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?