Cardiology (Week 5) Flashcards
Name two main features that characterise heart failure?
Systemic vasoconstriction and neurohumoral activation
List three causes of heart failure
- MI
- Hypertension
- Idiopathic
- Alcohol
- Chemotherapy
Name a common sign of heart failure
Displaced apex beat
3rd heart sound
Elevated JVP
What class of drugs are used for symptomatic relief in heart failure but do not improve outcomes
Diuretics
What does a neprilysin inhibitor do in terms of heart failure treatment?
Inhibits neprilysin, an enzyme which breaks down natriuretic peptides whose function is to cause vasodilation and diuresis (maintain this as is beneficial to HF)
Why should ACE inhibitors and angiotensin receptor blockers never be given together?
Because they both prevent the breakdown of bradykinin which causes cough and angioedema
What do low natriuretic peptides mean in terms of heart failure diagnosis?
That the patient does not have heart failure
What are Kerley B lines?
Fluid moving into the interstitial space and causing pressure build up in vessel s, appearing as small, white straight lines on the edge of chest X-ray
How does alveolar oedema present on chest X-ray and what is it indicative of?
Appears as fluffy white surrounding black tubes in the lungs and is a late sign of heart failure
In which condition would the loss of costophrenic angles be seen on chest X-ray?
Pleural effusion
What is the definition of myocardial infarction?
Elevated troponin in a clinical setting consistent with myocardial ischaemia
What is the difference between type 1 and type 2 MI?
Type 1 is due to plaque rupture and thrombus formation
whereas
Type 2 is due to increased oxygen demand or decreased oxygen supply
Describe unstable angina
An acute coronary event without a rise in troponin
What does ST elevation in MI indicate?
Coronary artery occlusion
Name the three types of atrial fibrillation in order of increasing duration?
Paroxysmal
Peristsent
Permanent
Name the two main features of AF on an ECG
Narrow, irregular QRS complex
No P waves
Subclinical thyrotoxicosis can cause which heart arrhythmia?
Atrial fibrillation
Describe the mechanism of action of Verapamil
Acts on Ca channels in the heart muscle to slow heart rate
Name three components of vegetation which can go onto damage cusps of heart valves
Any three of: Fibrin mesh Platelets WBCs RBC debris Trapped organisms
Strep. viridans is commonly associated with what type of endocarditis?
Native valve endocarditis
Which strain of bacteria is commonly found in endocarditis of IVDU?
Staphylococcus aureus
What are the two main categories of late stage infection in endocarditis?
Immunological and tissue damage
In foetal circulation, via which structure does blood pass from the IVC to the left atrium?
Foramen Ovale
Which term describes a heart with normal anatomy in a normal anatomical position?
Situs solitus
In Fontan circulation, what adaptations are made in order to allow perfusion of blood?
IVC and SVC are plumbed directly into the pulmonary arteries, allowing bypassing of the heart
What measurement defines systemic hypertension?
BP over 140/90mmHg
Name three potential causes of secondary hypertension
Hyperaldosteronism
Coarctation of aorta
NSAIDs
What is the first line treatment for under 55s with hypertension?
ACE inhibitor or low-cost angiotensin II receptor blocker
