Basic Principles

In this video we introduce the basic principles of cardiology. Recorded live at Imperial College School of Medicine, London

 

Lecture by

Video Duration: 24 minutes

  • Basic Principles
    Created by Jess Huebner
    General
    Epidemiology

    Use VINDICATE as system for identifying causes:

    - vascular; infection/inflammatory; neoplastic; degenerative; iatrogenic/idiopathic; congenital; autoimmune; trauma; endocrine/metabolic

    Pathology

    None

    Top three causes

    None

    Clinical Features
    Symptoms
    • Chest pain
    • SOB
    • Syncope
    • Oedema
    Signs

    Clubbing: many causes but CV related 2 most common are subacute endocarditis and congenital cyanotic heart disease (including tetralogy of fallot, coarctation of the aotra and pulmonary stenosis)

    Pulse: fell for rate (tachy/brady), rhythm (regular or irregular; if irregular, irregularly irregular [likely AF] or regularly irregular [heart block]), character (best done centrally)

    BP: hypo or hyper-tension, pulse pressure (difference between systolic and diastolic)

    JVP

    Heart sounds

    Murmurs

    Lung sounds

    Oedema

    Investigations
    Cultures

    Blood cultures - useful in diagnosis of infective endocarditis, also for pneumonia precipitating AF and for screening for systemic infection

    Bloods

    Arterial gas - looks at acid/base exchange and helps look for respiratory compromise

    Venous - FBC, ? CRP/ESR (mostly vasculitic in regards to CV), EUC, LFT, TFT (particularly if AF)

    Imaging

    CXR, Echo, cardiac MRI, myoperfusion scan/nuclear imaging

    Scopic/Biopsy

    Angiography

    Functional

    ECG

    Treatment
    Conservative

    Lifestyle modification to alter risk factors

    Medical
    • Antiplatelets/anticoagulants/thrombolytics
    • Impact function of heart (ABCD)
    • ACE inhibitors, beta blockers, Ca channel blockers, diuretics
    • Anti-arrhythmics (e.g. for AF)
    Surgical
    • Angioplasty
    • CABG (used in severe IHD eg triple vessel disease or left main stem disease)
    • Transplant (used mainly in cardiomyopathy)