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كيسات باطنية 🩺 / اكاديمية البيت الطبي 🩺💊
۲۹ اردیبهشت ۱۴۰۵، ۰۳:۲۷
🧠 Exam Golden Rule
Post-MI + sudden dyspnoea + pansystolic murmur at apex
= Papillary muscle rupture
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كيسات باطنية 🩺 / اكاديمية البيت الطبي 🩺💊
۲۹ اردیبهشت ۱۴۰۵، ۰۳:۲۷
Normal ECG + recurrent episodes → Holter monitor
• Abnormal ECG → Echo first
حفظ ✅
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كيسات باطنية 🩺 / اكاديمية البيت الطبي 🩺💊
۲۹ اردیبهشت ۱۴۰۵، ۰۳:۲۷
Constrictive pericarditis presents with signs of diastolic heart failure
(JVD, edema, ascites, Kussmaul sign) with a preserved ejection fraction. The septum in constriction may show a "septal bounce" or abnormal motion, but it is not thinned. EF is usually normal until very late stages.
حفظ✅
A 69 year old women had sudden burning chest pain and shortness of breath that started 4 hours ago. The pain was associated with nausea, vomiting and diaphoresis. Her ECG on admission shows ST elevation in leads II, III and aVF. Oxygen has been started and she was given sublingual GTN which has improved her chest pain. She was given aspirin 300 mg by the ambulance crew. Her heart rate is 70 bpm and respiratory rate is 18/min. What is the SINGLE most approprite next step in management?
A. Low molecular weight heparin
B. Streptokinase
C. Warfarin
D. Aspirin
E. Continue current management
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كيسات باطنية 🩺 / اكاديمية البيت الطبي 🩺💊
۲۹ اردیبهشت ۱۴۰۵، ۰۳:۲۷
A 69 year old women had sudden burning chest pain and shortness of breath that started 4 hours ago. The pain was associated with nausea, vomiting and diaphoresis. Her ECG on admission shows ST elevation in leads II, III and aVF. Oxygen has been started and…
435
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كيسات باطنية 🩺 / اكاديمية البيت الطبي 🩺💊
۲۹ اردیبهشت ۱۴۰۵، ۰۳:۲۷
📷 Photo
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كيسات باطنية 🩺 / اكاديمية البيت الطبي 🩺💊
۲۹ اردیبهشت ۱۴۰۵، ۰۳:۲۷
Step 2: Mechanism (very important for exams) Prolonged QT → delayed ventricular repolarization → electrical instability → triggers: ➡️ Polymorphic VT (Torsades de Pointes) This causes: • Sudden drop in cardiac output • Cerebral hypoperfusion • → Syncope…
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كيسات باطنية 🩺 / اكاديمية البيت الطبي 🩺💊
۲۹ اردیبهشت ۱۴۰۵، ۰۳:۲۷
Step 3: Why this patient specifically? Clues suggest Congenital Long QT Syndrome: • Young age • Athlete • Recurrent syncope since childhood • ECG shows prolonged QT
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كيسات باطنية 🩺 / اكاديمية البيت الطبي 🩺💊
۲۹ فروردین ۱۴۰۵، ۰۶:۵۰
A 22 year old male athlete has been having frequent fainting attacks since childhood. He has no family history of sudden death or arrhythmias. His ECG demonstrates a sinus rhythm with normal P-R and QRS intervals but a prolonged QT interval. What is the cause…
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كيسات باطنية 🩺 / اكاديمية البيت الطبي 🩺💊
۲۹ فروردین ۱۴۰۵، ۰۶:۵۰
Step 1: Identify the key abnormality The key finding is: ➡️ Prolonged QT interval This predisposes to a dangerous arrhythmia called: 🚨 Torsades de Pointes Which is a type of polymorphic ventricular tachycardia
