Cardiovascular 2 Flashcards
What are structural heart disease investigations?
ECG
chest X-rays
Echocardiogram
What are causes of heart failure?
Ischaemic heart disease
Hypertension
Valvular heart disease
Alcohol excess
What are symptoms of heart failure?
Fluid accumulation- oedema on lungs and peripheries
What is a sign of fluid on lungs?
Breathlessness on exertion and on lying flat
How does heart failure present?
Gradual onset
SOB- Often during night when lying flat
Sudden death
What medications are used to treat heart failure?
Diuretics
ACE inhibitors / angiotensin ll receptor antagonists
Beta blockers
Digoxin
What other treatments are used re. Heart failure?
Treatment of underlying causes Surgical - cabg Surgical- PTCA- Percutaneous transluminal coronary angioplasty Rarely- transplant Pacemaker
What should dentists be aware of re. Heart failure?
Polypharmacy
Avoid NSAIDS- cause fluid retention
Cautious when lying patient flat
Re. Valvular heart disease, what side of the heart is most commonly affected?
Left side- mitral, aortic valve
What are causes of heart disease?
Congenital
Infective endocarditis
Rheumatic fever
Age related
What Are the two types of valvular heart disease?
Regurgitation
Stenosis
What is regurgitation?m
Valve becomes floppy
Loss of valve integrity
Leaks
What is stenosis?m
Narrowing of valve, obstructing flow
What is the treatment of valvular heart disease?
Medication
Surgery:
Valve replacement - porcine, metallic
What is infective endocarditis?
Usually occurs on diseased or prosthetic valves Due to bacteraemia: Strep viridans Strep faecalis Strep aureus
What are clinical features of infective endocarditis?
Prolonged febrile illness
Valve degeneration and failure
Embolic disease
Immune complex formation
What investigations can be used re. Infective endocarditis?
Blood cultures
Echocardiogram
What is treatment for infective endocarditis?
Prolonged course of intravenous antibiotics
? Surgery
What is normal cardiac rhythm?
Sinus rhythm
What is arrhythmia?
Abnormal cardiac rhythm
Irregular
Too fast/slow
Abnormal beat conduction
What makes a too fast rhythm?
> 100/ minute
What makes a rhythm too slow?
What can be symptoms of cardiac arrhythmias?
Nil Palpitations Chest pain Heart failure Syncope
What is atrial fibrillation?
Irregular heart beat
What does atrial fibrillation increase risk of?
Stroke
What is tachyarrythmia?
Too fast heart beat
What are symptoms of supraventricular tachycardia?
Palpitations
Chest pain
Breathlessness
What can treatment be at time of SVT?
Vagal manoeuvres
Carotid sinus massage
Drugs- adenosine
What is bradyarrythmia?
Heart beat too slow
What are causes of bradyarrythmia?
Age
Ischaemia
Drugs
What treatment may bradyarrythmia require?m
May require pacemaker
What are ventricular arrhythmias?
Abnormal heart conduction- peri arrest rhythm
What can be the cause of ventricular arrhythmias?
Heart attack
Drugs
Congenital
Electrolyte disturbances
What is ventricular tachycardia?
Always symptomatic
Cardio respiratory arrest
What is ventricular fibrillation?
Always cardio respirator arrest
What are dental aspect relevant re. Pace makers?
Theoretical risk of electrical intereference see BNF
avoid adrenaline containing local anaesthetic in certain situations
What are structural heart diseases?
Heart failure- muscle weakness
Valvular heart disease
