Cardiovascular Flashcards
Who is Acute Coronary Syndrome most likely to effect and when?
Men, Early morning hours
What causes Acute Coronary Syndrome?
Coronary arteries become blocked/narrowed due to plaque = irreversible necrosis of heart muscle due to ischaemia
What can lead to blockage of the Coronary Arteries?
LDLs, Saturated fats, Trans fats
What 3 conditions come under the umbrella term of Acute Coronary Syndrome?
Unstable Angina, NSTEMI, STEMI
What is the difference between a NSTEMI and a STEMI?
NSTEMI = no changes on ECG but blood markers indicate damage
STEMI = ECG changes due to large area of heart muscle being affected
Acute Coronary Syndrome Risk Factors
High BP/Cholesterol, Diabetes, Obesity, Smoking, Age, Family Hx, Stress, Illicit drug use
Acute Coronary Syndrome Presentation
Tight chest, Pain radiating to back/jaw, Sweating, Nausea, Anxiety
Acute Coronary Syndrome Signs
Tachycardia or Arrhythmia, Hypertension initially and then Hypotension, Increased RR, Fever, Pallor
Acute Coronary Syndrome Investigations
ECG, Bloods (troponins), Angiogram, Echo
Acute Coronary Syndrome Treatment
Aspirin, Thrombolytics, Antiplatelets, GTN, Beta-blockers, ACE inhibitors, Statins, Analgesics, Surgery (CABG)
Angina Risk Factors
Smoking, Hypertension, Diabetes, Obesity, Hyperlipidaemia
Angina Presentation
Chest discomfort, Precipitated by exertion, Relieved by rest or GTN
What is Levine sign?
Clenched fist to describe pain - Angina
Angina Investigations
Exercise/Stress test, ECG, Angiography
Angina Treatment
Statins, Antiplatelets/Aspirin, Beta-blockers, CCBs, Ace inhibitors, Surgery if sever
What percentage of stoke patients have Atrial Fibrillation?
15%
What causes Atrial Fibrillation?
Electrical impulses from different places in the atria = Quivering
What conditions can lead to Atrial Fibrillation?
Heart failure, Ischaemia, Hypertension, Mitral valve disease
PE, Pneumonia, Hyperthyroidism, Alcohol, Sepsis
Atrial Fibrillation Presentation
Palpitations, Fatigue, SOB, Dizziness
Irregularly Irregular pulse
Atrial Fibrillation Investigations
ECG (no p waves), Bloods, Echocardiogram
Atrial Fibrillation Treatment
Digoxin/Amiodarone, Beta-blockers, Anticoagulants
Cardioversion if uncompensated
Who is most likely to have Hypertension?
Black people (4x more common)
What blood pressure values constitute Hypertension?
> 140 systolic
> 90 diastolic
Hypertension Risk Factors
Family Hx, >65, Obesity, Alcohol, Diabetes, Smoking, Salt in diet, CVD
Hypertension Presentation
Headache, Fatigue, Vision problems, Haematuria
Hypertension Medical Treatment
ACE inhibitors/ARBs
Calcium channel blockers
Diuretics
(Beta-blockers, Alpha blockers - if resistant)
What are the 3 factors of Virchow’s Triad which contribute to DVT?
Venous stasis, Hypercoagulability, Endothelial damage
What is the most commonly affected site for DVT?
Calf
DVT Risk Factors
Standing up for long periods of time, Surgery, Cancer, Obesity, Smoking, Birth control, Pregnancy
DVT Presentation
Pain, Swelling, Redness, Warmth
How many cases of DVT have no symptoms?
50%
What is Homans sign?
Pain on dorsiflexion of foot (DVT)
What score is used in the diagnosis of DVT?
Wells score
DVT Investigations
USS, D-Dimer, Venography
DVT Treatment
Anti-coagulation, Compression stockings
Who is most likely to have Left-Sided Heart Failure?
Men, 50-70yrs, African-American
What are the two classes of Left-Sided Heart Failure?
Systolic failure = cannot contract forcefully enough
Diastolic failure = stiff/thick ventricle, can’t fill properly
Causes of Left-Sided Heart Failure
Coronary Artery Disease, Hypertension, Arrhythmia, Valvular damage
Left-Sided Heart Failure Risk Factors
Cardiomyopathy, Cocaine use, Diabetes, Alcohol, Obesity, Smoking
Left-Sided Heart Failure Presentation
Respiratory symptoms (SOB, Crackles, Oedema, Orthopnea), Fatigue, Dizziness
Left-Sided Heart Failure Signs
Laterally displaced apex beat, Possible murmurs, Tachycardia
Left-Sided Heart Failure Investigations
Chest X-ray, Echo, ECG, Bloods, ABG, Sats
Left-Sided Heart Failure Treatment
Sodium restriction, Diuretics, Vasodilators, Inotropic agents (digoxin), Anticoagulants, Surgery (PCI)
What is Congestive Heart Failure?
Left and Right Sided Heart Failure at the same time
What extra symptoms are present with Congestive Heart Failure as well as those in Left-Sided Heart Failure?
Swelling in legs/ankles, Weight gain, Nausea
Causes of Valvular disease?
Aging, Congenital, Rheumatic disease, Pregnancy
Valvular Disease Presentation
Heart failure, Palpitations, Chest pain, Oedema
Which Valvular Disease presents with a diastolic murmur and left ventricle enlargement?
Aortic Regurgitation
Which Valvular Disease presents with a holosytolic murmur secondary to right ventricle dilation?
Tricuspid Regurgitation
Which Valvular Disease presents with a holosystolic murmur and left atrial/ventricle dilation?
Mitral Regurgitation
Which Valvular Disease presents with a harsh systolic murmur and an Enlarged left ventricle?
Aortic Stenosis
Which Valvular Disease presents with left atrial enlargement and a diastolic rumble?
Mitral stenosis
What is Right-Sided Heart Failure often caused by?
Cor Pulmonale
Right-Sided Heart Presentation
Swelling, Ascites, Nocturia, Pitting oedema
Right-Sided Heart Treatment
ACE/ARBs, Beta-blockers, Diuretics
Where does Infective Endocarditis effect?
Inner surface of heart - Particularly the valves
Infective Endocarditis Presentation
Fever, Fatigue, Murmur, Heart failure, Low RBCs
Most common bacterial cause of Infective Endocarditis?
Staph aureus
followed by Viridans strep and negative staph
What criteria is used for Infective Endocarditis?
DUKE Criteria
Infective Endocarditis Investigations
Blood culture, USS
Infective Endocarditis Treatment
IV antibiotics (usually start with vancomycin/ceftriaxone IV infusion), Surgery may be required
Postural Hypotension Definition
Fall in systolic blood pressure of at least 20 or diastolic of at least 10 when assuming a standing position
Postural Hypotension Causes
Medications (alpha blockers), Autonomic neuropathy, Age-related vessel stiffness
Postural Hypotension Presentation
Lightheadedness, Weakness, Blurred vision, Palpitations, Nausea, Syncope
Postural Hypotension Treatment
Increase salt and water intake, Compression stockings, Fludrocortisone