2. Cardiology Flashcards
Reversible CVD risk factors (7) Irreversible CVD risk factors (4) CVD prevention involves (4) Features of primary CVD prevention (3) Difference between primary and secondary prevention Functions of CV drugs (2)
Modifiable risk factors/lifestyle choices - obesity, diet, smoking, exercise, HTN, diabetes, stress
Genes, FH, sex, age
Lifestyle changes, control cholesterol, lower BP, aspirin
Diet, smoking, exercise
Medical intervention after CVD
Prevent further disease/reduce symptoms
Drugs used to prevent IHD (4)
Drugs used to treat IHD (5)
Function of anti platelet drugs and what do they reduce the risk of (2)
Function of anticoagulants and who are they used for
Antiplatelet example (1) and anticoagulant examples (2)
Function of statins (2) and side effects
Antiplatelets, statins, B-blockers, anti-arrhytmics
ACE inhibitors, Ca-channel blockers, diuretics, nitrates, anti-arrhytmics
Reduce platelet aggregation, reduce MI/CVA risk
Prevent/slow down clotting, patients at risk of thrombosis/pulmonary embolism in slow-moving areas
Aspirin; warfarin, heparin
Lower cholesterol/inhibit cholesterol synthesis in liver; myositis drug interactions
Function of B-blockers (2)
Side effects of B-blockers (3)
Function of diuretics (3)
Side effects of diuretics (2)
Function of nitrates (2) and types (2)
Side effect of nitrates
Function of Ca-channel blockers (2)
Side effect of Ca-channel blockers
Function of ACE inhibitors (3)
Side effects of ACE inhibitors (2)
Oral reactions of ACE inhibitors (2)
Stop arrhythmias, reduce heart muscle excitation
Prevent HR rise (postural hypotension), reduce heart efficiency, block B-receptors in lungs (asthma issues)
Antihypertensive drugs - increase salt and water loss, reduce plasma volume, reduce cardiac workload
Na/K imbalance, xerostomia
Reduce preload, reduce PR (after load); long/short-acting
Headaches - first-pass inactivation
Reduce BP by blocking smooth muscle Ca channels (some vasodilator peripheral BVs, some slow conduction of pacing impulses on heart muscles)
Gingival hyperplasia
Block Ang I –> Ang II and reduce (aldosterone-dependent) salt and water retention/reabsorption (block vasoconstriction), lower BP
Cough, low BP
Angio-oedema, lichenoid reactions
Definition of ischaemia Definition of infarction Infarction can lead to (2) Infarction treatment (2) Features of TIA (2)
BV narrowing - inadequate oxygen delivery for tissue needs
BV occlusion - no oxygen delivery to tissues. Secondary to ischaemia
Tissue death and loss of function
Reduce necrotic tissue loss, prevent further episode
Mini-stroke - may cause some loss of function, usually <24hrs
Angina
Cause/aetiology Types (2) Signs and symptoms (7) Investigations (4) Treatment (4) Drugs used to treat (6) Therapy (2) What is PVD Outcomes of PVD (4)
Narrowing and hardening of coronary arteries, reducing blood and oxygen to heart (caused by chemical and mechanical stimulation of sensory nerve endings on coronary vessels and myocardium)
Classical and unstable
Pain on exertion, SoB, chest pain, nausea, tired, dizzy, restless. Usually no signs
ECG, angiography, echocardiography, eliminate other diseases
Reduce afterload and preload, increase oxygen to tissues, vasodilation, reduce attack frequency
Aspirin, diuretics, Ca-channel blockers, ACE inhibitors, B-blockers, nitrates
Surgical - CABG, angioplasty
Claudication of limbs
Limited function, poor wound healing, tissue necrosis, gangrene
MI - STEMI and NSTEMI
Signs and symptoms (4) Investigations (2) Primary setting treatment (6) Hospital treatment (5) Thrombolysis contraindications (7) MI Complications (5) Management (2) Drugs used in management (3)
Pale, nausea, sweaty, chest pain radiating
ECG, cardiac enzymes (troponin leaks from dead cardiac muscle)
999, analgesia, aspirin, oxygen, loosen clothing, BLS
PCI (angioplasty/stenting), thrombolysis (tPA will dissolve all clots), drug treatment, secondary prevention, surgery (CABG)
Injury/surgery, severe HTN, PUD, diabetic eye disease, liver disease, pregnancy
Death, arrhythmias, HF, DVT, embolism
Prevent next MI (modify risk factors) and treat complications
Aspirin, B-blockers, ACE inhibitors
Definition of arteriosclerosis Definition of atherosclerosis Description of chronic inflammation stage (5) Description of healing stage (3) Effects of atherosclerosis (5) CCS causes (3) CCS effects (3) Mechanism leading to HF (5)
Hardening of BV/artery wall, loss of elasticity and flexibility
Changes in BV walls dur to tunica intima
Modifiable risk factors damage endothelial walls –> change surface receptors –> increased lipid permeability –> change in cell adhesion molecules –> monocytes can attach to endothelium and move into BV walls
Proliferation of smooth muscle cells and fibrous tissue growth - growth factors produced, fibrous plaque formed with central mass of liquid and necrotic tissue
Ischaemia, infarction, thrombosis, embolism, chronic periodontitis
Ischaemic heart disease, HTN, valve disease
Hypertrophy, oedema, CVC of lungs and liver
Hypertrophy of myocyte, capillaries don’t increase in number, heart heavier, increased metabolic demands –> ischaemia –> myocyte injury –> apoptosis and HF
Dental CV drug interactions Antiplatelets NSAIDs Anticoagulants Ca-channel blockers Diuretics/B-blockers (2)
Increased bleeding Mucosal damage Increased bleeding Gingival hyperplasia Xerostomia, increased caries risk
Hypertension (HTN)
Definition of high BP and low BP Target BP and cholesterol Risk factors (8) Causes of essential HTN (3) Signs and symptoms (3) Investigations (6) Treatment (3) Drugs used (4)
> 140/90 and <90/60
120/80 and <5mmol/l or reduce by 25%
Age, race, obesity, FH, alcohol, drugs, pregnancy, stress
No triggers, rarely endocrine tumours/renal artery stenosis
None, occasionally headaches, TIAs
Urinalysis, serum biochemistry and lipids, ECG, renal ultrasound
Modify risk factors, drugs, BP <140/90
B-blocker, Ca-channel blocker, thiazide diuretics, ACE inhibitors
Heart failure
When does HF occur Types (2) Causes (5) Signs and symptoms - right (4) and left (5) Treatment - acute/chronic Drugs used (5)
When heart is incapable of meeting tissue demands
High output (anaemia, thyrotoxicosis), low output (cardiac defect)
Heart muscle disease (MI), pressure overload (HTN), volume overload (mitral/atrial incompetence), arrhythmias (AF), drugs
Right - lung and systolic effects (SoB, increased HR, decreased BP, low volume pulse); left - increased venous pressure (swollen ankles, ascites, increased JVP, tender enlarged liver, poor GI absorption)
Hospitalisation/drugs
Diuretics, ACE inhibitor, nitrates, inotropes (digoxin), stop negative inotropes
Valve disease
Causes (4) Investigation Treatment Rheumatic heart disease caused by what reactions Features of calcific aortic stenosis
Congenital abnormality, MI, rheumatic fever, aortic root dilation
Ultrasound
Replacement valve
Type 2 and 4
Calcification due to tissue inflammation and hyperlipidaemia
Cyanosis
Cause
Types (2)
Signs and symptoms (5)
Low oxygen saturation - <5g/dl deoxygenated haemoglobin in blood
Peripheral and central
Blue lips, gums, skin, mucous membranes and finger clubbing
Infective endocarditis
Definition
Signs and symptoms (7)
Effects (2)
Infection of endocardium, usually valves, caused by microbial colonisation of thrombi on endocardial surfaces
Fever, heart murmur, embolic phenomena, skin manifestations, splenomegaly, septic complications, mycotic aneurysm
Prolonged antibiotic treatment, cardiac valve damage
Arrhythmias
Slow arrhythmias and fast arrhythmias are called VF definition VF causes (4) VF treatment (2) Asystole definition AF definition AF signs and symptoms (6) AF increases risk of (3)
Brady (heart block - slow - pacemakers treat), tachy
Disorganised ventricular activity; unstable heart activity
MI, electrocution, long QT syndrome, Wolf-Parkinson-White syndrome
AED, CPR
Absence of ventricular contractions lasting longer than the the maximum time for sustainable life (2s)
Rapid irregular beating of the atria
Often none - palpitations, fainting, lightheadedness, SoB, chest pain
CVA, MI, dementia
