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Phase 2a - Cardiovascular > Cardiovascular Conditions B > Flashcards

Cardiovascular Conditions B Flashcards

1
Q

Atrioventricular Block - Description

A

disrupted electrical conduction of AV node

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2
Q

Atrioventricular Block - Risk Factors (8)

A

1) >50 years old (tissue fibrosis)
2) male
3) increases vagal tone
4) AV node blocking agents (βB, CCB, digoxin)
5) hypertension
6) ischaemic heart disease (inf. MI —> Mobitz I, ant. MI —> Mobitz II)
7) cardiomegaly
8) heart failure

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3
Q

Atrioventricular Block - Types (4)

A

1) 1st degree
2) 2nd degree Mobitz I
3) 2nd degree Mobitz II
4) 3rd degree

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4
Q

Atrioventricular Block - Pathophysiology (1st Degree) (1)

A

1) delayed atrioventricular conduction

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5
Q

Atrioventricular Block - Pathophysiology (2nd Degree) (1)

A

1) decreased atrioventricular conduction

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6
Q

Atrioventricular Block - Pathophysiology (3rd Degree) (2)

A

1) no atrioventricular conduction

2) ventricular conduction maintained by escape rhythms

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7
Q

Atrioventricular Block - Symptoms (7)

A

1) asymptomatic
2) syncope
3) fatigue (esp. exertional)
4) dyspnoea (esp. exertional)
acute symptoms
5) chest pain
6) nausea
7) palpitations

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8
Q

Atrioventricular Block - Signs (3)

A

1) bradycardia (<40bpm - emergency)
2) hypertension (inc. wide pulse pressure)
3) hypotension (emergency)

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9
Q

Atrioventricular Block - Complications (1)

A

1) bradycardia

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10
Q

Atrioventricular Block - Investigations (3/2)

A 
initial
1) ECG*
2) UnE (abnormal K+, Ca2+)
3) troponin assay (may be elevated)
consider
1) ambulatory monitoring (24 hours)
2) chest x-ray
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11
Q

Atrioventricular Block - Investigations (ECG) (4)

A

1) 1st degree —> PR interval>200ms
2) 2nd degree Mobitz I —> PR interval progressively increasing
3) 2nd degree Mobitz II —> PR interval constant, QRS complex occasionally missed
4) 3rd degree —> P wave and QRS complex completely dissociated

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12
Q

Atrioventricular Block - Management (2/1/1)

A 
conservative
1) stop AV node blocking agents (βB, CCB, digoxin)
2) monitor (1st, 2nd I)
medical
1) atropine (2nd II, 3rd)
surgery
1) pacemaker
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13
Q

Right Bundle Branch Block - Description

A

heart block before right His bundle branch

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14
Q

Right Bundle Branch Block - Causes (5)

A

1) ischaemic heart disease
2) right ventricular hypertrophy
3) pulmonary embolism
4) atrial septal defect
5) ventricular septal defect

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15
Q

Right Bundle Branch Block - Pathophysiology (2)

A

1) heart block of right His bundle branch

2) left ventricle contracts before right ventricle

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16
Q

Right Bundle Branch Block - Symptoms (2)

A

1) asymptomatic

2) syncope

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17
Q

Right Bundle Branch Block - Signs (1)

A

1) wide S2 heart sound split (A2 then P2))

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18
Q

Right Bundle Branch Block - Complications (1)

A

1) bradycardia

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19
Q

Right Bundle Branch Block - Investigations (1/0)

A

initial

1) ECG*

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20
Q

Right Bundle Branch Block - Investigations (ECG) (4)

A

1) QRS complex >120ms
2) deep S wave in I, V5, V6
MarroW
3) M QRS complex in V1
4) W QRS complex in V6

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21
Q

Right Bundle Branch Block - Management (0/1/0)

A

medical

1) treat underlying cause

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22
Q

Left Bundle Branch Block - Description

A

heart block before left His bundle branch

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23
Q

Left Bundle Branch Block - Causes (4)

A

1) ischaemic heart disease
2) left ventricular hypertrophy
3) aortic regurgitation
4) aortic stenosis

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24
Q

Left Bundle Branch Block - Pathophysiology (2)

A

1) heart block of left His bundle branch

2) right ventricle contracts before left ventricle

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25
Q

Left Bundle Branch Block - Symptoms (2)

A

1) asymptomatic

2) syncope

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26
Q

Left Bundle Branch Block - Signs (1)

A

1) paradoxical S2 heart sound split (P2 then A2)

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27
Q

Left Bundle Branch Block - Complications (1)

A

1) bradycardia

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28
Q

Left Bundle Branch Block - Investigations (1/0)

A

initial

1) ECG*

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29
Q

Left Bundle Branch Block - Investigations (ECG) (4)

A

1) QRS complex > 120ms
2) deep S wave in V1, V2
WilliaM
3) W QRS complex in V1
4) M QRS complex in V6

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30
Q

Left Bundle Branch Block - Management (0/1/0)

A

medical

1) treat underlying cause

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31
Q

Sinus Tachycardia - Description

A

increased heart rate (>100bpm)

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32
Q

Sinus Tachycardia - Causes (7)

A

1) exertion
2) anxiety
3) pain
4) fever
5) anaemia
6) hyperthyroidism
7) hypovolaemia

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33
Q

Sinus Tachycardia - Symptoms (4)

A

1) asymptomatic
2) dyspnoea
3) fatigue
4) presyncope–>syncope

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34
Q

Sinus Tachycardia - Investigations (7/1)

A 
initial
1) ECG (sinus rhythm, >100bpm)
2) Holter monitoring
3) event monitoring
4) FBC
5) UnE
6) TFT
7) troponin assay
consider
1) implantable loop recorder
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35
Q

Sinus Tachycardia - Management (2/3/0)

A 
conservative
1) none
2) vagal manoeuvres
medical
1) treat underlying cause
2) IV adenosine
3) rate controller (e.g. βB, CCB)
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36
Q

Atrial Fibrillation - Description

A

irregularly irregular heart beat, type of supraventricular tachycardia

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37
Q

Atrial Fibrillation - Causes (10)

A

1) idiopathic (5-10%)
2) ischaemic heart disease
3) heart failure
4) hypertension
5) mitral stenosis
6) mitral regurgitation
7) chronic obstructive pulmonary disease
8) asthma
9) hyperthyroidism
10) alcohol

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38
Q

Atrial Fibrillation - Pathophysiology (4)

A

1) ectopic pulmonary vein discharge
2) dysfunctional electrical signalling
3) ectopic atrial beats
4) uncoordinated atrial contraction

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39
Q

Atrial Fibrillation - Symptoms (5)

A

1) asymptomatic
2) chest pain
3) dyspnoea
4) palpitations
5) syncope

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40
Q

Atrial Fibrillation - Signs (3)

A

1) irregularly irregular heart beat
2) apical pulse rate faster than radial pulse rate
3) tachycardia

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41
Q

Atrial Fibrillation - Complications (5)

A

1) atrial flutter
2) bradycardia (iatrogenic)
3) stroke
4) heart failure
5) hypotension

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42
Q

Atrial Fibrillation - Investigations (4/2)

A 
initial
1) ECG*
2) U&amp;E
3) TFT
4) chest x-ray
consider
1) LFT
2) echocardiogram (left atrial enlargement, mitral valve disease)
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43
Q

Atrial Fibrillation - Investigations (ECG) (5)

A

1) absent P waves
2) irregular RR intervals
3) narrow QRS complexes
4) atrial rate 350-600bpm
5) ventricular rate 100-180bpm

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44
Q

Atrial Fibrillation - Management (0/3/2)

A

medical
1) anticoagulant or antiplatelets (e.g. warfarin or aspirin)
2) antiarrhythmic (amiodarone or flecainide)
3) rate control (βB or CCB or digoxin)
surgery
1) DC cardioversion
2) catheter ablation (pulmonary vein)

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45
Q

Atrial Flutter - Description

A

intermittent increased atrial rate, type of supraventricular tachycardia

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46
Q

Atrial Flutter - Causes (10)

A

1) idiopathic (30%)
2) ischaemic heart disease
3) heart failure
4) hypertension
5) mitral stenosis
6) mitral regurgitation
7) chronic obstructive pulmonary disease
8) asthma
9) hyperthyroidism
10) alcohol

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47
Q

Atrial Flutter - Pathophysiology (4)

A

1) accessory conduction pathway
2) electrical impulse persists
3) atria recontract after refractory period
4) increased atrial contraction

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48
Q

Atrial Flutter - Symptoms (6)

A

1) chest pain
2) dyspnoea
3) palpitations
4) syncope
5) fatigue
6) worsening heart failure or pulmonary symptoms

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49
Q

Atrial Flutter - Signs (1)

A

1) tachycardia

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50
Q

Atrial Flutter - Complications (3)

A

1) atrial fibrillation
2) stroke
3) heart failure

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51
Q

Atrial Flutter - Investigations (4/2)

A 
initial
1) ECG*
2) U&amp;E
3) TFT
4) chest x-ray
consider
1) spirometry
2) echocardiogram (left atrial enlargement, mitral valve disease)
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52
Q

Atrial Flutter - Investigations (ECG) (3)

A

1) absent P waves –> F waves (sawtooth)
2) atrial rate : ventricular rate –> 2:1 or 4:1
3) atrial rate 240-320bpm

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53
Q

Atrial Flutter - Management (3/2)

A

medical
1) anticoagulants (warfarin + heparin)
2) antiarrhythmic (amiodarone or flecainide)
3) rate control (βB or CCB or digoxin)
surgery
1) DC cardioversion
2) catheter ablation (cavotricuspid isthmus) (refractory)

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54
Q

Aortic Aneurysm - Description

A

permanent dilation of aorta (>50%)

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55
Q

Aortic Aneurysm - Risk Factors (8)

A

1) family history
2) Ehlers-Danlos syndrome
3) Marfan syndrome
4) hypertension
5) hypercholesterolaemia
6) smoking
7) age
8) male

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56
Q

Aortic Aneurysm - Pathophysiology (2)

A

1) abnormal elastin and collagen

2) permanent dilation of aorta

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57
Q

Aortic Aneurysm - Symptoms (1)

A

1) asymptomatic (unruptured)

58
Q

Aortic Aneurysm - Signs (1)

A

1) pulsatile abdominal swelling

59
Q

Aortic Aneurysm - Complications (3)

A

1) aortic aneurysm
2) haemorrhagic shock
3) death

60
Q

Aortic Aneurysm - Investigations (1/2)

A 
initial
1) chest, abdominal ultrasound*
consider
1) FBC
2) CT angiogram
61
Q

Aortic Aneurysm - Management (0/1/1)

A

medical
1) prophylactic wide spectrum antibiotics
surgery
1) endovascular aneurysm repair

62
Q

Aortic Dissection - Description

A

blood in between aortic walls

63
Q

Aortic Dissection - Risk Factors (9)

A

1) family history
2) Ehlers-Danlos syndrome
3) Marfan syndrome
4) hypertension
5) hypercholesterolaemia
6) smoking
7) age
8) male
9) aortic aneurysm

64
Q

Aortic Dissection - Pathophysiology (4)

A

1) tear in aortic intima
2) blood under pressure enters aortic wall
3) haematoma separating intima and adventitia
4) false lumen created

65
Q

Aortic Dissection - Symptoms (4)

A

1) acute severe tearing chest pain (thoracic)
2) acute severe tearing interscapular pain (abdominal)
3) diaphoresis
4) presyncope–>syncope

66
Q

Aortic Dissection - Signs (5)

A

1) hypotension
2) left/right blood pressure differential
3) left/right pulse differential
4) pulse deficit
5) diastolic murmur

67
Q

Aortic Dissection - Complications (3)

A

1) cardiac tamponade
2) haemorrhagic shock
3) death (80%)

68
Q

Aortic Dissection - Investigations (4/2)

A 
initial
1) CT angiogram*
2) chest x-ray
3) ECG (exclude MI)
4) troponin assay (exclude MI)
consider
1) D dimer
2) echocardiogram
69
Q

Aortic Dissection - Management 0/2/2)

A 
medical
1) antihypertensive (βB + CCB)
2) analgesia (opioid)
surgery
1) open surgery (ascending aorta)
2) stent graft (descending aorta)
70
Q

Peripheral Vascular Disease - Description

A

stenosis arteries distal to aortic arch

71
Q

Peripheral Vascular Disease - Causes (1)

A

1) atherosclerosis

72
Q

Peripheral Vascular Disease - Risk Factors (8)

A

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

73
Q

Peripheral Vascular Disease - Pathophysiology (3)

A

1) artery atherosclerosis
2) narrowing of artery
3) ischaemia of area supplied by artery

74
Q

Peripheral Vascular Disease - Symptoms (4)

A

1) asymptomatic
2) intermittent claudication (cramping leg pain during exercise)
3) critical limb ischaemia (cramping leg pain during rest)
4) erectile dysfunction

75
Q

Peripheral Vascular Disease - Signs (5)

A

1) absent femoral pulse
2) absent popliteal pulse
3) absent foot pulse
4) cold legs
5) white legs

76
Q

Peripheral Vascular Disease - Complications (3)

A

1) ulcers (leg/foot)
2) gangrene
3) infection

77
Q

Peripheral Vascular Disease - Investigations (1/4)

A 
initial
1) ankle-brachial index
consider
1) toe-brachial index
2) Doppler ultrasound
3) CT angiogram*
4) MR angiogram*
78
Q

Peripheral Vascular Disease - Management (4/2/2)

A 
conservative
1) dietary advice
2) regular advice
3) weight loss
4) smoking cessation
medical
1) aspirin
2) cilostazol (intermittent claudication)
surgery
1) revascularisation
2) amputation (last resort)
79
Q

Acute Pericarditis - Description

A

acute inflammation of pericardium (<4-6 weeks)

80
Q

Acute Pericarditis - Causes (5)

A

1) idiopathic (80-90%)
2) viral
3) tuberculosis
4) autoimmune
5) Dressler’s syndrome (post-MI)

81
Q

Acute Pericarditis - Pathophysiology (3)

A

1) inflammation of pericardium
2) fluid accumulation in pleural cavity (pleural effusion)
3) fluid accumulation in pericardial cavity (pericardial effusion–>cardiac tamponade)

82
Q

Acute Pericarditis - Symptoms (8)

A

1) severe pleuritic chest pain
2) pain radiates to shoulder, arm
3) pain relieved by sitting forward
4) pain exacerbated by lying down
5) pain exacerbated by inspiration
6) dyspnoea
7) cough
8) fever

83
Q

Acute Pericarditis - Signs (5)

A

1) pericardial rub (high pitched squeaky rub heard at left sternal edge)
2) Kussmaul’s sign (JVP paradoxically rising with inspiration
3) pulsus paradoxus (SBP paradoxically falling with inspiration)
4) tachycardia
5) hypotension

84
Q

Acute Pericarditis - Complications (3)

A

1) pleural effusion
2) pericardial effusion –> cardiac tamponade
3) constrictive pericarditis

85
Q

Acute Pericarditis - Investigations (7/0)

A

initial

1) ECG* (depressed PR segment, saddle shaped elevated ST segment)
2) echocardiogram* (pleural effusion)
3) chest x-ray
4) FBC (leucocytosis)
5) troponin assay (mildly elevated)
6) high CRP + ESR
7) blood/pericardial fluid culture

86
Q

Acute Pericarditis - Diagnosis (4)

A

2 of:

1) pleuritic chest pain
2) pericardial rub
3) saddle shaped elevated ST segment (ECG)
4) pleural effusion (echocardiogram)

87
Q

Acute Pericarditis - Management (1/4/3)

A 
conservative
1) restrict exercise
medical
1) treat underlying cause
2) NSAID
3) colchicine (reduces recurrence by 50%)
4) PPI
surgery
1) thoracentesis (pleural effusion)
2) pericardiocentesis (cardiac tamponade)
3) pericardiectomy (high risk)
88
Q

Constrictive Pericarditis - Description

A

limited diastolic filling due to pericardium fibrosis

89
Q

Constrictive Pericarditis - Causes (1)

A

1) chronic pericarditis

90
Q

Constrictive Pericarditis - Symptoms (3)

A

1) dyspnoea
2) cough
3) fatigue

91
Q

Constrictive Pericarditis - Signs (5)

A

1) pericardial rub (high pitched squeaky rub heard at left sternal edge)
2) Kussmaul’s sign (JVP paradoxically rising with inspiration
3) pulsus paradoxus (SBP paradoxically falling with inspiration)
4) tachycardia
5) hypotension

92
Q

Constrictive Pericarditis - Complications (4)

A

1) pleural effusion
2) pericardial effusion –> cardiac tamponade
3) heart failure
4) atrial fibrillation

93
Q

Constrictive Pericarditis - Investigations (3/0)

A

initial

1) chest x-ray
2) echocardiogram
3) serum BNP (high)

94
Q

Constrictive Pericarditis - Management (0/0/1)

A

surgery

1) pericardectomy (high risk)

95
Q

Cardiac Tamponade - Description

A

fluid accumulation in pericardial cavity

96
Q

Cardiac Tamponade - Causes (5)

A

1) pericarditis
2) trauma
3) malignancy
4) aortic dissection
5) iatrogenic (cardiothoracic surgery)

97
Q

Cardiac Tamponade - Symptoms (3)

A

1) dyspnoea
2) chest pain
3) abdominal pain

98
Q

Cardiac Tamponade - Signs (7)

A

1) pericardial rub (high pitched squeaky rub heard at left sternal edge)
2) Kussmaul’s sign (JVP paradoxically rising with inspiration
3) pulsus paradoxus (SBP paradoxically falling with inspiration)
4) tachycardia
5) hypotension
6) soft/absent heart sounds
7) neck vein distension

99
Q

Cardiac Tamponade - Complications (4)

A

1) myocardial infarction
2) shock
3) recurrent pericarditis
4) recurrent pericardial effusion –> cardiac tamponade

100
Q

Cardiac Tamponade - Investigation (6/0)

A

initial

1) ECG* (depressed PR segment, saddle shaped elevated ST segment)
2) echocardiogram
3) chest x-ray
4) FBC (leucocytosis)
5) troponin assay (mildly elevated)
6) high CRP + ESR

101
Q

Cardiac Tamponade - Management (0/4/1)

A 
medical
1) treat underlying cause
2) NSAID
3) colchicine (reduces recurrence by 50%)
4) PPI
surgery
1) pericardiocentesis
102
Q

Infective Endocarditis - Description

A

infection of endocardium, e.g. heart valves

103
Q

Infective Endocarditis - Causes (7)

A

1) Staphylococcus aureus (most common)
2) Staphylococcus epidermidis (<2 months prosthetic valve)
3) Streptococcus viridans (dental)
4) Streptococcus bovis
5) Enterococci
6) Candida
7) Aspergillus

104
Q

Infective Endocarditis - Risk Factors (5)

A

1) IV drug abuser (esp. tricuspid valve)
2) immunocompromised
3) prosthetic valves
4) congenital heart defect
5) dental treatment

105
Q

Infective Endocarditis - Symptoms (3)

A

septic symptoms

1) fever (inc. night sweats, rigors)
2) malaise
3) weight loss

106
Q

Infective Endocarditis - Signs (5)

A

1) new murmur
2) Roth spots (retinal haemorrhages with pale centres)
3) Osler’s nodes (tender lesions on fingers/toes)
4) Janeway lesions (non-tender on palms/soles)
5) splinter haemorrhages (haemorrhage of vertical blood vessels under nails)

107
Q

Infective Endocarditis - Complications (8)

A

1) myocardial infarction
2) heart failure
3) arrhythmia
4) valve disease
5) kidney disease
6) systemic emboli (e.g. stroke, pulmonary embolism)
7) mycotic aneursym
8) osteomyelitis

108
Q

Infective Endocarditis - Investigations (6/0)

A

initial

1) blood cultures* (x3 from different sites)
2) FBC
3) high CRP + ESR
4) urine dipstick (haematuria)
5) ECG
6) echocardiogram)

109
Q

Infective Endocarditis - Diagnosis (Duke Criteria) (2/5)

A

2 major OR 1 major + 3 minor OR 5 minor
major
1) 2 separate positive blood cultures
2) endocardium involved (echocardiogram)
minor
1) fever
2) IV drug abuser or predisposing heart conditioni
3) immunological phenomoena (e.g. Osler’s nodes, Roth’s spots)
4) vascular phenomenon (e.g. Janeway lesions, mycotic aneurysm)
5) ambiguous blood culture)

110
Q

Infective Endocarditis - Management (1/2/1)

A

conservative
1) oral hygiene
medical
1) benzylpenicillin + gentamicin (Staph.)
2) benzlypenicillin + amoxicillin (Strep.)
surgery
1) valve repair/replacement

111
Q

Mitral Regurgitation - Description

A

blood blackflow from LV to LA during systole

112
Q

Mitral Regurgitation - Causes (6)

A

1) rheumatic heart disease
2) infective endocarditis
3) Ehlers-Danlos syndrome
4) Marfan syndrome
5) mitral valve prolapse
6) ischaemic heart disease (chordae tendineae, papillary muscle)

113
Q

Mitral Regurgitation - Pathophysiology (6)

A

1) blood backflow from LV to LA
2) blood volume overload in LA
3) progressive LA enlargement
4) progressive LV hypertrophy
5) progressive LV enlargement
6) progressive heart failure

114
Q

Mitral Regurgitation - Symptoms (2)

A

1) dyspnoea (esp. exertional)

2) fatigue

115
Q

Mitral Regurgitation - Signs (4)

A

1) pan systolic murmur
2) soft S1 heart sound
3) S3 heart sound
4) peripheral oedema

116
Q

Mitral Regurgitation - Complications (5)

A

1) congestive heart failure
2) infective endocarditis
3) atrial fibrillation
4) stroke
5) pulmonary hypertension

117
Q

Mitral Regurgitation - Investigations (3/0)

A

initial

1) ECG
2) chest x-ray
3) echocardiogram*

118
Q

Mitral Regurgitation - Management (1/2/1)

A 
conservative
1) serial endocardiograms
medical
1) ACEi
2) βB
surgery
1) valve replacement (+anticoagulant) (severe)
119
Q

Mitral Stenosis - Description

A

obstruction of LV inflow

120
Q

Mitral Stenosis - Causes (3)

A

1) rheumatic heart disease (95%)
2) infective endocarditis
3) senile calcification

121
Q

Mitral Stenosis - Pathophysiology (7)

A

1) narrowing of mitral valve
2) increased LA pressure
3) progressive LA hypertrophy
4) progressive LA enlargement
5) progressive LV hypertrophy
6) progressive LV enlargement
7) progressive heart failure

122
Q

Mitral Stenosis - Symptoms (3)

A

1) dyspnoea (esp. exertional)
2) haemoptysis
3) fatigue

123
Q

Mitral Stenosis - Signs (5)

A

1) mid diastolic murmur
2) loud S1 heart sound (opening snap)
3) peripheral oedema
4) neck vein distension
5) malar cheek flush

124
Q

Mitral Stenosis - Complications (5)

A

1) congestive heart failure
2) infective endocarditis
3) atrial fibrillation
4) stroke
5) pulmonary hypertension

125
Q

Mitral Stenosis - Investigations (3/0)

A

initial

1) ECG
2) chest x-ray
3) echocardiogram*

126
Q

Mitral Stenosis - Management (1/2/2)

A 
conservative
1) serial endocradiograms
medical
1) prophylactic antibiotics (infective endocarditis)
2) loop diuretic (e.g. furosemide)
surgery
1) percutaneous balloon valvuloplasty (non-surgical candidate)
2) valve replacement (+ anticoagulant)
127
Q

Aortic Regurgitation - Description

A

blood backflow from aorta to LV during diastole

128
Q

Aortic Regurgitation - Causes (6)

A

1) rheumatic heart disease
2) infective endocarditis
3) Ehlers-Danlos syndrome
4) Marfan syndrome
5) bicuspid aortic valve
6) ascending aorta dissection

129
Q

Aortic Regurgitation - Pathophysiology (5)

A

1) blood backflow from aorta to LV
2) blood volume overload in LV
3) progressive LV hypertrophy
4) progressive LV enlargement
5) progressive heart failure

130
Q

Aortic Regurgitation - Symptoms (4)

A

1) dyspnoea (esp. exertional)
2) angina
3) syncope
4) fatigue)

131
Q

Aortic Regurgitation - Signs (3)

A

1) early diastolic murmur
2) wide pulse pressure
3) collapsing pulse

132
Q

Aortic Regurgitation - Complications (4)

A

1) congestive heart failure
2) infective endocarditis
3) atrial fibrillation
4) stroke

133
Q

Aortic Regurgitation - Investigations (3/0)

A

initial

1) ECG
2) chest x-ray
3) echocardiogram

134
Q

Aortic Regurgitation - Management (2/3/1)

A 
conservative
1) reassurance
2) serial echocardiograms
medical
1) dopamine (emergency)
2) ACEi
3) CCB
surgery
1) valve replacement (+ anticoagulant) (severe)
135
Q

Aortic Stenosis - Description

A

obstruction of aorta inflow

136
Q

Aortic Stenosis - Causes (5)

A

1) rheumatic heart disease
2) infective endocarditis
3) senile calcification (most common >65 years old)
4) bicuspid aortic valve (most common <65 years old)
5) ascending aorta dissection

137
Q

Aortic Stenosis - Pathophysiology (6)

A

1) narrowing of aortic valve
2) increased aortic pressure
3) increased afterload
4) progressive LV hypertrophy
5) progressive LV enlargement
6) progressive heart failure

138
Q

Aortic Stenosis - Symptoms (4)

A

1) dyspnoea (esp. exertional)
2) angina
3) syncope
4) fatigue

139
Q

Aortic Stenosis - Signs (6)

A

1) ejection systolic murmur
2) soft S2 heart sound
3) S4 heart sound
4) narrowpulse pressure
5) pulsus tardus (late)
6) pulsus parvus (weak)

140
Q

Aortic Stenosis - Complications (2)

A

1) congestive heart failure

2) infective endocarditis

141
Q

Aortic Stenosis - Investigations (3/0)

A

initial

1) ECG
2) chest x-ray
3) echocardiogram

142
Q

Aortic Stenosis - Management (1/1/2)

A

conservative
1) serial echocardiogram
medical
1) prophylactic antibiotics (infective endocarditis)
surgery
1) percutaneous balloon valvuloplasty (non-surgical candidate)
2) valve replacement (+ anticoagulant)

Phase 2a - Cardiovascular (4 decks)

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