Cardiac disorders Flashcards
Heart failure?
Heart cannot maintain enough circulation for metabolic requirements of body
Comes secondary to cardiac damage
What is HFpEF?
Heart failure with preserved ejection fraction:
Ejection fraction >= 50% and decreased diastolic function
What is HFrEF?
Heart failure with Reduced ejection fraction:
Ejection fraction >= 40% and decreased systolic function
What does cardiac damage include?
Ischaemia, myopathy, hypertension, valve diseae
Signs and symptoms of heart failure?
Extertional dyspnoea = Shortness of breathduring exercise
What tests show heart failure?
Blood test to check elevated brain natriuretic peptide – BNP
Chest X –ray to look for cardiomegaly
What is worse systolic failure or diastolic failure?
Systolic heart failure is due to weakened heart muscle and hence the dilation causes reduced ejection fraction
Diastolic has no effect on ejection fraction despite a smaller than normal area for blood.
- Enlarged QRS can be seen due to increased muscle mass in Diastolic
What is atrial fibrilliation?
disorganized electric activity and contraction
Due to spontaneously active cells throughout the atria
What is Wolff-parkinson-white syndrome?
– syndrome that causes tachycardia and abnormal cardiac electrical conductance
Due to extra accessory conduction pathway knows as the bundle of Kent between atria and ventricle
What are the signs and symptoms of electrical transmission disorders ? ( Wolff + atrial fib )
Palpitations and chest pain
What does an ECG for atrial fib look like?
No p wave, irregular rhythm
What does ECG for Wolff look like?
QRS pre-excitation and inverted T wave ( biphasic )
Treatments for Atrial fibrillation?
maintain sinus such as – cardioversion, anti-arryhthmics, catheter ablation
What is a first degree conduction block?
Slowing down of conduction through AV node
What is a second degree block?
reduced transmission of signal from atria to ventricles
What is a third degree block?
complete block of current from atria to ventricles
What can cause heart block?
Damage to conduction system ( fibrosis, calcification, necrosis)
What can be found in a first degree ECG?
Increased P-R interval
What can be found in a second degree ECG?
Increased P-R or missing QRS depending of block type
What can be found in a third degree ECG?
P waves no followed by any QRS
Treatments for heart blocks?
discontinuation of AV-blocking drugs eg. (e.g. beta-blockers, calcium channel blockers)
pacemaker implantation in severe cases
What is hypertension?
Clinical BP ≥ 140/90 mmHg & ambulatory BP daytime average ≥ 135/85 mmHg
- hypertension itself isnt the problem, it increases risk of stroke, HF, MI and Kidney disease
What cases hypertension
Primary hypertension : unknown cause
Secondary hypertension : resulting from another medical condition e.g. Kidney disease, adrenal disease
How to treat hypertension?
Lifestyle changes followed by anti-hypertensive medication
What is Angina?
Chest pain due to myocardial ischaemia caused by atherosclerosis
What is NSTEMI?
Non - ST elevated myocardial infarction : Myocardial tissue damage due to prolonged ischaemia caused by atherosclerosis and artery blockage
What is STEMI?
ST-elevated myocardial infarction
Serious myocardial tissue damage due to prolonged ischaemia caused by severe atherosclerosis and complete artery blockage
What causes acute coronary syndromes ?
Atherosclerotic lesions of the coronary artery causing ischaemia (angina), artery blockage (NSTEMI) and then complete artery blockage (STEMI)
Signs and symptoms for angina, STEMI and NSTEMI?
Angina: chest pain on exertion (stable) or at rest (unstable)
NSTEMI: chest pain, sweating, nausea & vomiting
STEMI: radiating chest pain, sweating, nausea & vomiting
NSTEMI ECG? and bloods
ST depression / no changes and high troponin levels in blood test
STEMI ECG? and bloods
ST elevation with reciprocal ST depression and high troponin levels in blood test
How to treat Angina?
Vasodilators
How to treat NSTEMI and STEMI?
coronary stents, antiplatelets, vasodilators, anti-emetics, oxygen & pain-relief
