting stent - what
is of paramount
importance for 12
months?

DAPT

Delay routine surgery
etc

Aminophylline effect on
adenosine?

Which drug should be
avoided in VT?

Verapamil
Risk of VF - blocks AV

node

(hence why verapamil
and B blockers don't go

together)

How can you determine
between: Jervell-Lange-
Nielsen syndrome and

Romano-Ward
syndrome?

Both long QT

JLN - deafness (K+
channel problem)
RW - no deafness

HTN not controlled on
just an ACE inhibitor?

Add CCB or a thiazide
LIKE diuretic eg

Indapamide (preferable
to an actual Thiazide)

Treatment for heart
failure with LV failure?

ACE inhibitor and B
blocker, reduces after

load

DVLA advice for the
heart?

CABG 4 weeks
MI 4 weeks unless successfully

treated by angioplasty then 1
week

Elective angiogram 1 week
ICD: 6 months if for VT
1 month if prophylactic

Heavy goods never again
PPM 4 weeks

Pansystolic murmur
worse on inspiration?
When do you see this
valvular abnormality?

Tricuspid regurgitation

Happens in Ebsteins
anomaly (+WPW)

Takayasu arteritis

Granulomatous (giant cell)
inflammation of media and
adventitia of large elastic

arteries.
Most often affects thoracic

aorta and its proximal
branches and pulmonary

arteries.

If > 55 how useful is the
PERC score?

No - cant use after 55 yrs
of age

All patients post MI?

dual antiplatelet therapy
(aspirin plus a second

antiplatelet agent)
ACE inhibitor
beta-blocker
statin

Chest pain post initial MI
- which blood test?

CK-MB is useful to look
for reinfarction as it

returns to normal after 2-
3 days

(troponin T remains
elevated for up to 10

days)

Why does
ticagrelor/dypridamine

cause dyspnoea

due to the impaired
clearance of adenosine

(adenosine shouldn't be
given in asthmatics)

Treatment of PE?

DOAC!

LMWH in renal
impairment

In antiphospholipid -
LMWH then VKA

Length of treatment for
PE?

DOAC
- 3 months provoked
- 6 months unprovoked

First line treatment of
HTN in diabetics?

Hypertension in
diabetics - ACE-
inhibitors are first-line
regardless of age

Driving rules with ICD
insertion?

if implanted for sustained
ventricular arrhythmia:

cease driving for 6 months
if implanted prophylactically

then cease driving for 1
month. Having an ICD
results in a permanent bar

for Group 2 drivers

AF and cardioversion?

< 48 hours: heparinise and DC
cardiovert in ED or medical with

amiodarone (structural heart
disease) or flecainide in normal

heart
> 48 hours: heparinise for 3 weeks -

cardiovert - heparinise 4 weeks
(if high risk for failure then 4 weeks
amiodarone before cardioversion)

Treatment of HOCM?

Amiodarone
Beta-blockers or
verapamil for symptoms
Cardioverter defibrillator

Dual chamber
pacemaker

Endocarditis prophylaxis

HOCM gene?

the gene encoding β-
myosin heavy chain

protein or myosin
binding protein C

Causes of infective
endocarditis after dental

work?

Streptococcus mitis and
Streptococcus
sanguinis.

MOA of dipyridamole

Non-specific
phosphodiesterase
inhibitor and decreases
cellular uptake of

adenosine
Inhibits platelet

aggregation