Cardiovascular - Chronic Conditions Flashcards
features of heart failure?
SOB orthopnea PND fatigue peripheral/sacral oedema raised JVP
causes of heart failure?
impaired LV
excessive preload
excessive afterload
risk factors for heart failure?
CAD MI HT DM valvular disease arrythmias
Ix for heart failure?
ECG
CXR
Echo
bloods for Ix in heart failure?
NT-proBNP FBC U+Es LFTs Coag
difference between preserved and reduced ejection fraction?
preserved - less blood able to fill LV due to stiffness
reduced - LV unable to eject enough blood during systole
basics drug treatment for heart failure?
BASHeD
Bblocker ACE spironolactone hyralazine/nitrates loop diuretics
what is the definition of hypertension?
BP ≥140/90mmHg
risk factors for HT?
>65yrs alcohol lack of exercise FHx DM metabolic syndrome renal disease smoking
features of HT?
headache floaters SOB chest pain asymptomatic
how does salt increase BP?
salt increases renal blood flow
renin released from kidney
renin causes angiotensinogen -> angiotensin I
ACE causes angiotensin I -> angiotensin II
aldosterone released
causes Na and H20 retention
what can cause secondary HT?
renal disease conn's cushing's phaeochromocytoma RAS steroids
diagnostic test for HT?
ABPM or HBPM with an average of 135/85
other Ix for HT?
ECG
HDL, cholesterol, triglyc
U+Es, urinalysis (albumin: creatinine ratio)
what is the recommended amount of exercise?
150mins moderate or 75 vigorous
strengthening activities 2 days a week
<55yrs treatment pathway for HT?
ACE
+ CCB/diuretic
ACE + CCB + diuretic
> 55yrs/black treatment pathway for HT?
CCB/diuretic
+ ACE
ACE + CCB + diuretic
HT targets?
130/80
if DM, 135/85
features of stable angina?
provoked
relieved by rest
predictable timing
features of unstable angina?
no pattern
occurs at rest
can be prolonged or fleeting
what is the pathology of atherosclerosis?
endothelial dysfunction
macrophages become foam cells by engulfing lipid
fatty streak forms (irreversible)
plaque
fibrosis and plaque formation
luminal size decreases
Ix for angina?
exercise ECG
fasting lipid
FBC
angiography
why is FBC important in angina?
anaemia can worsen angina
treatment for angina?
GTN for symptomatic relief
75mg aspirin
Bblocker
statin
BP meds
what should be monitored after starting an ACE?
Na
K
kidney function (GFR)
what drugs should be avoided in those with reduced ejection fraction heart failure?
CCBs
verapamil and diltiazem
what should be monitored at heart failure review?
fluid status cardiac rhythm cognition medications renal function
what two drugs need K monitored? why?
ACE
spironolactone
hyperkalaemia risk
features of L sided heart failure?
SOB pulonary congestion fatigue cyanosis orthopnea PND tachycardia
features of R sided heart failure?
fatigue
raised JVP
ascites
oedema
what is cor pulmonale?
right sided heart failure due to a problem with the lungs (pulmonary hypertension)
what heart sound is heard in heart failure?
s3 gallop rhythm
acute heart failure Tx?
sit up oxygen furosemide GTN (if systolic BP is high enough) ECG CPAP
