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Pre-Reg Clinical > 2. Cardiovascular system (2) > Flashcards

2. Cardiovascular system (2) Flashcards

1
Q

Types of arrhythmia (5)

A 
Ectopic beat
Atrial fibrillation
Atrial flutter
Paroxysmal supraventricular tachycardia
Ventricular tachycardia
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2
Q

Types of bleeding disorders (2)

A

Clotting factor disorders

Subarachnoid haemorrhage

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3
Q

Types of blood clots

A

Clots in catheters and lines
VTE
Stroke

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4
Q

Types of blood pressure conditions

A 
Hypertension
Hypertension associated with phaeochromcytoma (adrenal gland tumour)
Hypertensive crises
Pulmonary hypertension
Hypotension and shock
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5
Q

Types of vascular disease

A

Peripheral vascular disease

Vein malformation

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6
Q

Describe the path of deoxygenated blood from the body to the supply of oxygenated blood to the body

A

Returns to the right atrium via the superior/ inferior vena cava
From the right atrium to the right ventricle via the tricuspid valve
From the right ventricle to the pulmonary artery via the pulmonary valve
From pulmonary artery to lungs where oxygenated
From the lungs to the left atrium via the pulmonary veins
From the left atrium to the left ventricle via the mitral valve
From left ventricle to aorta via aortic valve
From aorta, oxygenated blood supplied to body (returned via vena cava!)

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7
Q

Conduction system of the heart

A

Sinoatrial node is the pacemaker
Creates and action potential
Wave of excitation spreads across the atria, causing them to contract
On reaching the AV node, the signal is delayed
Then conducted in the bundle of HIs down the intervetricular septum
Bundle of His and Purkine fibres spread the wave impulses along the vetricles, causing them to contract

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8
Q

Conditions that affect the cardiovascular system

A
  1. Arrhythmias
  2. Clotting disorders
  3. Blood clots
  4. Blood pressure conditions
  5. Cardiovascular disease risk (+prevention)
  6. Heart failure
  7. Hyperlipidemia
  8. Myocardial ischaemia
  9. Oedema
  10. Vacular disease
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9
Q

What is an ectopic beat?

A

An extra or missed beat

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10
Q

What is an arrhythmia?

A

A condition in which the heart beats with an irregular or abnormal rhythm

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11
Q

What is atrial fibrillation?

A

Rapid and irregular beating of the atria

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12
Q

What is atrial flutter?

A

Rapid beating of the atria

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13
Q

What is paroxysmal supraventricular tachycardia (SVT)?

A

Heart suddenly beats much faster than normal. It can then slow down abruptly. Due to improper electrical activity in the upper part of the heart. Cause not known

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14
Q

Types of supraventricular tachycardias?

A

AF
Atrial flutter
Paroxysmal supraventricular tachycardia
Wolff-Parkinson White syndrome

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15
Q

Ventricular tachycardia

A

Regular, fast heart rate that arises from improper electrical activity in the ventricles of the heart

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16
Q

Ventricular fibrillation

A

Abnormal heart rhythm in which the ventricles of the heart quiver instead of pumping normally

17
Q

Treatment for ectopic beats

A

Nothing if heart normal, reassure patient. If particularly troublesome, beta blockers sometimes effective.

18
Q

Treatment for AF

A
  • Assess for stroke and bleed risk: anticoagulate as appropriate
  • Ventricular rate control (first line)
  • Sinus rhythm control (2nd line)
  • Paroxysmal
  • Electrical cardioversion
  • Pharmacological cardioversion
  • Ablation strategy
  • Pacemaker
19
Q

Anticoagulation for AF patients

A

CHA2DS2-VASc and HAS-BLED used to assess
Warfarin
DOAC if non-valvular cause
Anticoags also indicated during cardioversion
Aspirin less effective than warfarin at preventing eboli - should not be offered as a monotherapy solely for stroke prevention in atrial fibrillation

20
Q

Ventricular rate control treatment for AF patients

A
  1. Standard beta blocker (NOT sotalol)
  2. Rate limiting CCB
    Only use digoxin if sedentary patient and not paroxysmal, as only works to control ventricular rate at rest
    If don’t work as monotherapy, can use two in combination
21
Q

Sinus rhythm control treatment for AF patients

A

If ventricular function diminished - beta blocker (licensed for HF) +digoxin
If post-cardioversion: standard beta blocker
If not effective, consider oral antiarrhythmic (sotalol, flecanid,e propafenone, dronedarone)
If necessary, start amiodarone (consider in atients with left ventricular impairmnet/ HF)

22
Q

Treatment for paroxysmal AF

A

If symptomatic, control ventircular rate with a beta blocker.
If doesn’t work, an oral anti-arrhythmic drug e.g. dronedarone/ sotalol/ amiodarone can be given.
If infrequent episodes, ‘pill in hte pocket’ approach

23
Q

Electrical cardioversion treatment for AF

A

Controlled electric shock to try and restore rhythm

24
Q

Pharmacological cardioversion treatment for AF

A

Oral/ IV antiarrhythmic drug e.g. flecainide/ amiodarone

25
Q

Catheter ablation treatment for AF

A

Carefully destroys the diseased area of heart and interrupts abnormal electrical circuits

26
Q

Pacemaker treatment for AF

A

Small battery operated device implanted in chest just below collarbone. Can be used to help the heart beat regularly

27
Q

CHA2D2-VASc score for assessing thrombus risk in AF

A 
CHF(HF)
Hypertension
Age over 75 (2 points rather than 1)
Diabetes
Stroke/ TIA (2 points rather than 1)
Vascular disease
Age 65-74
Sex Category (female = 1 point)
As per NICE, anticoagulation treatment generally indicated by CHA2DS2VASC score of 2 or more. Treatment should also be considered for males with a score of 1 or more.
28
Q

HAS-BLED for assessing bleed risk in AF

A 
1 point for:
- HTN
- Abnormal liver function
- Abnormal renal function
- Stroke 
- Bleeding
- Labile INR
- Elderly (over 65)
- Drugs (antiplatelet/ NSAID)
- Harmful alcohol consumption
Use this to assess risk and facilitate the identifictaion of modifiable risks for bleeding e.g. uncontrolled HTN/ harmful etoh consumption, concurrent use of aspirin/ NSAID

Pre-Reg Clinical (25 decks)

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