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My Phase 2a Medicine > Cardiovascular Conditions > Flashcards

Cardiovascular Conditions Flashcards

1
Q

What is angina?

A

Acute chest pain caused by reduced blood flow to the heart

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2
Q

What is the difference between stable and unstable angina?

A

Stable angina is induced by effort and relieved by rest.

Unstable angina has a greater fequency and severity and occurs on minimal exertion or rest.

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3
Q

What is the main cause of angina and one other cause?

A

Atheroma is the main cause. Anaemia and coronary artery spasm.

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4
Q

What are the symptoms of angina?

A
  • tight, dull, heaving feeling in chest
  • pain triggered by exertion/stress
  • breathlessness
  • nausea
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5
Q

What are medication should be given during an angina attack?

A

GTN (glyceryl trinitrate) spray - causes vasodilation. Give second dose after 5 mins then ring 999 if pain not relieved 5 mins after second dose.

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6
Q

What medication should be used to treat angina?

A
  • Beta-blockers (slow heart rate and dec contraction strength)
  • Ca channel blockers (vasodilators)
  • ACE inhibitors (dec blood pressure)
  • Statins (reduce cholesterol)
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7
Q

Name 2 procedures used to treat angina.

A

Coronary artery bypass graft (CABG) - blood vessel implanted to bypass narrowed coronary vessel.
Percutaneous coronary intervention (PCI) - catheter used to insert stent in to widen narrowed vessel.

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8
Q

What is acute coronary syndrome? Give 2 examples

A

Umbrella term fro condition where the blood supply to the cardiac muscle is suddenly blocked/reduced.
Unstable angina, MI.

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9
Q

What is a myocardial infarction (MI)?

A

A sudden and complete blockage on the blood to the cardiac muscle.

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10
Q

What does STEMI stand for?

A

ST segment elevated myocardial infarction - more serious than NSTEMI.

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11
Q

What are the symptoms of a MI?

A
  • chest pain - pressure, tightness, heaviness, may spread to arms/jaw
  • shortness of breath
  • feel weak or lightheaded
  • palpitations
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12
Q

What are the signs of a MI?

A
  • anxiety/distress
  • pallor
  • 4th heart sound
  • tachycardia
  • tachypnoea
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13
Q

What are the risk factors of a MI?

A
  • hypertension
  • family history
  • smoking
  • diabetes mellitus
  • obesity
  • sedentary lifestyle
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14
Q

How is a MI managed?

A
  • control chest pain with GTN spray and opiates
  • reduce risk factors
  • cardioprotective medication (anti-platelets, anti-coagulants, anti-hypertensives)
  • revascularisation (CABG, PCI, medication to resolve clot)
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15
Q

What are the complications of a MI?

A
  • cardiac arrest (sudden loss of blood causing heart to stop pumping)
  • cardiogenic shock (inadequate tissue perfusion due to cardiac dysfunction)
  • arrhythmias
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16
Q

What is cardiac failure?

A

Heart is unable to pump blood sufficiently around the body

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17
Q

What is cardiac arrest?

A

Heart stops pumping blood around the body.

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18
Q

What are the signs of cardiac failure?

A
  • tachycardia
  • tachypnoea
  • hypotension
  • pulmonary rales (abnormal lung sounds)
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19
Q

What are the symptoms of cardiac failure?

A
  • breathlessness
  • tiredness (especially after exercise)
  • oedema
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20
Q

What are the causes of cardiac failure?

A
  • coronary heart disease (reduce blood to heart)
  • hypertension
  • cardiomyopathy
  • damage to heart valves
  • congenital heart disease
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21
Q

Describe the acute management of cardiac failure.

A
  • oxygen treatment
  • treat underlying cause
  • diuretic (dec blood pressure)
  • GTN (vasodilator)
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22
Q

Describe the chronic management of cardiac failure.

A
  • treat cause (pacemaker, CABG)
  • heart transplant
  • reduce risk factors
  • vasodilators
  • ACE inhibitors
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23
Q

What is valvular heart disease? What are the 2 types of valvular heart disease?

A

Diseased or damaged valves which affect the blood flow through the heart. Valve stenosis and valve regurgitation.

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24
Q

What is valve stenosis?

A

Passage becomes narrowed due to stiffening of the heart valve.

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25
Q

What is valve regurgitation?

A

Valve does not close properly causing backflow of blood through the valve.

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26
Q

What are the causes of valve stenosis?

A
  • calcification due to ageing
  • genital conditions
  • rheumatic heart disease
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27
Q

What are the symptoms of valve stenosis?

A
  • chest pain
  • shortness of breath
  • syncope (temporary loss of consciousness)
  • dizziness
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28
Q

What are the signs of valve stenosis?

A
  • heaving
  • systolic ejection murmur
  • slowly rising pulse with narrow pulse pressure
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29
Q

How is valve stenosis treated?

A
  • valve replacement
  • percutaneous valvuloplasty (balloon used to enlarge valve)
  • anti-coagulants
  • beta-blockers
  • ACE-inhibitors
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30
Q

What are the causes of valve regurgitation?

A 
Acute
-infective endocarditis
-chest trauma
Chronic
-congenital defects
-tissue disorders (Marfans)
-rheumatic fever
-cardiomyopathy
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31
Q

What are the symptoms of valve regurgitation?

A
  • exertional dyspnoea
  • orthopnea (short of breath lying down)
  • palpitations
  • angina
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32
Q

What are the signs of valve regurgitation?

A
  • collapsing pulse (rapidly increasing then decreasing)
  • wide pule pressure
  • high pitched early diastolic murmur
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33
Q

How is valve regurgitation treated?

A
  • valve replacement
  • ACE inhibitors
  • echocardiogram for monitoring
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34
Q

What is cardiomyopathy?

A

Condition where the cardiac muscle is structurally or functionally abnormal

35
Q

What is the difference between primary and secondary cardiomyopathy?

A

Primary is idiopathic (unknown cause). Secondary is as a result of another condition.

36
Q

Name 3 examples of conditions which result in secondary cardiomyopathy.

A

CKD, diabetes mellitus, thyroid disease, drugs/alcohol abuse, infection, genetic conditions

37
Q

What is dilated cardiomyopathy and what are the symptoms?

A

Ventricles are enlarged so blood is pumped less efficiently.

  • fatigue
  • dyspnoea
  • oedema
38
Q

What is hypertrophic cardiomyopathy and its symptoms?

A

Myocytes increase in size causing thickening of the cardiac muscle.

  • angina
  • dyspnoea
  • palpitations
39
Q

What is restrictive cardiomyopathy?

A

Condition where the ventricle do not fill to max volume due to stiffening of the cardiac muscle.

40
Q

What is arrhythmogenic cardiomyopathy?

A

Progressive replacement of cardiac muscle with fatty/fibrous tissue, due to abnormal proteins holding cells together which leads to cell death..

41
Q

How is cardiomyopathy managed?

A
  • beta-blockers (irregular heart beat)
  • ECG and echocardiogram
  • lifestyle changes
  • anti-hypetensives
  • diuretics
  • anti-coagulants
  • heart transplant
42
Q

What is coarctation of the aorta and what are the symptoms?

A

Congenital narrowing of the aorta.

  • palor
  • irritability
  • heavy sweating
  • dyspnoea
43
Q

How is coarctation of the aorta managed?

A

Angioplasty - stent with balloon is inserted into the aorta to widen it

44
Q

What is a patent ductus arteriosus and how is it treated?

A

Ductus arteriosus remains open causing blood to flow from the aorta into the pulmonary artery. Closed surgically

45
Q

What is a patent foramen ovale and how is it treated?

A

Foramen ovale remains open so blood flow from the LA into the RA. Surgically closed if hole is of a significant size.

46
Q

What is hypoplastic left heart syndrome?

A

Congenital defect causing the left of the heart to be underdeveloped (small ventricles, ascending aorta, valves)

47
Q

What are the symptoms of hypoplastic left heart syndrome?

A
  • weak pulse
  • dyspnoea
  • pale skin
48
Q

What are the causes of hypoplastic left heart syndrome?

A
  • genetic mutations
  • genetic risk factors
  • antenatal environment
49
Q

How is hypoplastic left heart syndrome treated?

A
  • surgery
  • diet control
  • medication to strengthen the heart muscle
50
Q

What are cardiac arrhythmias?

A

Abnormal heart rate/rhythm

51
Q

What is supraventricular tachycardia?

A

Heart rate is not controlled by the SA node but by another part of the heart which is causing a fast heart rate

52
Q

What is atrial fibrillation?

A

Random electrical impulses from the atria cause rapid and partial contraction of the atria.

53
Q

What is atrial flutter?

A

Atria rapidly contract but ventricles don’t.

54
Q

What is ventricular tachycardia?

A

Ventricles beat rapidly but atria don’t.

55
Q

What is ventricular fibrillation?

A

Random electrical impulses originating from the ventricle cause weak heart contractions.

56
Q

What is heart block?

A

Electrical impulses partially or fully blocked between the atria and ventricles.

57
Q

What are the causes of cardiac arrhythmia?

A
  • congenital
  • hypertension
  • ageing
  • cardiomyopathy
  • coronary heart disease
58
Q

What are the symptoms of cardiac arrhythmias?

A
  • palpitations (sensation of heart skipping of adding a beat)
  • dizziness/faint
  • short of breath
  • chest pains
59
Q

What are the treatments for cardiac arrhythmias?

A
  • cardioversion (electrical shock given under anaesthetic to restart heart)
  • pacemaker
  • implantable cardioverter defibrillaters (small device in body which detects heart rate and triggers a small electrical shock when it is abnormal
  • catheter ablations (small wire used to destroy part of the heart causing abnormal impulses)
60
Q

What is an aortic aneurysm?

A

Enlargement/ballooing of the aortic artery

61
Q

What are the causes of an aortic aneurysm?

A
  • atheroma
  • trauma
  • infection
  • connective tissue disorder
62
Q

What are the symptoms of an aortic aneurysm?

A

Often asymptomatic, unless pressing on other structures then may cause pain

63
Q

How is an aortic aneurysm managed?

A
  • modify risk factors (dec BP, smoking cessation)
  • monitor size
  • EVAR (endovascular repair) if: expanding >1cm/year, >5.5cm, symptomatic
64
Q

What are the complications of an aortic aneurysm?

A
  • rupture (artery burst causing internal bleeding)
  • thrombosis
  • embolism
  • fistula (abnormal connection between an artery and vein)
65
Q

What are the symptoms of a ruptured aortic aneurysm?

A
  • pain

- expansible abdominal mass

66
Q

How is a ruptured aortic aneurysm managed?

A

41% mortality if treated

  • ECG, crossmatch
  • IV access
  • O Rh-ve blood (universal donor - no antigens to be rejected)
  • emergency surgery to clamp aorta above leak and insert graft
67
Q

What is aortic dissection?

A

Inner layer of the aorta tears causing blood to pass through the tear and separate the inner and middle layers of the aorta

68
Q

What are the causes of aortic dissection?

A
  • hypertension
  • aortic aneurysm
  • Marfans (tissue disorder)
  • strenuous exercise
  • cocaine use
69
Q

What are the symptoms of an aortic dissection?

A
  • tearing chest pain (may radiate to the back)
  • weakness in part of the body
  • shortness of breath
70
Q

What are the complications of aortic dissection?

A

limb ischaemia

  • MI
  • cardiac arrest
  • aortic valve incompetence
71
Q

How is an aortic dissection managed?

A
  • ECG, CXR, CT scan
  • hypotensives (beta blockers)
  • surgery to repair artery
72
Q

What is peripheral vascular disease?

A

Narrowing/blockage/spasm of the blood vessels outside the brain and heart (usually in the leg - femoral)

73
Q

What causes peripheral vascular disease?

A

Atheroma

74
Q

What are the risk factors for peripheral vascular disease?

A
  • excessive alcohol consumption
  • obesity
  • diabetes mellitus
  • hyperlipidemia
  • genetics
  • smoking
  • immobility
75
Q

What are the symptoms of peripheral vascular disease?

A
  • pain in the legs after exercise which is relieved by exercise
  • pain in the foot at rest
  • ulceration
  • gangrene (death of tissue due to ischaemia
76
Q

What are the signs of peripheral vascular disease?

A
  • weak pulse in the foot, popliteal, femoral
  • pale/cold feet
  • sores on feet
77
Q

How is peripheral vascular disease managed?

A
  • modify risk factors
  • anti-platelets (Clopidogrel)
  • anti-hypertensives
  • statins
  • surgery (amputate, angioplasty, bypass artery
78
Q

What is cardiogenic shock?

A

Inadequate tissue perfusion due to cardiac dysfunction. Leading to

  • hypoperfusion: dec blood flow to organ
  • hypoxia: dec oxygen at the tissue level
79
Q

What are the causes of cardiogenic shock?

A
  • MI
  • arrhythmias
  • pulmonary embolus
  • tension pneumothorax
  • cardiac temponade
  • myocarditis
  • aortic dissection
  • valve damage
  • drugs
80
Q

What is cardiac temponade?

A

Fluid accumulates in the pericardium (sac around the heart) causing compression of the heart. So the heart is unable to fill/pump properly

81
Q

What are the symptoms of cardiogenic shock?

A
  • chest pain
  • dyspnoea
  • sweating
  • confusion
  • faint
  • nausea/vomiting
82
Q

What are the signs of cardiogenic shock?

A
  • pale skin
  • hypotension
  • tachycardia or bradycardia
  • raised jugular vein pressure
83
Q

How is cardiogenic shock managed?

A
  • oxygen therapy to reach O2 sats of 94-98%
  • diamorphine for pain
  • correct any arrhythmias/electrolyte imbalances
  • optimise filing pressure (underfilled = plasma expander, overfilled = ionotropic support)
  • treat cause
84
Q

Define:
Cardiac failure
Cardiogenic Shock
Myocardial infarctions

A

Cardiac failure = heart unable to pump blood sufficiently around the body
Cardiogenic shock = state of inadequate tissue perfusion due to dysfunction of the heart.
MI = sudden and complete blockage of blood to the heart causing serious damage.

My Phase 2a Medicine (5 decks)

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