Cardiac Conditions Flashcards
What is cardiomyopathy?
Disease of the heart muscle, causing it to become enlarged, thick or rigid
What are the 2 types of cardiomyopathy?
- Dilated cardiomyopathy
- Hypertrophic cardiomyopathy
What is dilated cardiomyopathy?
- L ventricle enlarged
- Thinner walls weakened and not able to contract normally
- Caused by genetics, viral infections or exposure to toxins
What is hypertrophic cardiomyopathy?
- Portion of the heart becomes thickened without an obvious cause
- Hear unable to pump blood effectively
What are the 2 types of septal defect?
- Atrial
- Ventricular
What are the symptoms of an atrial septal defect?
- Shortness of breath
- Cyanosis
- Recurrent chest infections
- Lethargy
What is a ventricular septal defect?
- Genetic defect (sometimes linked with Down’s syndrome)
- Complications include heart failure, hypertension and endocarditis
What is Marfans syndrome?
- Genetic condition affecting elasticity of skin, lungs and heart
- Characteristics include tall, slim frame, wide arm span, long digits and a concave chest
What is coronary heart disease?
- Coronary arteries become narrowed by a gradual build up of fatty material
- Caused by raised BMI, smoking, alcohol and a diet high in fat/sugar
What is peripartum cardiomyopathy?
Heart muscle enlarged during 3rd trimester or first few months PN
How are cardiac conditions managed?
- Consultant care
- IV diuretics
- Beta-blockers
- Hydralazine
- ACE inhibitors
Name the different parts of the circulatory system in order
R atrium - R AV valve - R ventricle - Pulmonary arteries - Lungs - Pulmonary veins - Left atrium - L AV valve - L ventricle - Aorta - Body - Vena cava
How does the heart contract?
- SA node sends an electrical signal to the atria
- Atria contract
- Signal travels to AV node and is delayed
- Signal travels down the Bundle of His
- Signal travels down Purkinje fibres
- Ventricles contract from bottom up
Why is the electrical signal delayed at the AV node?
To allow the blood to flow through to the ventricles
What are some of the main cardiac changes that occur in pregnancy?
- Vasodilation
- Increased cardiac output
- Decreased BP
What is chronic hypertension?
Women diagnosed with high BP before pregnancy or within the first 20 weeks (>140and/or >90)
What is it called when women are diagnosed with high BP after 20 weeks?
PIH or PET (depending on other symptoms)
What is the management for chronic hypertension?
- Advice (e.g. weight management, diet, exercise, reduce salt intake)
- Anti-hypertensives
- Aspirin
What are the most common anti-hypertensives used in pregnancy?
Labetalol
Nifedipine
Methyldopa
Why is aspirin given?
To reduce the risk of blood clots
What is the main cause of hypotension in pregnancy?
Shock (e.g. sepsis, haemorrhage, anaphylaxis)
What is the management for hypotension/ shock?
- Oxygen if needed
- IV access x 2
- Continuous cardiac monitoring
- Fluid balance (catheter)
- Treat underlying condition
What is sinus arrhythmia?
- Irregular HR
- Normal rate (60-100bpm)
- Normal PR and QRS intervals
What are PVCs?
- Premature ventricular contractions
- Also known as ectopic beats
- Normal rate (60-100bpm)
- Normal PR and QRS intervals
What is sinus tachycardia?
- Regular HR
- High HR (>100bpm)
- Normal PR and QRS intervals
What is 1st degree heart block?
- Regular HR
- Low HR (approx. 60bpm)
- Prolonged PR interval
- Normal QRS interval
What is agonal arrhythmia?
- Unable to determine rhythm
- Rate approx 2bpm
- No P wave
- Wide QRS interval
What is asystole?
No electrical activity evident
What is ventricular fibrillation?
- Irregular HR
- Unable to determine HR/ PR/ QRS intervals
- High amplitude(variability)
What is ventricular tachycardia?
- Regular rhythm
- Unable to determine HR/ PR interval
- QRS complex wide and unusual
What is central venous pressure?
Pressure in the vena cava near the R atrium relative to atmospheric pressure
What is preload?
The force from blood that stretches the cardiac muscle prior to contraction
What are some of the indications for a CVP line in an obstetric patient?
- Hypovolaemia
- PE
- Amniotic fluid embolism
- Hypotension
What is an amniotic fluid embolism?
Obstetric emergency where the AF enters the maternal blood stream, resulting in cardiorespiratory collapse and haemorrhage
What can cause an amniotic fluid embolism?
Starting oxytocin augmentation when the patients waters are still intact
How are CVP recordings taken?
- Must be zeroed at level of R atrium and each measurement taken in this zero position
- Manually displace the uterus to the left
What is a normal CVP reading?
7-14mmHg
What does an abnormal CVP reading indicate?
Increase = Patient's circulating volume is increasing Decrease = Patient's circulating volume is decreasing
What are some indications for arterial monitoring?
- Major haemorrhage
- Severe preeclampsia
- Maternal collapse
- Maternal sepsis
- ABG sampling
What does arterial monitoring measure?
MAP (Mean Arterial Pressure) = an average BP during the cardiac cycle
What is a normal MAP reading?
65-110mmHg
