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Hugh's MD2 Foundation > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What are the three general groups of factors that can cause HTN?

A

Increased Preload

Cardiac aetiology

Increased Afterload

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2
Q

What are the acute coronary syndromes?

A

AMI

Unstable angina

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2
Q

What are the cardiovascular risk factors?

A

Hypertension

Increasing age

Diabetes

FHx IHD

Hyperlipidaemia

Smoking

Obesity

Sedentary lifestyle

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3
Q

How does hypertension typically lead to heart failure?

A

Increased afterload > LVH > Stiff LV > Diastolic failure > Often leads to systolic HF

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3
Q

What are the possible causes of exacerbation of chronic heart failure?

A

Mad Hatter

MI

Anaemia

Diabetes

HTN

Arrhythmia

Thyrotoxicosis

Temp (Infection)

Embolism

Renal

Regularly taking meds?

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4
Q

What is primary hypertension?

A

Hypertension with no specific aetiology

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4
Q

Why are beta-blockers not preferred anti-hypertensives?

A

Heavy side effects

  • Nightmares
  • Increased weight
  • Insulin resistance
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4
Q

What some adjunct treatments for AMI?

A

O2

Morphine

Aspirin

IV heparin

IV GTN

Possibly other anti-platelets

Beta-blockers & ACE inhibitors

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5
Q

What are some causes of secondary hypertension?

A

Renal disease eg damage to nephrons

Renal artery stenosis

Adrenal secreting tumours

Sleep apnoea

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6
Q

What are some signs that reperfusion has occurred?

A

Resolution of pain or ST elevation

Reperfusion Arrhythmia - Idioventricular rhythm

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8
Q

What is the target BP is patients with CV risk factors?

A

130/80

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10
Q

At what point in the CV system does the BP drop most significantly?

A

Arterioles

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11
Q

What is the mechanism of action of calcium channel blockers?

A

Inhibit the L-type Ca channels. Different types have different binding properties therefre can reducing contractility, SA activity, AV node conduction or vascular tone

Can be vascularly selective - dihydropyridine CCBs > arteriolar vasodilation > reduce afterload (Ca is required for SM contraction)

Or cardiac and vascular selective with negative inotropic and chronotropic properties > used for HTN, arrhythmias and angina

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13
Q

The WHO definition of AMI requires 2 out of 3 of the following criteria. Name those 3

A

Symptoms of myocardial ischaemia

Elevated cardiac enzymes (troponin or CK)

Typical electrocardiographic pattern involving the developent of Q waves, ST segment changes or T wave changes

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14
Q

What is the usual ejection fraction?

A

50% of ventricular volume therefore ~70ml (of 140ml)

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15
Q

Why are anterior infarcts the worse?

A

Because the area they supply contributes most to the ejection fraction

17
Q

In which type of heart failure can ejection fraction be preserved? How?

A

Diastolic heart failure

Ventricle doesn’t fill (eg due to mitral stenosis)

18
Q

Why can heart failure trigger fluid retention?

A

Reduced CO > Reduced renal blood flow > Activation of RAAS > fluid retention

19
Q

How does cardiac hypertrophy effect EDV?

A

Hypertrophic myocardium is less conpliance

Diastolic refill is impair

EDV is reduced

20
Q

What is pulse pressure?

A

The difference between systolic and diastolic BP

21
Q

When is high systolic BP seen in isolation?

A

Elderly with stiff arteries

22
Q

What is the cut off for EDP over which point oedema/congestion will occur?

A

20-30mmHg

23
Q

What is can be concluded for a LVHF patient with a normal echo?

A

Diastolic HF as EF is preversed

24
Q

List the heart murmur in order of commonality?

A
  1. Aortic Stenosis
  2. Mitral Regurgitation
  3. Aortic Regurgition
  4. Mitral stenosis
25
Q

Which is more life threatening, VF or VT?

A

VF

26
Q

Describe the pathophysiology of Wolff-Parkinson-White syndrome

A

Abnormal conduction pathways allow impulses to bypass the AV node and can lead to tachyarrhythmias

27
Q

What causes a 3rd heart sound? When is it heart?

A

Sloshing of blood around the ventricle

Early to mid diastole

28
Q

What causes a 4th heart sound? When is it heart?

A

Forceful contraction of the atria to overcome a stiff ventricle

29
Q

How is the diagnosis of hypertension made?

A

BP >140/90 after 5mins seated and 2 readings 2 minutes apart

A follow up reading 1-4 weeks later

30
Q

What are the classes of drugs used for the treatment of HTN? When is each used for first line?

A

A - ACEI or ARBs - If patient is <55y.o.

B - Beta-blockers - avoided due to side effects

C - Calcium channel inhibitors - If >55 or black

D - Diuretics - If there is a component of fluid retention

31
Q

What are some side effects of beta-blockers?

A

Postural hypotension

Weight gain

Insulin resistance

Nightmares

Impotence

32
Q

Which anti-hypertensives are avoided in HF?

A

Non-dihydropyridines

Hugh's MD2 Foundation (47 decks)

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