Cardiovascular Flashcards

Question

How common is essential hypertension and who does it affect?

Answer 1

20-30% of population - 80-90% is essential/primary hypertension Affects of 40-45% of black African adults

Answer 2

``` Genetic component Low birth weight Obesity Excess alcohol intake High salt intake Metabolic syndrome ```

Answer 3

Family history Personal history Age

Answer 4

Generally Asymptomatic In extremes: - headaches - fatigue/confusion - dizziness - nausea - vision problems - chest pains

Answer 5

High blood pressure End organ signs: - loud second heard sound - left ventricular heave - fourth heart sound - retinal abnormalities

Answer 6

Secondary hypertension Anaemia Malignant hypertension

Answer 7

Need to exclude any end organ damage - U&Es, and renal ultrasound - urine dip - blood glucose - serum lipids - ECG

Answer 8

``` Lifestyle modification Drug therapy - Diuretics (loop&thiazide) - beta blockers - ACE inhibitors - Angiotensin 2 receptor blockers - calcium channel blockers ```

Answer 9

1/1000 people on UK develop DVT per year More common as you get older >60yrs More common in males

Answer 10

Thrombosis in the deep veins of the of the limbs/trunk, mainly in leg/pelvis Usually originates from valves where thrombin made up of RBC and fibrin detach Cause associated with risk factors

Answer 11

``` Age >60 years Severe medical co-morbidities Obesity Major abdo/pelvic surgery Pregnancy Immobility- surgery, illness/injury, travel Vessel luminal damage - varicose veins Oestrogen contraceptive pill, HRT - oestrogen causes blood to clot more easily Family/personal history ```

Answer 12

Often Asymptomatic | pain/tenderness

Answer 13

Swollen leg Warm leg Calf tenderness Superficial vein distension

Answer 14

``` Ruptured Bakers cyst Oedema from surrounding msk injuries Cellulitis Chronic oedema Haematoma Superficial thrombophlebitis ```

Answer 15

Serum D-dimer (good to rule out DVT but not confirm) - high levels of D-dimer (+ve result) indicates further investigation and high probability a DVT is present - normal levels of D-dimer (-ve result) confirm no DVT is present Ultrasound

Answer 16

- LMW heparin by subcutaneous injection every 24hrs for 5 days till oral Anticoagulation established - Warfarin for rapid Anticoagulation in VTE - maintenance dose warfarin

Answer 17

1-3 of every 100 people will develop LVF Prevalence increases with age

Answer 18

``` Myocardial ischaemia Hypertension Aortic stenosis/incompetence Mitral incompetence MI Hypothyroidism ```

Answer 19

``` Hypertension Previous MI Congenital heart defects Diabetes Excessive alcohol use Irregular heart beat ```

Answer 20

Dominated by PULMONARY OEDEMA ``` Tachypnoea Cough Frothy/bloody mucus Cyanosis Dyspnoea on exertion and at rest Orthopnoea Paroxysmal nocturnal dyspnoea Fatigue, Weakness Exercise intolerance Wheezing ```

Answer 21

``` Crackles on lung bases Laterally displaced apex beat Galloping rhythm Increased BP/intra-cardiac pressure Heart murmur (aortic stenosis, mitral regurgitation) ```

Answer 22

PE Lung cancer Upper airway obstruction

Answer 23

``` CXR Coronary angiography ECG Heart stress test Cardiac Ultrasound ```

Answer 24

Complex clinical syndrome resulting from structural or functional cardiac disorder that impairs the ability of the ventricles to fill or eject blood Affects the ventricles

Answer 25

Affects around 900,000 people in UK

Answer 26

``` Coronary artery disease MI Myocardial disease Heart valve disease Hyperthyroidism Hypertension ```

Answer 27

``` Dyspnoea Cardiac asthma Cough Frothy bloody sputum Orthopnoea Paroxysmal nocturnal dyspnoea Peripheral oedema ```

Answer 28

Cyanosis | Pulmonary oedema

Answer 29

``` Diuretics ACEi Beta blockers Spironolactone Digoxin Vasodilators ```

Answer 30

When the lumen is reduced to 1cm or less

Answer 31

Long suffering rheumatic fever

Answer 32

Rheumatic fever results in inflammation of all layers of the heart-pericardium, myocardium and endocardium Causes pathological scarring of valve cusps and shortening and tightening of chordae tendinae

Answer 33

Causes poor emptying of the atrium - increasing pulmonary venous pressure - pulmonary hypertension - right ventricular Hypertrophy, dilation and failure

Answer 34

Ischaemic Heart disease

Answer 35

Myxoid degeneration of cusps and chordae tendinae causing cusps to balloon into the atrium and chordae tendinae may rupture

Answer 36

Syncope Angina Left Ventricular failure

Answer 37

Infective endocarditis | Aortic root dilation

Answer 38

Systolic hypertension Wide pulse pressure Water hammer pulse

Answer 39

Failure of the ventricle to eject blood out of the ventricle to the lungs Usually occurs as a result of left sided heart failure causing increased pressure through the lungs and to the right ventricle Blood flow to the pulmonary arteries falls as blood begins to accumulate in the right ventricle, left atrium and systemic circulation

Answer 40

Elevation of systemic venous pressure - JVP Ascites & jaundice (liver and spleen congestion) Peripheral pitting oedema Parasternal heave (compensatory increase in contraction strength) Nocturia - fluid retained in limbs re enter systemic circulation

Answer 41

Endovascular infection of cardiovascular structures including cardiac valves, atrial and ventricular endocardium large intrathoracic vessels and intracardiac foreign bodies (prosthetic valves)

Answer 42

Vegetation which occur on valve leaflets and chordae tendinae Vegetation a consist of fibrin, inflammatory cells and microbes on the endocardium

Answer 43

Acute: staph aureus | Sub-acute: strep viridans

Answer 44

Septic signs Cardiac lesions (new murmur, changing murmur) Immune complex deposition: - Vasculitis - Roth spots, splinter haemorrhages, oslers nodes Embolic phenomena