Cardiovascular

Question 1

Why does a heart attack cause pain?

Answer 1

the resulting ischaemia is painful

Question 2

a completely irregular heartbeat is often what diagnosis?

Answer 2

atrial fibrillation

Question 3

what is angina?

Answer 3

reversible, temporary coronary ischemia due to narrowing of vessels - the pain occurs during stress

Question 4

How does angina differ from a heart attack?

Answer 4

usually with an MI they will tell you that they weren’t exerting themselves at all when it occurred.

Question 5

what sort of rhythmic patters can you observe?

Answer 5

irregular-regularly
regular
or completely irregular

Question 6

how does cocaine use influence coronary health?

Answer 6

cocaine use greatly accelerates plaque formation and deposition in the coronary arteries

Question 7

how does oestrogen effect coronary health?

Answer 7

oestrogen is a protector of the coronary arteries - hormone replacement therapy does the same after menopause

Question 8

what is the widow maker vessel of the heart?

Answer 8

left anterior descending - lesions in this vessel are particularly dangerous

Question 9

how might caffeine effect heart function?

Answer 9

Can cause an increased heart beat- potentially effect proper profusion to the brain; cause fainting

Question 10

what is it called when a patient wakes up in the night gasping for air?

Answer 10

Paroxysmal Noctural Dyspnoea - where the liquid in their lungs distributes throughout the lungs when they lie flat - they are literally drowning in their own fluids and wake up gasping for air - this is made better if you sleep sitting up/standing

Question 11

how do we measure the severity of paroxysmal nocturnal dyspnoea?

Answer 11

“Orthopnoea” - which is the number of pillows you sleep proped up with

Question 12

What is a TIA?

Answer 12

transcient ischemic attack - these are mini strokes where there are small blood clots in the carotid arteries leading to a temporary ischaemia of the brain (like angina of the brain)

Question 13

how does heart failure effect your weight?

Answer 13

extravascular water in your tissues leads to weight gain (you drink more to replace what is lost in extracellular space) - this is a way we measure your cardiac failure and ensure you’re getting the correct amount of diuretics

Question 14

why do you ask patients with an MI - “ what were you thinking when this occurred?”

Answer 14

b/c some patients have “impending demise” where they honestly feel like “this is it” more so than “ I worry that I could die from this”

Question 15

pressure in the chest is associated with cardiac - but stabbing like pain is commonly what…?

Answer 15

respiratory

Question 16

glycerol nitrate spray has what effect?

Answer 16

it’s a cardiac dilator

Question 17

How do women present with an MI?

Answer 17

can present like a male - or they get weird throat issues, pain in the neck or on the jaw line - these sort of things are odd symptoms of heart attack that are more commonly shown in women

Question 18

what is the most common reason for acute chest pain that is due to respiratory issue?

Answer 18

pulmonary embolism - presents similarly to MI in the sense of acute onset/difficulty breathing etc.

Question 19

what are some risk factors for PE

Answer 19

travel, use of contraceptives, immobility, atrial fibrillation, malignancy, recent surgery etc

Question 20

what type of contraceptive is most associated with PE ?

Answer 20

the combined pill - progesterone/estrogen

Question 21

what does cocaine do to the vessels?

Answer 21

vasoconstricts

Question 22

how does a cocaine overdose present?

Answer 22

similar to a heart attack, but no arm pain - tachycardia etc.

Question 23

what is the difference between infective endocarditis and infective myocarditis and pericarditis ?

Answer 23

endocarditis = inflammation/infection of heart valves- not necessarily painful, but would present with fever

myocarditis = inflammation/infection of the heart muscle

pericarditis= inflammation of the pericardium-

Question 24

what is cardiac tamponade?

Answer 24

accumulation of pericardial fluid around the heart which is causing back pressure problems