Cardiovascular Flashcards
1
Q
What is prolonged QT syndrome?
A
where the QT interval is greatly increased
ECG DIAGNOSTIC
2
Q
Causes of prolonged QT syndrome
A
- congenital
- hypokalaemia
- hypocalcaemia
- drugs → amiodarone, tricyclic antidepressants
- bradycardia
- acute MI
- diabetes
3
Q
Presentation of prolonged QT syndrome
A
- syncope
- palpitations
- may progress to VF
4
Q
Treatment of prolonged QT syndrome
A
- cardioversion
- treat underlying cause
- if acquired → IV isoprenaline
5
Q
What is rheumatic fever?
A
- systemic infection common in developing countries
- from Lancefield group A B-haemolytic streptococci
- antibody from cell wall cross-reacts with valve tissue → permanent damage to heart valves
6
Q
Symptoms of rheumatic fever
A
- fever
- arthritis
- chest pain
- SOB
- fatigue
- chorea → jerky movements
7
Q
Signs of rheumatic fever
A
- tachycardia
- murmur → depends on valve
pericardial rub - erythema marginatum
- prolonged PR interval
8
Q
Investigations for rheumatic fever
A
Jones criteria
9
Q
Treatment for rheumatic fever
A
- rest until CRP is normal
- IV benzylpenicillin then phenoxymethylenicillin for 10 days
- analgesia
- haldoperidol/diazepam for chorea
10
Q
Causes of cardiogenic shock
A
- pump failure
- MI
- cardiac arrest
11
Q
Pathophysiology of cardiogenic shock
A
- decreased CO
- decreased MAP
12
Q
Presentation of cardiogenic shock
A
- tachycardia
- tachypnoea
- decreased urine output, BP
- cold peripheries
- chest pain
13
Q
Treatment for cardiogenic shock
A
- ABCDE
- rescucitation
14
Q
Causes of hypovolaemic shock
A
- low fluid volume
- haemorrhage
- dehydration
15
Q
Pathophysiology of hypovolaemic shock
A
- decreased MAP
- decreased CO
16
Q
Presentation of hypovolaemic shock
A
- tachypnoea
- weak rapid pulse
- cyanosis
- increased CRT
17
Q
Treatment of hypovolaemic shock
A
- ABCDE
- resuscitation
- fluids
- vasodilator GTN
18
Q
Causes of septic shock
A
toxins. inblood
19
Q
Pathophysiology of septic shock
A
- decreased MAP
- derangement in physiology
20
Q
Presentation of septic shock
A
- tachycardia
- D&V
- decreased urine output, O2, BP
21
Q
Treatment of septic shock
A
- broad spectrum IV Abs
- fluid
- O2
22
Q
Causes of anaphylactic shock
A
severe allergic reaction
23
Q
Pathophysiology of anaphylactic shock
A
- histamine release
- vasodilation
- hypoxia
24
Q
Treatment for anaphylactic shock
A
- rescucitation
- adrenlaine
25
What does resuscitation entail in shock
- CPR
- fluids
- O2
26
What is cardiomyopathy?
a group of diseases of the myocardium that affect mechanical or electrical function
27
What are the types of cardiomyopathy?
- hypertrophic
- dilated
- restricted
28
What is dilated cardiomyopathy?
the left ventricle is dilated with thin muscle → contracts poorly
29
Causes of dilated cardiomyopathy
- ischaemia
- alcohol
- thyroid disorder
- genetic
30
Pathophysiology of dilated cardiomyopathy
- poorly generated contractile force → progressive dilation of the heart
- diffuse interstitial fibrosis
- systolic dysfunction of left or both ventricles
31
Signs of dilated cardiomyopathy
- HF
- arrhythmia
- thromboembolism
- increased JVP
- sudden death
32
Symptoms of dilated cardiomyopathy
- SOB
- fatigue
- dyspnoea
33
Investigations for dilated cardiomyopathy
- chest xray → cardiac enlargement
- ECG → tachycardia, arrhythmia, T wave changes
- echo → dilated ventricles
34
Treatment of dilated cardiomyopathy
treat cause
35
What is hypertrophic cardiomyopathy?
ventricular hypertrophy → obstruction of outflow tract
36
Causes of hypertrophic cardiomyopathy
- genetic → autosomal dominant
- 50% sporadic
37
Pathophysiology of hypertrophic cardiomyopathy
- gene mutation for sarcomere protein
- impaired diastolic filling
- reduced stroke volume
- reduced CO
38
Symptoms of hypertrophic cardiomyopathy
- sudden death may be first symptom
- chest pain/angina
- dyspnoea
- dizziness
- palpitations
- syncope
39
Signs of hypertrophic cardiomyopathy
- ejection-systolic murmur
- jerky carotid pulse
- left ventricular outflow obstruction
40
Investigations for hypertrophic cardiomyopathy
- ECG → T wave inversion, deep Q waves
- genetic analysis
41
Treatment for hypertrophic cardiomyopathy
- amiodarone → anti-arrhythmic
- CCB → verapamil
- beta blocker → atenolol
42
What is restrictive cardiomyopathy?
scar tissue replaces normal heart muscle and ventricles become rigid so don't contract properly
43
Causes of restrictive cardiomyopathy
- amyloidosis
- idiopathic
- sarcoidosis
- end-myocardial fibrosis
44
Symptoms of restrictive cardiomyopathy
- dyspnoea
- fatigue
- embolic symptoms
45
Signs of restrictive cardiomyopathy
- increased JVP → diastolic collapse, elevated on inspiration
- hepatic enlargement
- ascites
- oedema
- 3rd and 4th heart sounds
46
Pathophysiology of restrictive cardiomyopathy
- normal/decreased volume in both ventricles
- bi-atrial enlargement
- impaired ventricle filling
- rigid myocardium restricts ventricular filling
47
Investigations for restrictive cardiomyopathy
DIAGNOSTIC = cardiac catheterisation
48
Treatment for restrictive cardiomyopathy
no treatment → poor prognosis
