Cardiovascular

Question 1

Name and define the spectrum of conditions that affect the vessels of the heart, presenting as mild chest pain all the way to syncope.

Answer 1

• stable angina
  
  • when you get angina symptoms during moderate physical activity or when you are pushing yourself physically
• unstable angina
  
  • when you get angina symptoms while doing very little or resting.
• MI & STEMI
  
  • An NSTEMI can be less serious than an STEMI because the supply of blood to the heart may be only partially, rather than completely, blocked. As a result, a smaller section of the heart may be damaged. However, an NSTEMI is still regarded as a serious medical emergency.

Question 2

name 4 types of heart failure

Answer 2

• hypertensive
• myopathic
• ischaemic
• valvular
• cor pulmonale

Question 3

what’s the difference between primary and secondary HTN, what is another name for primary HTN, and give an examlpe of secondary HTN

Answer 3

• High blood pressure that doesn’t have a known cause is called essential or primary hypertension
• In contrast, secondary hypertension has a known cause
  
  • eg Conn’s syndrome (hyper-aldosteronism)

Question 4

Name 2 aortic pathologies

Answer 4

• aortic dissection
  
  • occurs when an injury to the innermost layer of the aorta allows blood to flow between the layers of the aortic wall, forcing the layers apart. In most cases, this is associated with a sudden onset of severe chest or back pain, often described as “tearing” in character.
• (abdominal) aortic aneurysm
  
  • see pic

Question 5

specify 2 peripheral vascular diseases

Answer 5

• claudication
  
  • pain and/or cramping in the lower leg due to inadequate blood flow to the muscles. The pain usually causes the person to limp.
• critical (limb) ischaemia
  
  • a severe obstruction of the arteries which markedly reduces blood flow to the extremities (hands, feet, and legs) and has progressed to the point of severe pain and even skin ulcers or sores. The pain caused by CLI can wake up an individual at night.

Question 6

what are the 4 main kinds of valve disorders

Answer 6

• stenosis and regurgitation of the mitral and aortic valve

Question 7

what are 2 cardiac pathologies that end with -itis

Answer 7

• endocarditis
  
  • inflammation of the endocardium - usually caused by bacteria (infective endocarditis)
• pericarditis
  
  • inflammation of the pericardium

Question 8

3 main kinds of cardiomyopathy and define

Answer 8

• dialated
  
  • a disease of your heart muscle where it becomes stretched and thin.
• hypertrophic
  
  • an inherited disease of your heart muscle, where the muscle wall of your heart becomes thickened.
• ARVC
  
  • (genetic + insidious) cardiac myocytes are held together by proteins but in ARVC these proteins do not develop properly and so cannot keep the heart muscle cells togethe; the muscle cells become detached and fatty deposits build up in an attempt to repair the damage.
    
    • these physiological changes cause the ventricle walls to become thin and stretched, leading to heart failure
    • also electrical impulse issues
• also inflammatory (myocarditis), restrictive cardiomyopathy (RCM), left ventricular noncompaction (LVNC) & peripartum cardiomyopathy (PPCM).

Question 9

Answer 9

• Heart blocks
  
  • AV block
    
    • electrical signal traveling from the atria to ventricles is impaired. Normally, the SA node produces an electrical signal to control the heart rate
  • LBBB
    • activation of LV is delayed so LV contracts later than RV
  • RBBB
    
    • activation of RV is delayed and caused by spread of LV myocardium rather than normal septal branch conduciton system

Question 10

Answer 10

• supraventricular tachycardias
  
  • WPW syndrome
    
    • WPW syndrome is a condition that makes the heart suddenly beat abnormally fast, in an abnormal heart rhythm called supraventricular tachycardia (SVT). Episodes can last for seconds, minutes, hours or, in rare cases, days (I think maybe a type of PST)
  • PST
    
    • a type of supraventricular tachycardia, named for its intermittent episodes of abrupt onset and termination
  • Atrial fib (worse)
    
    • Atrial fibrillation is a condition that causes an irregular and often fast heartbeat.
  • Atrial flutter (less bad)
    
    • In atrial fibrillation, the atria beat irregularly. In atrial flutter, the atria beat regularly, but faster than usual and more often than the ventricles, so you may have four atrial beats to every one ventricular beat.

Question 11

Answer 11

• Tachycardias
  
  • Sinus tach
    
    • an elevated sinus rhythm characterized by an increase in the rate of electrical impulses arising from the sinoatrial node (>100bpm)
  • ventricular tach
    
    • ‘3 or more heartbeats in a row, at a rate of more than 100 beats a minute’, can lead to v fib
  • v fib
    
    • VF is responsible for 75% to 85% of sudden deaths in persons with heart problems.

Question 12

Answer 12

• ectopic beats
  
  • Ectopic beats are early (premature) or extra heartbeats, which can cause you to have palpitations. ‘Ectopic’ means out of place. Ectopic beats happen when cells away from your hearts own natural pacemaker get a little excited (or irritable) and release an electrical signal, causing an ‘extra’ or early heartbeat.
  • if it only happens occaisonally it shouldn’t cause a problem but treatment is needed if it happens on a regular basis

Question 13

Answer 13

• sinus bradycardia
  
  • Sinus bradycardia is a slow, regular heartbeat. It happens when your heart’s pacemaker, the sinus node, generates heartbeats less than 60 times in a minute. For some people, such as healthy young adults and athletes, sinus bradycardia can be normal and a sign of cardiovascular health.

Question 14

Answer 14

• long qt syndrome
  
  • a genetic or acquired condition characterised by a prolonged QT interval on the surface ECG and is associated with a high risk of sudden cardiac death due to ventricular tachyarrhythmias. Mutations within 13 identified genes result in a variety of channelopathies affecting myocardial repolarisation, thus prolonging the QT interval.