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Year 3 - MedEd Lectures > Cardio 1 > Flashcards

Cardio 1 Flashcards

1
Q

What is the difference between low and high output Heart Failure?

A

Low Output:

  • Reduced Cardiac Output
  • Fails to increase with exertion

High Output:

  • Increased needs (Pregnancy, hyperthyroidism)
  • Normal Cardiac Output
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2
Q

What are the main causes of Chronic Left-Sided Heart Failure?

A

Valvular

Heart Muscle

Systemic

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3
Q

What are the valvular causes of Chronic Left-Sided Heart Failure?

A

Aortic Stenosis (Increased Afterload)

Aortic Regurgitation (Increased pressure in the LV)

Mitral Regurgitation (Increases Preload)

*All these lead to remodelling and hypertrophy of the LV

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4
Q

What are the muscular causes of Chronic Left-Sided Heart Failure?

A

Ischaemic Heart Disease

Cardiomyopathy

Myocarditis

Arrhythmias

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5
Q

What are the systemic causes of Chronic Left-Sided Heart Failure?

A

Hypertension

Amyloidosis

Drugs:

  • Alcohol
  • Cocaine
  • Chemotherapeutics (eg. doxorubicin)
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6
Q

What are the causes of Chronic Right-Sided Heart Failure?

A

Left Heart Failure (Congestive)

Pulmonary Hypertension

Pulmonary Embolism

Chronic Lung Disease (Interstitial, fibrosis, CF)

Tricuspid Regurgitation

Pulmonary Valve Disease

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7
Q

What are the main causes of High-Output Heart Failure?

A

NAP MEALS

Nutritional Deficiency (Thiamine)

Anaemia

Pregnancy

Malignancy

Endocrine (Hyperthyroidism)

AV Malformations

Liver Cirrhosis

Sepsis

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8
Q

What are the main presenting symptoms of Left Heart Failure?

A

Exertional Dyspnoea

Orthopnoea

Nocturnal Dyspnoea

Fatigue

Nocturnal Cough (Pink, frothy sputum)

Wheeze

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9
Q

Which signs would you observe on a patient with Left Heart Failure?

A

Pulsus Alternans

AF (Co-existent with Mitral Regurgitation)

Displaced Apex Beat

S3 Gallop Rhythm

S4 in severe HF

Murmur (due to underlying cause)

Fine end-insiratory crackles at lung bases

Wheeze

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10
Q

What are the main presenting symptoms of Right Heart Failure?

A

Swelling (Pitting Ankle Oedema, ascites etc)

Weight Gain

Fatigue

Reduced exercise tolerance

Anorexia

Nausea

Nocturia

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11
Q

What are the main signs you may observe on a patient with Right Heart Failure?

A

Face Swelling

Raised JVP

Tricuspid Regurgitation murmur

Ascites

Hepatomegaly

Pitting Oedema in ankles and sacrum

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12
Q

What is Cor Pulmonale?

A

RHF due to increased Pulmonary Pressure

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13
Q

How would you investigate suspected Heart Failure?

A

ECG

FBC, U&Es, LFTs, TFTs, BNP (used to exclude HF)

CXR

Transthoracic Echo with Doppler - Diagnostic

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14
Q

How would you manage a case of Heart Failure?

A

Treat the Cause

Lifestyle advice

Ace Inhibitors

Beta Blockers

Diuretics

Digoxin

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15
Q

How does Acute HF differ from Chronic HF?

A

Rapid onset/worsening of symptoms of Heart Failure.

Either due to:

Acute worsening of existing Heart failure Symptoms

or

New-onset symptoms, often due to ACS

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16
Q

How would you manage a case of Acute Heart Failure?

A

ABC

Sit patient up

High flow O2

Furosemide IV

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17
Q

What are the main complications of Heart Failure?

A

Pleural Effusion

Renal Failure

Acute Exacerbations

Death

18
Q

What is the prognosis for Heart Failure?

A

50% of severe cases die within 2 years.

2-20% mortality in acute cases

19
Q

How is Cardiomyopathy defined?

A

A group of disease in which the myocardium becomes structurally and fucntionally abnormal.

20
Q

How does Cardiomyopathy typically present?

A

Symptoms of HF may occur (Dizziness, SOB on exertion)

Collapse

Sudden Death

FHx

21
Q

Which signs on examination could point towards a diagnosis of Cardiomyopathy?

A

Signs of HF (resp. crackels, increased JVP)

Murmurs

S3

S4

22
Q

How would you investigate suspected Cardiomyopathy?

A

Bloods

BNP
CXR

ECG

Stress testing

Echo

Cardiac Catheterisation

23
Q

What is Dilated Cardiomyopathy?

A

Enlarged Ventricles become dilated and weaken, preventing effective contraction.

24
Q

What may cause Dilated Cardiomyopathy?

A

Alcohol

Viral Illness

Autoimmune conditions

Haemochromatosis

Hereditary

25
Q

How would you investigate suspected Dilated Cardiomyopathy?

A

CXR - Globular Heart

Echo - Dilated Ventricle

Signs/Symptoms of Tricuspid and Mitral Regurgitation

26
Q

What is Hypertrophic Cardiomyopathy (HOCM)?

A

The heart muscle thickens inwards, eventually blocking blood flow out of the ventricle.

In SBAs - Tends to be Young Athletes having Syncopal Episodes with FHx of Sudden Cardiac Death

27
Q

Describe the inheritance pattern of HOCM.

A

Autosomal Dominant

50% of cases are Familial

28
Q

How would you investigate suspected Hypertrophic Cardiomyopathy?

A

ECG

Q waves

LAD

LVH signs

Echo

Ventricular Hypertrophy

29
Q

How would Left Ventricular Hypertrophy appear on an ECG?

A

Deep S in V1/V2

Tall R in V5/6

S in V1 + R in V5 or V6

30
Q

What is Restrictive Cardiomyopathy

A

Ventricles become abnormally Rigid.

This means they progressively lack the flexibility to expand as the ventricles fill with blood.

31
Q

What is Kussmaul’s Sign?

A

Paradoxical rise in JVP in inspiration.

Due to restricted filling of the Ventricles.

Seen in restrictive Cardiomyopathy.

32
Q

What is Arrhythmogenic Right Ventricular Cardiomyopathy?

A

Progressive fatty and fibrous replacement of the Ventricular Myocardium.

33
Q

What is Constrictive Pericarditis?

A

Chronic Inflammation of the Pericardium, leading to thickening and scarring.

34
Q

What may cause Constrictive Pericarditis?

A

Idiopathic

Infectious (TB, Bacterial, Viral)

May be acute

Cardiac Surgery and Radiation

35
Q

How does Constrictive Pericarditis present?

A

Resembles Restrictive Cardiomyopathy

Kussmaul’s Sign

36
Q

How would you investigate a suspected case of Constrictive Pericarditis?

A

CXR - Pericardial Calcification

Echo - Increased Pericardial Thickness

Cardiac CT/MRI (Usually before surgical management)

37
Q

What is Myocarditis and what causes it?

A

Inflamation of the Myocardium in the absence of ischaemia

Causes include:

Infection

Drugs (Cocaine, penicillins, cephalosporins, digoxin, anticonvulsants)

Radiation

38
Q

How does Myocarditis typically present?

A

Symptoms

Flu-like symptoms

Positional Chest Pain (Worse when lying)

SOB Palpitations

Signs

Pericardial Rub

Arrhythmias

39
Q

How would you investigate a suspected case of Myocarditis?

A

ECG (Non-specific ST changes, T-Wave abnormalities)

CK & Troponin (Mild rise, not seen in pericarditis)

Endomyocardial Biopsy (Diagnostic, not routinely performed)

40
Q

Which murmur would likely be heard in a patient with HOCM?

A

Ejection Systolic

HOCM leads to Aortic Stenosis

Year 3 - MedEd Lectures (29 decks)

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