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