Cardiology

Which channel is
normally affected in long

Qt syndrome?

Alpha subunit of slow
delayed rectifier

potassium channel
(LQTS)

Which drugs reduce the
effects of adenosine?

Aminophylline

Which antibiotics
shouldn't be prescribed

with statins?

Erythromycin and
clarithromycin

How does Amiodarone
work?

Blocks potassium
channels

Investigations in people
with cardiac syndrome

X?

Normal angiogram
despite ECG changes on

exercise

Treatment of aortic
dissection?

Type A (ascending) IV
labetalol and surgery
Type B (descending) IV

labetalol

Treatment of pulmonary
arterial hypertension?

Do vasodilator testing first
If positive —> oral calcium channel

blocker
If negative —> prostacyclin

analogues (treprostinil or iloprost)

Endothelium receptor antagonists

(bosentan, ambrisentan)
Phosphodiesterase inhibitors –

sildenafil

Whenchebaching in MI

If inferior - Atropine
(RCA)

If anterior- Pace (LAD)

Causes of infective
endocarditis?

Strep viridans - most
common in UK

Staph aureus - most common
worldwide

Staph epidermis - post
surgery

Step bovis - bowel cancer

Ix for IE?

TOE
3 x blood cultures

Mechanism of action of
Furosemide?

Loop - Na+/K+/2Cl- co-
transporter

Mechanism of action of
digoxin?

inhibition of Na/K
ATPase --> --> increase

intracellular Ca -->
inotropic effect

Name a class 1
antiarrhythmic?

Na+ channel blocker

Lidocaine
Flecainide

Name two class 3
antiarrhythmics?

K+ channel blockers

Amiodarone
Solatol

BP targets?

140/90
If > 80 yrs: 150/90

If diabetic: 140/80
If end organ damage:

130/80

What are the diastolic
murmurs?

IE - cultures back
- staph
- strep

Staph - flucloxacillin

Strep - Ben Pen

For both vanc and low
dose gent if pen allergic

Mechanical valves INR?

Aortic 3
Mitral 3.5

Complete heart block in
MI?

Inferior (RCA) - observe
Anterior – PACE

VT management?

Amiodarone if fine

Any signs of shock - DC
cardiovert

Stop exercise tolerance
test if...

exhaustion / patient request
'severe', 'limiting' chest pain

> 3mm ST depression
> 2mm ST elevation.Stop if
rapid ST elevation and pain
systolic blood pressure > 230

mmHg

continued…

systolic blood pressure falling
> 20 mmHg

attainment of maximum
predicted heart rate

heart rate falling > 20% of
starting rate

arrhythmia develops



Where does the
coronary sinus (venous
drainage of heart) drain

into?

RA

When would you replace
the aortic valve in

asymptomatic patients?

Pressure gradient > 40
Damage to LV

Pansystolic murmurs

mitral/tricuspid
regurgitation (high-pitched
and 'blowing' in character)

tricuspid regurgitation
becomes louder during
inspiration, unlike mitral

stenosis

PAH treatment?