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Year 1 - BRS > 6.18 - Cardiovascular Disorders > Flashcards

6.18 - Cardiovascular Disorders Flashcards

1
Q

What is the definition of heart failure?

A

Heart unable to maintain adequate circulation for metabolic requirements of body

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2
Q

What is systolic heart failure?

A
  • reduced ejection fraction (HFrEF) where EF > 40% but reduced systolic function
  • left ventricle has weakened heart muscle and muscle is more dilated so less able to pump blood out of it thus reduced EF
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3
Q

What is diastolic heart failure?

A
  • preserved ejection fraction (HFpEF) where EF > 50% and reduced diastolic function
  • stiff heart muscle in left ventricle means smaller area for blood in it so less blood fills ventricle - but still get reasonable amount pumped out which is why EF is preserved
  • so you get ventricular hypertrophy
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4
Q

What is the main ECG finding of heart failure?

A

Bigger QRS complex due to increased muscle mass in heart so more electrical current - not always found in heart failure

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5
Q

What are some underlying causes of heart failure?

A
  • secondary to cardiac damage (ischaemia, myopathy)
  • hypertension
  • valve disease
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6
Q

What are the signs and symptoms of heart failure?

A

Exertional dyspnoea (i.e. breathlessness during exertion)

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7
Q

What are the tests for heart failure?

A
  • blood test - elevated brain natriuretic peptide (BNP)
  • chest X-ray - cardiomegaly
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8
Q

What are the treatment options for heart failure?

A

Drugs that reduce the exertional pressure on the heart

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9
Q

What is atrial fibrillation? (Electrical transmission disorders - atrial arrhythmias)

A
  • disorganised electric activity and contraction due to pacemaker cells forming in regions outside of SAN and AVN
  • prevents smooth transition of electrical current from SAN to AVN
  • caused by spontaneously active cells throughout the atria
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10
Q

What are the ECG findings for atrial fibrillation?

A

Absent P-waves and ‘irregularly irregular’ rhythm

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11
Q

How is atrial fibrillation treated?

A

Strategies to maintain sinus rhythm (e.g. cardioversion, anti-arrhythmics, catheter ablation)

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12
Q

What is Wolff-Parkinson-White (WPW)? (Electrical transmission disorders - atrial arrhythmias)

A
  • syndrome causing tachycardia and abnormal cardiac electrical conductance
  • caused by additional accessory conduction pathway (the bundle of Kent) between the atria and ventricles
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13
Q

What are the ECG findings for Wolff-Parkinson-White?

A
  • QRS pre-excitation
  • biphasic/inverted T-wave of ECG - caused by current not being stopped at AVN and another depolarisation starting when ventricles are still repolarising
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14
Q

What are the treatment options for Wolff-Parkinson-White?

A

Benign - no treatment required

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15
Q

What are the signs and symptoms of atrial fibrillation and Wolff-Parkinson-White? (Atrial arrhythmias - electrical transmission disorders)

A

Palpitations and chest pain

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16
Q

What is a first-degree block? (Conduction block - electrical transmission disorders)

A

Slowing down of conduction through AV node (like a traffic jam where current cannot pass through AVN from atria to ventricles as well)

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17
Q

What is the ECG like for a first-degree block?

A

Increased P-R interval

18
Q

What is a second-degree block? (Conduction block - electrical transmission disorders)

A

Reduced transmission of signal from atria to ventricles (types I, II, III)

19
Q

What is the ECG like for a second-degree block?

A

Increased P-R interval or ‘missing’ QRS complexes, depending on type of block

20
Q

What is a third-degree block? (Conduction block - electrical transmission disorders)

A
  • complete block of current from atria to ventricles
  • medical emergency - no ventricular depolarisation and muscle contraction
21
Q

What is the ECG finding for a third-degree block?

A

P-waves not followed by QRS complexes

22
Q

What is the underlying cause of conduction block?

A

Damage (fibrosis, calcification, necrosis) to the conduction system (AV node or His-Purkinje system)

23
Q

What are the treatment options for conduction block?

A
  • discontinuation of AV-blocking drugs (e.g. beta-blockers, calcium channel blockers)
  • pacemaker implantation in severe cases
24
Q

What is hypertension? (Vasculature disorders)

A

Clinical BP > 140/90 mmHg & ambulatory BP daytime average > 135/85 mmHg for prolonged period

25
Q

What does hypertension increase the risk of?

A
  • stroke
  • MI & heart failure
  • kidney disease
  • these can also turn around and increase risk of hypertension = vicious circle
26
Q

What are the underlying causes of hypertension?

A
  • primary (essential) - unknown
  • secondary - resulting from another medical condition e.g. kidney disease, adrenal disease
27
Q

What investigations can be done into hypertension?

A

Blood pressure measurement: readings > 135/85 mmHg

28
Q

What are the treatment options for hypertension?

A

Lifestyle changes followed by anti-hypertensive medication

29
Q

What are the types of acute coronary syndromes?

A
  1. Angina - chest pain due to myocardial ischaemia caused by atherosclerosis (two types - stable and unstable)
  2. Non-ST-elevated myocardial infarction (NSTEMI) - myocardial tissue damage due to prolonged ischaemia caused by atherosclerosis and artery blockage, coronary artery partially occluded
  3. ST-elevated myocardial infarction (STEMI) - serious myocardial tissue damage due to prolonged ischaemia caused by severe atherosclerosis and complete artery blockage
30
Q

What are the signs and symptoms of angina?

A

Chest pain on exertion (stable) or at rest (unstable)

31
Q

What is the ECG finding for angina?

A

Not too likely to see changes

32
Q

What is the treatment for angina?

A

Vasodilators

33
Q

What is the underlying cause for angina?

A

Atherosclerosis lesions of the coronary artery causing ischaemia

34
Q

What are the signs and symptoms of NSTEMI?

A
  • chest pain
  • sweating
  • nausea
  • vomiting
35
Q

What are the ECG and blood test findings for NSTEMI?

A
  • ST-depression/no changes
  • high troponin levels
36
Q

What are the treatment options for NSTEMI?

A
  • coronary stents
  • antiplatelets
  • vasodilators
  • anti-emetics
  • oxygen
  • pain-relief
37
Q

What is the underlying cause of NSTEMI?

A

Artery blockage

38
Q

What are the signs and symptoms of STEMI?

A
  • radiating chest pain
  • sweating
  • nausea
  • vomiting
39
Q

What are the ECG and blood test findings for STEMI?

A
  • ST-elevation with reciprocal ST-depression
  • high troponin levels
40
Q

What are the treatment options for STEMI?

A
  • coronary stents
  • antiplatelets
  • vasodilators
  • anti-emetics
  • oxygen
  • pain-relief
41
Q

What is the underlying cause of STEMI?

A

Complete artery blockage

Year 1 - BRS (73 decks)

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