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Phase 2a - Cardiovascular > Cardiovascular Conditions A > Flashcards

Cardiovascular Conditions A Flashcards

1
Q

Stable Angina Pectoris - Description

A

chest pain during exertion or stress due to myocardial ischaemia

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2
Q

Stable Angina Pectoris - Causes (2)

A

1) atherosclerosis

2) anaemia (rare)

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3
Q

Stable Angina Pectoris - Risk Factors (9)

A

1) age
2) male
3) family history
4) hypertension
5) hypercholesterolaemia
6) diabetes mellitus
7) smoking
8) obesity
9) sedentary lifestyle

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4
Q

Stable Angina Pectoris - Pathophysiology (2)

A

1) coronary atherosclerosis

2) myocardial ischaemia

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5
Q

Stable Angina Pectoris - Symptoms (5)

A

1) heavy, tight, central chest pain
2) pain radiates to arms, neck, jaw
associated
3) dyspnoea
4) nausea
5) diaphoresis

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6
Q

Stable Angina Pectoris - Signs (3)

A

1) brought on by exertion
2) relieved by rest
3) relieved by GTN spray

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7
Q

Stable Angina Pectoris - Complications (4)

A

1) myocardial infarction
2) heart failure
3) stroke
4) depression

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8
Q

Stable Angina Pectoris - Investigations (4/4)

A 
initial
1) ECG (depressed ST segment, inverted T wave)
2) FBC (<90g/L if anaemia)
3) fasting blood glucose
4) fasting lipid profile
consider
1) coronary angiogram*
2) coronary CT angiogram
3) stress ECG (depressed/elevated ST segment)
4) stress echocardiogram
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9
Q

Stable Angina Pectoris - Management (4/4/2)

A 
conservative
1) dietary advice
2) regular exercise
3) weight loss
4) smoking cessation
medical
1) GTN spray (symptomatic relief)
2) antiplatelet (aspirin or clopidogrel)
3) antihypertensive (βB or CCB)
4) statin
surgery
1) percutaneous coronary intervention (PCI)
2) coronary artery bypass graft (CABG)
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10
Q

Unstable Angina Pectoris - Description

A

chest pain during rest due to myocardial ischaemia

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11
Q

Unstable Angina Pectoris - Causes (2)

A

1) atherosclerosis

2) anaemia (rare)

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12
Q

Unstable Angina Pectoris - Risk Factors (9)

A

1) age
2) male
3) family history
4) hypertension
5) hypercholesterolaemia
6) diabetes mellitus
7) smoking
8) obesity
9) sedentary lifestyle

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13
Q

Unstable Angina Pectoris - Pathophysiology (2)

A

1) coronary atherosclerosis

2) myocardial ischaemia

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14
Q

Unstable Angina Pectoris - Symptoms (5)

A

1) heavy, tight central chest pain
2) pain radiates to arms, neck, jaw
associated
3) dyspnoea
4) nausea
5) diaphoresis

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15
Q

Unstable Angina Pectoris - Signs (2)

A

1) relieved by GTN spray

2) S4 heart sound

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16
Q

Unstable Angina Pectoris - Complications (4)

A

1) myocardial infarction
2) heart failure
3) stroke
4) depression

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17
Q

Unstable Angina Pectoris - Investigations (5/4)

A 
initial
1) ECG (depressed ST segment, inverted T wave)
2) FBC (<90g/L if anaemia)
3) troponin assay (unelevated)
4) fasting blood glucose
5) fasting lipid profile
consider
1) coronary angiogram*
2) coronary CT angiogram
3) stress ECG (depressed/elevated ST segment)
4) stress echocardiogram
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18
Q

Unstable Angina Pectoris - Management (4/4/2)

A 
conservative
1) dietary advice
2) regular exercise
3) weight loss
4) smoking cessation
medical
1) GTN spray (symptomatic relief)
2) antiplatelet (aspirin or clopidogrel)
3) antihypertensive (βB or CCB)
4) statin
surgery
1) percutaneous coronary intervention* (PCI)
2) coronary artery bypass graft
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19
Q

Non-ST-Elevated Myocardial Infarction - Description

A

myocardial infarction due to narrowing of coronary artery

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19
Q

Non-ST-Elevated Myocardial Infarction - Causes (2)

A

1) atherothrombosis

2) emboli (rare)

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19
Q

Non-ST-Elevated Myocardial Infarction - Risk Factors (9)

A

1) age
2) male
3) family history
4) hypertension
5) hypercholesterolaemia
6) diabetes mellitus
7) smoking
8) obesity
9) sedentary lifestyle

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20
Q

Non-ST-Elevated Myocardial Infarction - Pathophysiology (3)

A

1) coronary thrombosis
2) narrowing of coronary artery
3) myocardial infarction

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21
Q

Non-ST-Elevated Myocardial Infarction - Symptoms (6)

A

1) heavy, tight, central chest pain (>20 minutes)
2) radiates to arms, neck, jaw
associated
3) dyspnoea
4) nausea
5) diaphoresis
6) palpitations

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22
Q

Non-ST-Elevated Myocardial Infarction - Symptoms (Silent Myocardial Infraction) (3)

A

1) epigastric pain
2) syncope
3) vomiting

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23
Q

Non-ST-Elevated Myocardial Infarction - Signs (4)

A

1) anxiety
2) pallor
3) bradycardia/tachycardia
4) hypotension/hypertension

24
Q

Non-ST-Elevated Myocardial Infarction - Complications (6)

A

1) arrhythmia
2) heart failure
3) pericarditis
4) cardiac tamponade
5) systemic embolism
6) depression

25
Q

Non-ST-Elevated Myocardial Infarction - Investigations (2/3)

A 
initial
1) ECG (depressed ST segment, inverted T wave)
2) troponin assay* (elevated)
consider
3) chest x-ray
4) coronary angiogram
5) echocardiogram
26
Q

Non-ST-Elevated Myocardial Infarction - Management (Initial) (5)

A 
1) thrombolysis (<4 hours within MI)
MONA
2) morphine
3) oxygen
4) nitrates
5) aspirin
27
Q

Non-ST-Elevated Myocardial Infarction - Management (4/5/2)

A 
conservative
1) dietary advice
2) regular exercise
3) weight loss
4) smoking cessation
medical
1) antiplatelet (aspirin or clopidogrel)
2) anticoagulation (warfarin)
3) antihypertensive (βB or ACEi/ARB)
4) statin
5) spironolactone
surgery
1)  percutaneous coronary intervention* (PCI)
2) coronary artery bypass graft (CABG)
28
Q

ST-Elevated Myocardial Infarction - Description

A

myocardial infarction due to blockage of a coronary artery

29
Q

ST-Elevated Myocardial Infarction - Causes (2)

A

1) atherothrombosis

2) emboli (rare)

30
Q

ST-Elevated Myocardial Infarction - Risk Factors (9)

A

1) age
2) male
3) family history
4) hypertension
5) hypercholesterolaemia
6) diabetes mellitus
7) smoking
8) obesity
9) sedentary lifestyle

31
Q

ST-Elevated Myocardial Infarction - Pathophysiology (3)

A

1) coronary thrombosis
2) blockage of coronary artery
3) myocardial infarction

32
Q

ST-Elevated Myocardial Infarction - Symptoms (6)

A

1) heavy, tight, central chest pain (>20 minutes)
2) pain radiates to arms, neck, jaw
associated
3) dyspnoea
4) nausea
5) diaphoresis
6) palpitations

33
Q

ST-Elevated Myocardial Infarction - Symptoms (Silent Myocardial Infarction) (3)

A

1) epigastric pain
2) syncope
3) vomiting

34
Q

ST-Elevated Myocardial Infarction - Signs (4)

A

1) anxiety
2) pallor
3) hypotension/hypertension
4) bradycardia/tachycardia

35
Q

ST-Elevated Myocardial Infarction - Complications (6)

A

1) arrhythmia
2) heart failure
3) pericarditis
4) cardiac tamponade
5) systemic embolism
6) depression

36
Q

ST-Elevated Myocardial Infarction - Investigations (2/3)

A 
initial
1) ECG (elevated ST segment, inverted T waves, pathological Q wave)
2) troponin assay* (elevated)
consider
1) chest x-ray
2) coronary angiogram
3) echocardiogram
37
Q

ST-Elevated Myocardial Infarction - Management (Initial) (5)

A 
1) thrombolysis (<4 hours within MI)
MONA
2) morphine
3) oxygen
4) nitrates
5) aspirin
38
Q

ST-Elevated Myocardial Infarction - Management (4/5/2)

A 
conservative
1) dietary advice
2) regular exercise
3) weight loss
4) smoking cessation
medical
1) antiplatelet (aspirin or clopidogrel)
2) anticoagulation (warfarin)
3) antihypertensive (βB + ACEi/ARB)
4) statin
5) spironolactone
surgery
1) percutaneous coronary intervention* (PCI)
2) coronary artery bypass graft (CABG)
39
Q

Heart Failure - Description

A

inadequate cardiac output for body’s requirements

40
Q

Heart Failure - Categories (4)

A

1) right heart failure
2) left heart failure
3) diastolic failure (preserved ejection fraction, LVEF>50%)
4) systolic failure (reduced ejection fraction, LVEF<40%)

41
Q

Heart Failure - Causes (Left Heart Failure) (6)

A

1) ischaemic heart disease (S)
2) hypertension (S, D)
3) dilated cardiomyopathy (S)
4) hypertrophic cardiomyopathy (D)
5) restrictive cardiomyopathy (D)
6) aortic stenosis (D)

42
Q

Heart Failure - Causes (Right Heart Failure) (5)

A

1) left heart failure
2) atrial septal defect
3) ventricular septal defect
4) cor pulmonale (RHF 2nd to pulmonary disease)

43
Q

Heart Failure - Risk Factors (6)

A

1) age
2) male
3) myocardial infraction
4) hypertension
5) hypercholesterolaemia
6) diabetes mellitus

44
Q

Heart Failure - Pathophysiology (Congestive Heart Failure) (14)

A

1) heart failure
2) decreased kidney perfusion
3) RAAS activated
4) increased fluid retention (Na+, H2O)
5) increased preload
6) increased SNS activation
7) increased heart rate
8) peripheral vasoconstriction
9) increased afterload
10) left ventricular hypertrophy
11) increased contraction strength
12) inadequate O2 supply
13) myocyte atrophy
14) worsening heart failure

45
Q

Heart Failure - Symptoms (Left Heart Failure) (8)

A

1) dyspnoea
2) orthopnoea
3) paroxysmal nocturnal dyspnoea
4) chest pain
5) fatigue
6) weight loss
7) muscle weakness
8) cold peripheries

46
Q

Heart Failure - Symptoms (Right Heart Failure) (3)

A

1) nausea
2) anorexia
3) epistaxis

47
Q

Heart Failure - Signs (Left Heart Failure) (5)

A

1) cardiomegaly*
2) S3 heart sound*
3) rales (abnormal crackling lung sounds)
4) tachycardia
5) hypotension

48
Q

Heart Failure - Signs (Right Heart Failure) (11)

A

1) cardiomegaly
2) S3 heart sound
3) rales (abnormal crackling lung sounds)
4) tachycardia
5) hypotension
6) high JVP
7) neck vein distension*
8) hepatojugular reflex* (neck vein distension when pressure applied on liver)
9) hepatomegaly
10) ascites
11) peripheral oedema (esp. ankles)

49
Q

Heart Failure - Complications (7)

A

1) cardiogenic shock
2) arrhythmia
3) pleural effusion
4) pulmonary oedema
5) acute kidney injury/chronic kidney disease
6) anaemia
7) death (25-50% in 5 years)

50
Q

Heart Failure - Investigations (7/0)

A 
initial
1) echocardiogram*
2) chest x-ray
3) serum BNP (high)
4) ECG
5) FBC
6) UnE
7) LFT
normal BNP and ECG exclude heart failure
51
Q

Heart Failure - Classification (New York Heart Association) (4)

A

I) no physical activity limitation
II) slight physical activity limitation
III) marked physical activity limitation
IV) extreme physical activity limitation

52
Q

Heart Failure - Diagnosis (Framingham Criteria) (7/6)

A 
2 majors OR 1 major, 2 minors
major
1) cardiomegaly
2) S3 heart sound
3) pulmonary oedema
4) rales
5) dyspnoea or paroxysmal nocturnal dyspnoea
6) neck vein distension
7) hepatojugular reflex
minor
1) tachycardia
2) pleural effusion
3) exertional dyspnoea
4) nocturnal cough
5) hepatomegaly
6) ankle oedema
53
Q

Heart Failure - Management (5/6/3)

A 
conservative
1) dietary advice (e.g. low dietary sodium)
2) regular exercise
3) weight monitoring
4) smoking cessation
5) screening
medical
1) antihypertensive (βB + ACEi/ARB)
2) diuretic
3) digoxin
4) hydralazine (arterial vasodilator)
5) isosorbide nitrate (venous vasodilator)
6) spironolactone
surgery
1) implantable cardiac defibrillator (LVEF<35%, no LBBB)
2) pacemaker (LVEF<30%, LBBB)
3) heart transplant
54
Q

Hypertension - Description

A

high blood pressure

55
Q

Hypertension - Causes (6)

A

1) primary (unknown, 95%)
2) chronic kidney disease
3) endocrine disorders (e.g. Cushing’s, Conn’s, acromegaly, hyperparathyroidism)
4) coarctation of aorta
5) pregnancy
6) iatrogenic (steroids, oral contraceptive pill, antidepressants)

56
Q

Hypertension - Risk Factors (10)

A

1) age (>65 years old)
2) male
3) family history
4) Afro-Caribbean
5) sleep apnoea
6) diabetes mellitus
7) metabolic syndrome
8) smoking
9) obesity
10) sedentary lifestyle

57
Q

Hypertension - Symptoms (3)

A

1) asymptomatic
2) headache (malignant)
3) visual disturbances (malignant)

58
Q

Hypertension - Investigations (1/1)

A

initial
1) clinic BP (>140/90 - stage 1, >160/100 - stage 2, >180/110 -severe)
consider
1) ABPM (>135/85 - stage 1, >150/95 - stage 2)

59
Q

Hypertension - Management (5/3/0)

A

conservative
1) dietary advice (low dietary fat, salt)
2) regular exercise
3) weight loss (5-10kg loss = 1 medication)
4) smoking cessation
5) alcohol control
medical
QRISK2>20%/10 years or end organ failure
1) ACEi/ARB (<55 years old)
2) CCB/thiazide diuretic (>55 years old or Afro-Caribbean)
3) +ACEi/ARB/CCB/thiazide diuretic as necessary

Phase 2a - Cardiovascular (4 decks)

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