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Year 3 > Cardio Core Conditions > Flashcards

Cardio Core Conditions Flashcards

1
Q

Who has an MI?

A

> 50 (risk increases with age)

M>F (pre menopause, post menopause risk is equal)

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2
Q

Causes of MI?

A 
Clot in CA due to atheroma beginning to rupture 
Clot travelling to the heart 
Inflammation of the CAs
Stab to the heart
Cocaine use
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3
Q

Risk factors for MI?

A 
HTN
High cholesterol
Lack of exercise 
Alcohol 
Smoking 
Hyperglycaemia
Age
FHx
Hypercholesterolaemia
Angina 
Ethnicity
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4
Q

Symptoms of an MI?

A 
Severe chest pain for >20 mins 
Not relieved with GTN
Pain moves up jaw, down L arm
Elderly/diabetics may complain of dyspnoea, fatigue, syncope 
Pale, clammy, sweating
Hypotensive, tachy or brady 
ST-elevation on ECG
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5
Q

Differentials for MI?

A 
ACS
Anxiety 
Aortic dissection 
Asthma
Endocarditis 
Oesophagitis
Gastritis
GORD
Hypotension 
Pancreatitis
PE 
Shock 
VSD
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6
Q

Investigations for MI?

A

ECG
Cardiac troponins, FBC, U+E, BM
Echocardiography for pericarditis, PE, aortic dissection

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7
Q

Treatment for MI?

A

MONAC
Fibrinolysis (reteplase, tenecteplase)
PCI

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8
Q

Who gets angina?

A

> 50y/o
M>F
Can occur in those younger as well

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9
Q

Causes of angina?

A

Narrowing of CAs due to atheroma
Artery spasm (variant)
Caused by exertion, lying down, nocturnal
Cardiac X syndrome (+ve exercise test, angiography = normal, good prognosis, highly symptomatic)
Unstable angina

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10
Q

Risk factors for MI?

A 
HTN
High cholesterol
Lack of exercise 
Alcohol
Smoking 
DM
Age
FHx
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11
Q

Symptoms of angina?

A 
Pain, ache, discomfort
Tightness in chest 
Ease on rest (not unstable)
SOB 
Nausea 
Fatigue 
Dizzy/restless
Check for anaemia, thyrotoxicosis, hyperlipidaemia
Check BP 
Exclude aortic stenosis
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12
Q

Differentials for angina?

A 
MI
Acute pericarditis 
MSK pain 
GORD
Pleuritic chest pain 
Aortic dissection 
Biliary colic
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13
Q

Investigations for angina?

A

ECG

FBC, U+E, BM, fasting cholesterol and triglycerides, LFTs, TFTs, troponin (emergency admission)

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14
Q

Treatment for angina?

A

GTN
B blockers or Ca blocker
+ in a long standing nitrate, ivabradine or tanolazine
Use slow release Ca blocker if on a beta blocker/ivabradine alongside the Ca blocker
Aspirin/clopidogrel
Stable angina + DM = ACEi
Statins if stable and due to atherosclerosis
Coronary revasc if high risk or unresponsive to therapy

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15
Q

Who gets AF?

A

M>F

Older

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16
Q

Causes of AF?

A 
HTN
Rh heart disease 
Alcohol intoxication 
Thyrotoxicosis
Heart failure 
Idiopathic/lone 
Seen post CA bypass in 1/3rd of patients 
Complication of IHD
Valve problems 
Cardiomyopathy 
Pericardial disease
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17
Q

Risk factors for AF?

A 
Congenital heart disease 
Obesity 
Caffeine
Smoking 
Amphetamine and cocaine use
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18
Q

Symptoms of AF?

A 
30% asymptomatic 
Fast irregular pulse 
Palpitations 
SOB 
Tired
Dizzy 
Chest pain 
Loss of exercise capability
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19
Q

Classifications of AF?

A

Paroxysmal (sudden bursts)
Persistent
Permanent (cardioversions unsuccessful)

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20
Q

Differentials for AF?

A 
Atrial flutter
Supraventricular tachyarrhythmias 
AVN re-entrant tachycardia
WPW syndrome 
Ventricular tachycardia
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21
Q

Investigations for AF?

A

ECG
FBC, TFTs, U+E, LFTs, coag screen
CXR
CT/MRI of head if evidence of TIA

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22
Q

Treatment for AF?

A

Thromboprophylaxis
Treat underlying cause
Cardioversion (anticoag 3 weeks prior and 4 weeks post)
Control arrhythmias (amiodarone, disopyramide, flecainide, propafenone)
Paroxysmal AF 1st line = B Blockers
Digoxin can only be used if patient is sedentary

23
Q

What percentage of adult HTN is essential HTN?

A

80-90%

24
Q

Who gets HTN?

A

M>F

Adults

25
Q

Causes of HTN?

A 
FHx
Low birth weight 
Lack of exercise 
Obesity 
Alcohol
Smoking 
Stress
High salt/fat diet
Type II DM
26
Q

Risk factors for HTN?

A

> 65
Ethnicity (black African)
Same as causes

27
Q

Symptoms of HTN?

A 
Persistent headache
Blurred vision 
Nosebleeds
SOB
May be asymp
>140/90mmHg each time it is taken 
Can be systolic, diastolic or both
28
Q

Differentials for HTN?

A 
Anxiety
Sleep apnoea 
Cardiomyopathy 
Cocaine
Congestive heart failure
PE 
Hyperaldosteronism 
Hyperthyroidism 
MI 
Stroke
29
Q

Investigations for HTN?

A

Urinalysis (protein/blood)
U+E, creatinine, cholesterol, BM
ECG
Risk factor calculator (>2/10 = risk of developing cardio disease in next 10 years)

30
Q

Treatment for HTN?

A 
Lifestyle changes (lose weight, exercise eat healthy, restrict caffeine/alcohol, stop smoking)
Diuretics 
ACEi
Angiotensin II receptor antagonist 
Ca channel blockers 
B blockers
31
Q

How many people per year in the UK have DVT?

A

1 in 1,000

32
Q

Who gets DVT?

A

Anyone

Risk increases with age

33
Q

Causes of DVT?

A 
Inactivity 
Post-surgery 
Damage to vessels (narrowing, vasculitis, varicose veins, chemo)
Cancer
Heart and lung disease 
Hepatitis 
RhA
Thrombophilia 
Hughes syndrome 
Pregnancy 
OCP and HRT
34
Q

Risk factors for DVT?

A 
Previous DVT/PE
FHx
Obesity 
Smoking 
Trauma
35
Q

Symptoms of DVT?

A 
Can be asymp
Red, hot, tender, swollen calf 
Engorged surface veins Ankle oedema
Homan's sign 
Unilateral (usually)
PE = SOB, pleuritic chest pain, sudden collapse
36
Q

Differentials for DVT?

A 
Baker's cyst 
Cellulitis 
Congestive HF 
Calf muscle haematoma 
Pelvic/thigh mass/tumour compressing venous outflow 
Thrombophlebitis
37
Q

Investigations for DVT?

A

Clinical picture
D-dimer levels
Ileofemoral thrombosis confirmed using B mode venous compression and doppler
Venography (contrast + XR)

38
Q

Treatment for DVT?

A

Warfarin and LMWH
Once warfarin is in a good INR range heparin is stopped
Compression stockings
Exercises

39
Q

What % of hospital admissions are due to HF?

A

5%

40
Q

Who gets LV-HF?

A

Increases with age

M>F (young men are at higher risk of ischaemic heart disease)

41
Q

Causes of LV-HF?

A 
Ischaemic heart disease 
HTN
Cardiomyopathy following infection 
Drug abuse 
Side effect of prescription drugs 
AF
Valvular heart disease 
Anaemia 
Hyperthyroidism
42
Q

Risk factors for LV-HF?

A

Male
Increasing age
Congenital cardiac disease
Cardiovascular risk factors

43
Q

Symptoms of LV-HF?

A 
Exertional dyspnoea 
Orthopnoea 
PND
Fatigue 
Oedema 
Haemoptysis 
Pleural effusion 
Cardiomegaly 
3rd and 4th heart sounds 
Elevated JVP 
Tachycardia 
Hypotension
44
Q

How is LV-HF classified?

A

1) No limitation in physical activity
2) Mild limitation
3) Marked limitation
4) Symptomatic at rest

45
Q

Differentials for LV-HF?

A 
Acute renal failure 
ARDS
COPD
Cirrhosis 
Emphysema 
MI
Nephrotic syndrome 
PE
46
Q

Investigations for LV-HF?

A 
FBC, U+E, cardiac enzymes, BNP, TFT 
CXR
ECG
Echo
Stress Echo
Cardiac MRI
47
Q

Treatment for LV-HF?

A 
Diet and weight control 
Stop smoking 
Alcohol in moderation 
Exercise 
Flu vaccination
Diuretics 
ACEi
Angiotensinogen II receptor antagonist 
Beta blocker 
Aldosterone antagonists 
Cardiac glycosides (dig)
Vasodilators 
Nitrates 
Aspirin and statins (IHD)
Oral anticoags (AF)
Ivabradine reduces HR by inhibiting channels in the SAN)
Revascularisation 
Implanter cardioverter defib
Pacemakers 
Cardiac transplant
48
Q

Who gets congestive cardiac failure?

A

Older people (uncommon in the young)

49
Q

Causes of CCF?

A 
IHD
HTN
Infective cardiomyopathy 
Cor pulmonale
Alcohol and drug abuse 
Side effect of prescribed drugs 
AF 
Valvular disease 
Anaemia 
Hyperthyroidism 
LV HF --> CCF
50
Q

Risk factors for CCF?

A

Male
Congenital heart disease
Cardiovascular risk factors

51
Q

Symptoms of CCF?

A 
Fatigue 
Ankle oedema 
Leg/abdo oedema 
Exertional dyspnoea 
PND
Nausea 
Abdo pain 
Increased urination 
Cold peripheries 
Weight loss 
Muscle wasting 
Tachypnoea 
Peripheral +/- central cyanosis 
Displaced apex bear 
RV heave 
3rd and 4th heart sound 
Raised JVP 
Mitral/arotic murmurs 
Bilateral crackles 
Wheeze 
Pleural effusion
Tender hepatomegaly (pulsatile in tricuspid regurg)
Reduced peak flow
52
Q

Differentials for CCF?

A 
Aging 
Physical inactivity 
COPD
Pulmonary fibrosis 
Pneumonia 
PE 
Post-partum cardiomyopathy
Cirrhosis 
Nephrotic syndrome 
Pericardial disease 
DVT
53
Q

Investigations for CCF?

A 
FBC, U+E, cardiac enzymes, BNP, TFT 
CXR
ECG
Echo (inc stress test)
Cardiac MRI
54
Q

Treatment for CCF?

A 
Lifestyle changes 
Diuretics 
ACEi
ARA
B Blockers 
Aldosterone antagonists
Cardiac glycosides 
Vasodilators and nitrates 
Aspirin and statins (IHD)
Anticoag (AF)
Ivabradine to reduce HR
Revascularisation 
Implantable cardioverter defib
Pacemaker 
Cardiac transplant

Year 3 (9 decks)

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