Breathlessness Flashcards
Which conditions cause increased in work of breathing through airflow obstruction?
Asthma
Chronic bronchitis
Tracheal obstruction
Which conditions cause increased work of breathing by decreased pulmonary compliance “stiff lung”?
Fibrosis
Pulmonary oedema
Which conditions caused increased work of breathing by restricted chest expansion?
Respiratory muscle paralysis
Which conditions cause increased ventilatory rate by V/! mismatch (physiological dead space)?
Infection
Pulmonary embolism
How does systemic hypertension lead to left ventricular failure?
Systemic Hypertension Raised peripheral resistance Increased ventricular afterload Left ventricular hypertrophy Left ventricular failure
How does left ventricular failure cause pulmonary oedema?
Increase pressure in left atrium and left ventricle (increase preload)
Back pressure on the lungs
Increase in pulmonary capillary hydrostatic pressure
Accumulation of fluid in interstitial/alveolar spaces (pulmonary oedema)
What is orthopnoea?
Breathlessness on lying flat
What is the sign that is described by patients as having to wake up suddenly during the night gasping for breath?
Paroxysmal nocturnal dyspnoea (PND)
How do you investigate chest pain?
ECG
CXR
ETT (if on exertion)
(Thallium)
How do you investigate dyspnoea?
ECG
CXR
ECHO
How do you investigate palpitation?
ECG
24-hr ECG
ECHO
How do you investigate a murmur?
ECG
ECHO
How do you investigate infective endocarditis?
Blood cultures
ECHO
What is thallium perfusion scintogoraphy?
Radiolabelled isotope taken up by normally perfused myocardial cells
Gamma camera counts radioactivity across the myocardium
Image taken at rest and after stress (exercise/pharma-induced)
Radioactivity should be equal over whole myocardium
What does unequal distribution of radioactivity over the myocardium suggest?
Perfusion defect (fixed = infarction: reversible = ischaemia)
What is ECHO used for?
Non-invasive visualisation of the cardiac chambers and valves
What is cardiac catheterisation?
Insertion of flexible gathers into heart and coronary arteries
What is cardiac catheterisation used for?
Allows pressure to be measured via transducers or radio contrast to be injected to take x-ray pictures
Allows examination of valves, ventricular function, CO, systemic or pulmonary artery pressure, vascular resistance, shunt quantification, view of aorta + coronary arteries, abnormal communication
What is CT coronary angiography?
X-ray exam with iodine containing contrast material to determine if fatty / calcium deposits have narrowed the patient’s coronary arteries
CT coronary angiography is indicated as an investigation for?
Anatomical abnormalities IHD PE MASK causes of chest pain Congenital heart disease Myocardial function
