Cardiovascular Conditions

Question 1

Acute Coronary Syndrome

Answer 1

Angina, STEMI and NSTEMI
Arise due to reduced blood flow causing chest pain

reduced blood flow can be due to a ruptured atherosclerosis or formation of a clot

Question 2

Stable Angina

Answer 2

Tight, dull or heavy pain across the chest
pain radiates to arms, neck, back and epigastrium
accompanied by belching
due to stenoses of at least one coronary artery

Question 3

What classifies angina as stable?

Answer 3

chest discomfort which is provoked by exertion or emotional distress and should be relieved by rest or GTN

Question 4

Symptoms of Stable Angina

Answer 4

sweating, nausea, vomiting, breathlessness, feeling faint, pale and clammy skin.

Question 5

Acute coronary syndrome and angina management

Answer 5

GP instructs patient to take GTN spray (wait 5 mins and then take second dose). If pain continues call and ambulance.

3 lead ECG then 12 lead

300mg Aspirin - check patient isn’t allergic and that they haven’t taken any

400-800mcg GTN spray

Pain relief - morphine sulphate

Oxygen if sats are less than 94% on air

Question 6

What is heart failure?

Answer 6

heart is unable to pump the blood around the body properly and needs treatment to help it work because it has become to weak

Question 7

Heart failure management

Answer 7

3 lead ECG followed by 12 lead

oxygen if sats are below 94%

salbutamol nebuliser if patient is wheezing

systolic pressure less than 90= titration of fluids

Question 8

Aortic dissection

Answer 8

A tear occurs in the inner layer of the aorta

Question 9

Symptoms of aortic dissection

Answer 9

sudden and severe pain
ripping or tearing pain
pain radiates into neck of interscapular area
loss of consciousness
limb ischaemia
breathlessness

Question 10

Management of aortic dissection

Answer 10

pain relief (entonox or morphine sulphate)
calm and reassure patient
emergency transfer

Question 11

Aneurysm

Answer 11

abnormal weakening in the lining of an artery wall which causes a ballooning effect

Question 12

Signs of an AAA

Answer 12

pulsing sensation in abdomen
abdominal pain that doesn’t go away
lower back pain that doesn’t go away

Question 13

Symptoms that an AAA has burst

Answer 13

sudden and severe abdominal pain
sweating, pale and clammy skin
shortness of breath
tachycardia
hypotension

Question 14

Management of AAA

Answer 14

3 lead ECG then 12 lead

oxygen if sats are less than 94%

pain relief (entonox and morphine sulphate)

calm and reassure patient

emergency transfer

Question 15

What is syncope

Answer 15

Transient loss of consciousness usually due to insufficient blood flow to the brain

Question 16

Management of Syncope

Answer 16

raise legs, 3 and 12 lead ECG, blood pressure, pulse, oxygen sats and blood glucose