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STP 1st year exams > Cardiac > Flashcards

Cardiac Flashcards

1
Q

Heart failure =

A

Heart cannot pump blood to body at rate that is needed

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2
Q

coronary veins drain into…

A

right atrium via coronary sinus

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3
Q

heart function =

A

filling (diastole)

pumping (systole)

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4
Q

Systole determines…

A

cardiac output

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5
Q

Cardiac output =

A

stroke volume x HR

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6
Q

cardiomyopathy =

A

cardiac muscle abnormality (enlarged, thickened or stiff) - reduce effectiveness of heart - lead to HF

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7
Q

Dilated cardiomyopathy

A

dilated ventricles

less blood pumped from heart as ventricles are dilated and weakened

can lead to systolic HF (decrease in ejection fraction)

caused by excessive alcohol, pregnancy, genetic

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8
Q

Hypertrophic cardiomyopathy

A

ventricular hypertrophy

thick ventricles = small chamber = prevents proper filling

less blood pumped from heart because ventricles cannot fully relax

can lead to diastolic HF (doesn’t influence ejection fraction)

Caused by mutations in genes encoding sarcomeric proteins = myocardial disarray

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9
Q

Restrictive cardiomyopathy

A

stiff heart muscles = diastolic problems = dilated atria

LV maintains normal dimensions but left atrial hypertrophy and dilation

back flow of blood from LA to pulmonary system

this leads to right ventricular hypertrophy

e.g. cardiac amyloidosis

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10
Q

myxoma

A

cardiac tumour

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11
Q

Arryhthmogenic right ventricle cardiomyopathy

A

effects right ventricle (can effect left)

mutation in desmosome

Mutations that cause desmosomal abnormality = causes fibrofatty replacement of RV muscle

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12
Q

Brugada syndrome is caused by

A

Sodium ion channel abnormality in RV epicardium

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13
Q

Causes of Left Ventricular Hypertrophy…

A

Hypertension

Aortic stenosis

Coarctation of the aorta

Cardiomyopathies

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14
Q

Causes of Right Ventricular Hypertrophy …

A

Chronic obstructive pulmonary disease

Idiopathic pulmonary hypertension

Pulmonary stenosis

Complex congenital heart disease

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15
Q

Syncope =

A

reversible LOC due to inadequate blood flow to the brain

fast onset

short duration

spontaneous recovery

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16
Q

Non-cardiac cause of syncope =

A

Reflex - vasovagal or carotid sinus syndrome (usually a prodrome - sweating, nausea, pallor = patient feels like they will pass out so try to hold on to something)

Neural - situational (follows a specifc trigger like coughing)

Orthostatic hypotension - autonomic failure or volume depletion (haemorrhage, vomiting) - patient may feel dizzy when changing position

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17
Q

Non- cardiac cause of LOC =

A

epilepsy, stroke, pulmonary embolus, hypoglycaemia

18
Q

Cardiac causes of syncope =

A

arrhythmia - Brady/tachy

aortic stenosis

HCM

prosthetic valve dysfunction

MI

acute aortic dissection

19
Q

How to know if syncope is cardiac?

A

no prodome = no warning/trigger

patient just drops

may hear heart murmur

ECG/ ambulatory monitor (?pauses, HB, arrhythmia)

echo might show structural abnormality

20
Q

cardiac output (systole) is influenced by…

A

contractility of myocardium

preload (amount of blood filling ventricles before systole)

afterload applied to ventricles (what ventricles have to overcome to push blood out of heart)

heart rate

21
Q

HF early adaptations

A

reduced stroke volume + decreased cardiac output

increased amount of blood left in ventricles in diastole (increased end diastolic volume)

= muscle fibres in ventricles lengthen + tighten more to promote more forceful contraction to eject excess blood (frank-starling law)

increased end diastolic volume = increased contractility = increased cardiac output

Reduced cardiac outpatient is also picked up by baroreceptors = activation of sympathetic nervous system = stimulation of increased myocardial contractility = increased cardiac output , increased HR, increased venous retention

22
Q

HF chronic adaptations

A

sympathetic activation causes ventricular remodelling + dysfunction

reduced cardiac output also causes decreased renal blood flow = activated renin-angiotensin-aldosterone system = further contributes to cardiac remodelling + dysfunction

eventually chronic adaptations cause increased pressure in ventricles = increased pressure in atria = pulmonary congestion + peripheral oedema

23
Q

right sided HF symptoms

A

congestion of peripheral tissue

increased mutual venous pressure

pitting Lower leg oedema

liver congestion

24
Q

left sided HF symptoms

A

reduced cardiac output = pre syncope, fatigue, SOB on exertion, orthopnea,

pulmonary congestion = SOB, cough, course crackles, hypoxia

excessive pulmonary congestion = pulmonary hypertension = right sided HF

25
Q

ventricular remodelling can be

A

eccentric = systolic problem = HFrEF

concentric = diastolic problem = HFpEF

26
Q

eccentric ventricular remodelling -

A

HFrEF

EF <40%

systolic (pumping) problem

27
Q

concentric ventricular remodelling -

A

HFpEF

EV >50%

diastolic (filling) problem

hypertrophy = smaller ventricle size + fibrosis/stiffness = reduced blood filling

EF is normal because heart can still pump the smaller volume of blood out

28
Q

HFrEF medication

A

systolic

Beta blockers

ACE inhibitors or ARB

Spironolactone

frusemide

29
Q

HFpEF medication

A

diastolic

ACE inhibitors or ARB

Spironolactone

frusemide

*no beta blocker

30
Q

EF =

A

ejection fraction = % blood ejected by heart with each beat

31
Q

HF investigations

A

BNP - released by damaged myocytes

ECG - ?ischemic event/arrythmia

Echo - ?EF, ventricle size

Chest xray - cardiomegaly (large), pulmonary oedema (fluid in lung), pleural effusion (fluid around lung)

32
Q

HFrEF treatment

A

cardiac resynchronisation device

ICD

Ventricular assisted devices

heart transplant

33
Q

causes of HFpEF:

A

hypertension - LVH

aortic stenosis

cardiomyopathy

associated with OSA, obesity, diabetes

34
Q

aspirin =

A

anti-thrombotic

prevents blood clotting

give for MI

35
Q

nitrates =

A

vasodilator

open up vessels

given as GTN spray to relieve angina

36
Q

ACE inhibitor =

A

anti-hypertensive

reduces blood pressure

37
Q

beta-blocker =

A

anti-arrythmic

38
Q

calcium channel blocker =

A

anti-hypertensive

reduces blood pressure

39
Q
A
40
Q

increased end diastolic volume =

A

increased contractility = increased cardiac output

STP 1st year exams (4 decks)

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