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Cardiology Bullet Points For NEET PG & INICET

 

1. Defects in dynein (a protein in cilia which is  involved in L/R asymmetry) or cardiac looping can lead to dextrocardia, a condition in which the heart lies on the right side of the thorax.

It often accompanies Kartagener syndrome, an autosomal recessive genetic disorder that results in dysfunctional cilia in the reproductive and genitourinary tracts as well.

 

2. A failure of the septum primum to fuse with the endocardial cushions can lead to an ostium primum ASD at the
inferior part of the atrial septum. This type of endocardial cushion defect is associated with trisomy 21.

 

3. The 5 T’s of early cyanosis (right- to-left shunts):

1. Truncus arteriosus
2. Transposition
3. Tricuspid atresia
4. Tetralogy of Fallot
5. TAPVR

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4. Persistent truncus arteriosis is often associated with DiGeorge syndrome.

 

5. Tetralogy of Fallot—

  • Pulmonic stenosis
  • RV hypertrophy
  • Overriding aorta
  • VSD

 

6. Deoxyhemoglobin levels must be at least 4 g/dL, which correlates to an oxygen saturation of 80–85%, before
clinically apparent cyanosis can be detected. Anemia by itself never causes cyanosis.

 

7. Although bicuspid aortic valves often calcify prematurely in adults, leading to eventual aortic stenosis, it is also
the most common cause of isolated aortic regurgitation in young adults in developed countries.

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8. Indomethacin, a nonsteroidal anti- inflammatory drug (NSAID), is used to close a patent ductus arteriosus
(PDA). Exogenous administration of prostaglandins (PGE2) is used to keep a PDA open.

 

9. Enlargement of the LA, a characteristic finding in mitral valve (MV) insufficiency, may cause dysphagia due to impingement on the esophagus.

 

10. The use of certain drugs during pregnancy (lithium, benzodiazepines) has been associated with a rare congenital defect called Ebstein anomaly, in which tricuspid valve leaflets are located deep in the right ventricle. If there is an associated ASD, build-up of blood in the right atrium secondary to poor tricuspid valve function can lead to right-to-left shunting and cyanosis.

 

Can you answer It?
A 30-year-old magician swallows an open safety pin as part of his show.
Which chamber of the heart is most
likely to be punctured?

11. Because the switch from fetal (alpha and gamma chains) to adult hemoglobin (alpha and beta chains) takes several months to reach a new steady-state after birth, it explains why β-thalessemias (inherited blood disorders with decreased or no synthesis of the beta chains of hemoglobin) usually manifest later in infancy, around 6 months of age.

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12. In cardiomegaly the apex is shifted laterally; therefore the point of maximal impulse (PMI) is palpated more lateral than the midclavicular line.

 

13. Aortic stenosis (AS) and hypertrophic obstructive cardiomyopathy (HOCM) both produce systolic crescendo-decrescendo murmurs.

In AS, the murmur is best heard in the right upper sternal border and radiates to the carotids and/or cardiac apex.

In HOCM, the murmur does not typically radiate and is best heard at the left sternal border; it also increases in intensity with Valsalva (AS murmur decreases in intensity with Valsalva)

 

14. Mitral regurgitation (MR) causes a holosystolic blowing murmur, heard best at the cardiac apex. It can
sometimes be confused with tricuspid regurgitation; however, the murmur of tricuspid regurgitation becomes louder with inspiration.

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15. Cardiac tamponade is the compression of the heart by fluid (ie, blood) in the pericardial sac, leading to decreased cardiac output (CO). Classic signs are distended neck veins, hypotension, and muffled heart sounds (Beck triad). Treatment is pericardiocentesis.

 

16. Hypertrophy of the myocardium occurs in hypertrophic obstructive cardiomyopathy (HOCM) and can result in sudden death due to ventricular arrythmias from poorly functional myocytes.

 

17. Transmural infarction affects all three layers of the heart. Subendocardial infarction affects only the
endocardium, which is furthest from the coronary artery and most susceptible to ischemia and necrosis.

 

18. Pericarditis is inflammation of the pericardium; causes of which vary and include systemic lupus erythematosus (SLE), rheumatoid arthritis, myocardial infarction (MI), tuberculosis (TB), and malignancy. Findings include chest pain and friction rub on auscultation, and the ECG shows diffuse ST elevations, often with PR segment depression, in all leads.

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19. Acute MI of the inferior portion of the heart (RV) is associated with characteristic ECG findings of ST- segment elevation in leads II, III, and aVF.

 

20. Complete AV block can lead to no conduction between atria and ventricles, often requiring a pacemaker.

 

21. P Pulmonale causes Peaked P waves. P Mitrale causes M-shaped P waves.

 

22. The most common cause of right-sided heart failure is left-sided heart failure.

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23. Acute CHF management—

  • lasix
  • Morphine
  • Nitrates
  • oxygen
  • Position (upright)

 

24. An S3 gallop signifies rapid ventricular filling in the setting of fluid overload and is associated with dilated cardiomyopathy.

 

25. HOCM is the most common cause of sudden death in young, healthy athletes.

 

26. An S4 gallop signifies a stiff, noncompliant ventricle and “atrial kick” and may be associated with hypertrophic cardiomyopathy.

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27. Major risk factors for CAD include age, male gender, LDL, HDL, DM, hypertension, a family history, smoking,
and peripheral arterial disease.

 

28. Women, diabetics, the elderly, and post–heart transplant patients may have atypical, clinically silent MIs.

 

29. Only ASA and β-blockers have been shown to have a mortality benefit in the treatment of angina.

 

30. Common causes of chest pain include GERD, angina, esophageal pain, musculoskeletal disorders (costochondritis, trauma), and pneumonia.

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31. Indications for CABG are

  • unable to perform PCI (diffuse disease)
  • left main coronary artery disease
  • triple-vessel disease
  • Depressed ventricular function

 

32. Dyslipidemia:

  • LDL > 130 mg/dL
  • HDL < 40 mg/dL

 

33. Causes of 2° hypertension—

  • cushing’s syndrome
  • Hyperaldosteronism (Conn’s syndrome)
  • aortic coarctation
  • Pheochromocytoma
  • stenosis of renal arteries

 

34. Hypertensive crises are diagnosed on the basis of the extent of end-organ damage, not BP measurement.

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35. Beck’s triad can diagnose acute cardiac tamponade:

  • JVD
  • Hypotension
  • Distant heart sounds

 

36.  Aortic aneurysm is most often associated with atherosclerosis, whereas aortic dissection is commonly linked to
hypertension.

 

37. The United States Preventive Services Task Force (USPSTF) guidelines recommend one-time screening for AAA by ultrasound in males ages 65–75 who have ever smoked.

 

38. Ascending aortic dissections are surgical emergencies; descending dissections are still emergencies but can often be treated medically.

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39. Virchow’s triad: (1) hemostasis, (2) trauma (endothelial damage), (3) hypercoagulability.

 

40. A negative d-dimer test can be used to rule out the possibility of PE in low-risk patients

 

41. The 6 P’s of acute ischemia:

Pain
Pallor
Paralysis
Pulse deficit
Paresthesias
Poikilothermia

 

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42. ABI = Pleg / Parm

ABI < 0.4 with rest pain.

 

43. Cardiac syncope is associated with 1-year sudden cardiac death rates of up to 40%.

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