a little bit more of the cardiovascular Flashcards
Stuff nearer the end of the list, but nevertheless important.
pathology of peripheral vascular disease
atherosclerotic blockages leading to arterial insufficiency
signs of peripheral vascular disease
pallor pulses decreased perishing cold pain paraesthesia paralysis
symptoms of peripheral vascular disease
impairment in walking pain discomfort numbness tiredness in legs that is relieved by rest
treatment of peripheral vascular disease
exercise revascularisation stenting ACEi BB antiplatelets
diagnosis of peripheral vascular disease
pt with a history of leg pain relieved by rest
MRI angiography
duplex US
what is critical limb ischaemia?
Fontaine classification 4 peripheral arterial disease
signs of critical limb ischaemia
ulceration
gangrene
intermittent claudication
symptoms of critical limb ischaemia
burning pain at night, relieved by hanging legs over the bed
complications of critical limb ischaemia
gangrene
mass tissue loss
diagnosis of critical limb ischaemia
triad of rest pain, arterial insufficiency, gangrene & ulcers
pathology of pericarditis
inflammation of the pericardium
signs of pericarditis
central chest pain relived by leaning forward fever pericardial rub (like crunching snow) tachypnoea tachycardia cough dyspnoea pulsus paradoxus Beck's triad hiccups
what is Beck’s triad? (cardiac tamponade)
distant heart sounds
distended jugular veins
decreased arterial pressure
what causes constrictive pericarditis?
build up of calcium around heart
complications of pericarditis
tamponade - compression upon atria (and later the ventricles)
treatment of pericarditis
analgesia
steroids/immunosuppressants
treat primary pathology
ECG diagnosis of pericarditis
diffuse ST elevation
PR depression
sinus tachycardia
concave ST segment with no reciprocal ST depression
how to distinguish STEMI from pericarditis on ECG
for pericarditis, everything above the isoelectric line looks normal
pathology of aortic stenosis
orifice reduced to a quarter of normal size due to…
degenerative calcification
congenital
rheumatoid factors
signs of aortic stenosis
murmur
pulsus trades et parvus (slow rising)
soft/absent 2nd heart sound
symptoms of aortic stenosis
syncope
angina
dyspnoea
treatment of aortic stenosis
surgery - TAVI - inflate balloon to open valve (don’t give vasodilators)
ECG diagnosis of aortic stenosis
P mitrale (bifid P wave)
diagnostic tests for aortic stenosis
ECG LVH LAD CXR echocardiogram
pathology of mitral regurgitation
regurgitation causes left atrial dilation which causes pulmonary venous HTN –> pulmonary HTN
regurgitation can also cause left ventricular dilation –> left ventricular hypertrophy – left ventricular heart failure due to volume overload
signs of mitral regurgitation
heart murmur
displaced hyper dynamic apex
atrial fibrillation
pan systolic murmur at apex radiating to axilla
symptoms of mitral regurgitation
fatigue
dyspnoea on exertion
complications of mitral regurgitation
pulmonary hypertension (pressure can back up to lungs)
LA and LV enlargement
heart failure
treatment of mitral regurgitation
surgery ACEi (vasodilation) BB (rate control) anticoagulation if AF present diuretics
ECG diagnosis of mitral regurgitation
P mitrale in lead II
evidence of LA enlargement
diagnostic tests for mitral regurgitation
ECG
CXR
echocardiogram
(evidence of LA enlargement on all of the above)
pathology of shock
circulatory failure - inadequate organ perfusion
types of shock
haemorrhage/hypovolaemic anaphylactic septic cardiogenic neurogenic
features of haemorrhage/hypovolaemic shock
bleeding
diarrhoea
ascites
pancreatitis
features of anaphylactic shock
vascular tone
histamine
urticaria
oedema
features of septic shock
SIRS + suspected infection + hypotension
causes of cardiogenic shock
pump failure
inadequate lining
causes of neurogenic/spinal shock
traumatic section
iatrogenic
signs of shock
pallor rapid but weak pulse low bp decreased capillary refill time oliguria confusion chest pain
treatment of shock
IV access
fluids
high flow oxygen
pathology of Naxos disease
arrhythmogenic cardiomyopathy
woolly hair and predisposition to ventricular tachycardia –> likely to drop dead
pathology of hypertrophic cardiomyopathy
sarcomeric gene mutations
pathology of dilated cardiomyopathy
cytoskeletal mutations
LV/RV/4 chamber dysfunction and failure
pathology of arrhythmic cardiomyopathy
desmosome gene mutation
symptoms of hypertrophic cardiomyopathy
angina
dyspnoea
palpitations
syncope
symptoms of dilated cardiomyopathy
heart failure symptoms
symptoms of arrhythmic cardiomyopathy
arrhythmia
complications of hypertrophic cardiomyopathy
arrhythmias due to fibrosis
sudden death - more likely if little bursts of ventricular tachycardia
complications of dilated cardiomyopathy
arrhythmias
diagnosis of cardiomyopathy
ECG
genetic tests
treatment of cardiomyopathy
beta blockers
ACEi
implantable defib
dilated cardiomyopathy likely to get a heart transplant
ECG sign of hypertrophic cardiomyopathy
deep T wave inversion
what is brigada?
ST elevation in anterior leads
