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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
How can we surgically treat cardiovascular disease
1. Coronary artery bypass graft (CABG) 2. Heart valve replacement 3. Implanted cardiac defibrillator
26
When treating patients with complex medical history what should we think about
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
Name the most common type fo arterial disease
Atherosclerosis
28
Give examples of different arterial disease
1. Peripheral atrial disease 2. Aneurysm 3. Carotid artery stenosis
29
How does Peripheral atrial disease manifest
Largerly affects lower limbs and feet | It starts with muscle pain on exercise but can end in gangrene and amputation
30
What is carotid artery stenosis a big risk factor for
stroke and TIA
31
What is an aneurysm
Localised pathological blood dilation of a blood vessel caused by disease or weakening of the vessel wall
32
Name the most deadly aneurysm
Abdominal aortic aneurysm (triple A)
33
Why are aneurysms deadly
As they can spontaneously rupture
34
Describe coronary artery disease
Atherosclerotic plaque develops over time n cardiac arteries
35
List some risk factors for coronary artery disease
1. Dyslipidaemia 2. Hypertension 3. Tobacco 4. Smoking 5. Diabetes Mellitus
36
How can coronary artery disease manifest
Can manifest in stable angine or acute contrary syndrome (unstable angina or a myocardial Infarction)
37
What is angina
Pain in the chest when demands in the heart increases due to insufficient blood flow to the myocardium
38
When treating patient with arterial disease what score should we consider
The ASA score
39
What does the ASA score measure
Serves as a measure of the impact of a patients chronic health condition on a treatment
40
Do we avoid treating patients with heart conditions
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
List the 4 key determinants of blood pressure
1. Cardiac output 2. Total peripheral resistance 3. Circulating blood volume 4. Blood viscosity
42
State a normal systolic and diastolic reading
<120 | <80
43
State an elevated systolic and diastolic reading
120-129 | <80
44
State a high blood pressure stage 1 systolic and diastolic reading
130-139 | 80-89
45
State a high blood pressure stage 2 systolic and diastolic reading
>140 | >90
46
State a hypertension crisis systolic and diastolic reading
>180 | >120
47
Which system in the body provides rapid adjustments to cardiac output
The autonomic nervous system
48
Where does the autonomic nervous system relieve its signally from
Arterial baroreceptors
49
What do Arterial baroreceptors measure
Pressure changes in the artery
50
What happens when blood pressure increaeses
Sympathetic nerve fibres increase total peripheral resistance, heart rate and cardiac output via activation at the SAN
51
What happens when blood pressure decreases
Parasympathetic innervation decreasing total peripheral resistance, heart rate and cardiac output via activation at the SAN
52
Which pathways in the body help monitor long term blood pressure
multifactorial and involve the renin-angiotensin system, aldosterone and anti-diuretic hormone.
53
List some risk factors fro hypertension
``` High fat high salt diets Obesity Adro Caribbean Sedentary lifestyle Drug use Alcohol consumption Contraceptive pill Stress Organ surgery ```
54
How do we treat hypertension from a pharmacological point of view
Ace inhibitors Beta blocker Calcium channel blocker Diuretic
55
What is arterial fibrillation a risk factor for
Stroke
56
Which drugs can we use to prevent secondary complication of atrial fibrillation
Anticoagulants
57
What is infective endocarditis
An infection of the endocardium which arises with vegetative plaque

4th yr- CMS- Medicine (14 decks)

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