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4th yr- CMS- Medicine > Cardiovascular disease > Flashcards

Cardiovascular disease Flashcards

1
Q

Describe the heart in health

A
  1. Right and left Atria
  2. Right and left ventricles
  3. Sinoatrial node
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2
Q

What does the sinoatrial nerve do

A

It is the pace maker (the guardian of electrical activity)

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3
Q

Talk through the electrical journey that makes the heart contract

A
  1. Action potential at sinoatrial node
  2. Travels through the AV node
  3. This allows atria to empty into the ventricle
  4. Action potential travels down the bundle of His into the pukinje fibres
  5. Ventricles contract ejecting blood out of heart
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4
Q

What does an ECG represent

A

A tracing of the movement of electrical activity through the cardiac tissue

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5
Q

Name the different points of interest on an ECG

A
  1. P wave
  2. PR segment
  3. QRS complex
  4. ST segment
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6
Q

What does the P wave represent

A

Depolarisation of the atria

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7
Q

What does the PR segment represent

A

Represents the time it takes for the electrical activity to move between the atrium and ventricles

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8
Q

What does the QRS complex represent

A

Ventricular depolarisation

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9
Q

What does the ST segment represent

A

Time between depolarisation and repolarisation

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10
Q

When do we say the heart is failing

A

When it is unable to pump in inefficient manner

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11
Q

What does cardiac output=

A

Stroke volume x heart rate

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12
Q

List the different reason the heart can fail

A
  1. Systolic failure
  2. Diastolic failure
  3. Left sided heart failure
  4. Right sided heart failure
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13
Q

When does Systolic failure of the heart occur and what happens

A

When coronary heart disease leads to ineffective ejection of blood from the chamber of the heart

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14
Q

When does diastolic failure of the heart occur and what happens

A

Fibrosis, hypertrophy of the ventricles, hypertension or pericarditis leads to ineffective filling of blood

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15
Q

What is pericarditis

A

Inflammation of the tissues of the heart

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16
Q

Give some signs and symptoms of heart failure

A
  1. Breathlessness
  2. fatigue
  3. Difficulty exercising
  4. Peripheral oedema (eg ankle)
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17
Q

Give a sign that is specific to left sided heart failure

A

Pulmonary oedema

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18
Q

What causes heart failure

A
  1. Coronary artery disease
  2. Myocardial infarcts
  3. Hypertension
  4. Faulty heart valves
  5. Dilated cardiomyopathy
  6. Arrhythmia
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19
Q

What is coronary artery disease

A

Build of plaque in the blood vessels leading to the heart needing to pump harder and some muscles not getting enough blood

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20
Q

Treatment of heart failure

A
  1. Lifestyle changes
  2. Pharmaceuticals
  3. Surgical
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21
Q

List some lifestyle changes we can adopt to reduce risk of cardiovascular disease

A
  1. Regular physical activity
  2. Healthy weight management
  3. No smoking
  4. Limit alcohol
  5. Healthy eating
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22
Q

Which medical conditions should we try and treat to reduce risk of cardiovascular disease

A
  1. Treat high blood pressure
  2. Control diabetes
  3. Maintain healthy cholesterol levels
  4. Take heart protective medication as prescribed
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23
Q

What pharmacological agents can we use to treat heart failure

A

Diuretics with an ace inhibitor or angiotensin 2 receptive antagonist

24
Q

How do we treat a patient with acute heart failure

A

Intravenous innatropes

25
Q

How can we surgically treat cardiovascular disease

A
  1. Coronary artery bypass graft (CABG)
  2. Heart valve replacement
  3. Implanted cardiac defibrillator
26
Q

When treating patients with complex medical history what should we think about

A
  1. Think about the drugs they are taking
  2. Think about postural problems
  3. Think about any barriers to health care they may have
  4. Read through NICE and SDCEP guidelines
27
Q

Name the most common type fo arterial disease

A

Atherosclerosis

28
Q

Give examples of different arterial disease

A
  1. Peripheral atrial disease
  2. Aneurysm
  3. Carotid artery stenosis
29
Q

How does Peripheral atrial disease manifest

A

Largerly affects lower limbs and feet

It starts with muscle pain on exercise but can end in gangrene and amputation

30
Q

What is carotid artery stenosis a big risk factor for

A

stroke and TIA

31
Q

What is an aneurysm

A

Localised pathological blood dilation of a blood vessel caused by disease or weakening of the vessel wall

32
Q

Name the most deadly aneurysm

A

Abdominal aortic aneurysm (triple A)

33
Q

Why are aneurysms deadly

A

As they can spontaneously rupture

34
Q

Describe coronary artery disease

A

Atherosclerotic plaque develops over time n cardiac arteries

35
Q

List some risk factors for coronary artery disease

A
  1. Dyslipidaemia
  2. Hypertension
  3. Tobacco
  4. Smoking
  5. Diabetes Mellitus
36
Q

How can coronary artery disease manifest

A

Can manifest in stable angine or acute contrary syndrome (unstable angina or a myocardial Infarction)

37
Q

What is angina

A

Pain in the chest when demands in the heart increases due to insufficient blood flow to the myocardium

38
Q

When treating patient with arterial disease what score should we consider

A

The ASA score

39
Q

What does the ASA score measure

A

Serves as a measure of the impact of a patients chronic health condition on a treatment

40
Q

Do we avoid treating patients with heart conditions

A

no
eg stable angina is not a contraindication but consider limiting exposure to risks
If a patient has had an MI in 6 months avoid complex surgical treatment and just stick with pain management until thieyve completed their cardiac rehabilitation

41
Q

List the 4 key determinants of blood pressure

A
  1. Cardiac output
  2. Total peripheral resistance
  3. Circulating blood volume
  4. Blood viscosity
42
Q

State a normal systolic and diastolic reading

43
Q

State an elevated systolic and diastolic reading

A

120-129

<80

44
Q

State a high blood pressure stage 1 systolic and diastolic reading

A

130-139

80-89

45
Q

State a high blood pressure stage 2 systolic and diastolic reading

46
Q

State a hypertension crisis systolic and diastolic reading

A

> 180

>120

47
Q

Which system in the body provides rapid adjustments to cardiac output

A

The autonomic nervous system

48
Q

Where does the autonomic nervous system relieve its signally from

A

Arterial baroreceptors

49
Q

What do Arterial baroreceptors measure

A

Pressure changes in the artery

50
Q

What happens when blood pressure increaeses

A

Sympathetic nerve fibres increase total peripheral resistance, heart rate and cardiac output via activation at the SAN

51
Q

What happens when blood pressure decreases

A

Parasympathetic innervation decreasing total peripheral resistance, heart rate and cardiac output via activation at the SAN

52
Q

Which pathways in the body help monitor long term blood pressure

A

multifactorial and involve the renin-angiotensin system, aldosterone and anti-diuretic hormone.

53
Q

List some risk factors fro hypertension

A 
High fat high salt diets 
Obesity 
Adro Caribbean  
Sedentary lifestyle 
Drug use
Alcohol consumption 
Contraceptive pill
Stress
Organ surgery
54
Q

How do we treat hypertension from a pharmacological point of view

A

Ace inhibitors
Beta blocker
Calcium channel blocker
Diuretic

55
Q

What is arterial fibrillation a risk factor for

56
Q

Which drugs can we use to prevent secondary complication of atrial fibrillation

A

Anticoagulants

57
Q

What is infective endocarditis

A

An infection of the endocardium which arises with vegetative plaque

4th yr- CMS- Medicine (14 decks)

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