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Medical Lectures > Cardiovascular Disease > Flashcards

Cardiovascular Disease Flashcards

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USMLE® Step 1 flashcards
1
Q

Cardinal Symptoms of Cardiovascular Disease

A 
Chest, neck, and/or arm pain or discomfort
Palpitation
Dyspnea
Syncope (fainting)
Fatigue
Cough
Cyanosis
Vascular component
Edema
Leg pain (claudication)
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2
Q

What can mimic atypical chest pain?

A

Cervical disk disease and arthritic changes

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3
Q

What spinal segment is the heart and diaphragm supplied by?

A

C5-C6

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4
Q

Dyspnea

A

Breathlessness or shortness of breath

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5
Q

What are forms of extreme dyspnea?

A

paroxysmal nocturnal dyspnea (PND)

orthopnea

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6
Q

PND

A

sudden unexplained episodes of shortness of breath
Will awaken a person sleeping in supine, due to amount of blood returning to heart and lungs from the Les
Frequently seen with congestive heart failure (CHF)

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7
Q

Orthopnea

A

Breathlessness that is relieved by sitting upright, using pillows to prop the head and trunk
Can occur anytime – day or night

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8
Q

What is dyspnea relieved by?

A

specific breathing pattern (pursed lip) or specific body position (leaning forward on arms to lock shoulder girdle)

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9
Q

Cardiac syncope

A

Fainting or lightheadedness

Caused by reduced oxygen to the brain

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10
Q

What are cardiac conditions that result in syncope?

A

arrhythmias, orthostatic hypotension, poor ventricular function, CAD, and vertebral artery insufficiency

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11
Q

Syncope without any warning period of lightheadedness, dizziness, or nausea may be sign of :

A

heart valve or arrhythmia and sudden death can occur

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12
Q

What is fatigue of a cardiac nature associated with?

A

dyspnea, chest pain, palpitations, or headache

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13
Q

What is edema a hallmark sign of?

A

Hallmark of right ventricular failure

Usually bilateral and dependent

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14
Q

What is edema accompanied by?

A

Accompanied by jugular venous distention (JVD), cyanosis, and abdominal distension from ascites

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15
Q

Claudication

A

Leg pain that occurs with peripheral vascular disease (PVD) (arterial or venous), often simultaneously with CAD

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16
Q

What is usually associated with vascular disease?

A

Presence of pitting edema along with leg pain

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17
Q

Noncardiac causes of leg pain

A

sciatica, anterior compartment syndrome, gout, peripheral neuropathy

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18
Q

Trophic changes in presence of vascular disease:

A

thin, dry, hairless skin

19
Q

What is cool skin indicative of?

A

vascular obstruction

20
Q

What can warm skin be a sign of?

A

infection or inflammation

21
Q

Abrupt onset of ischemic rest pain or sudden worsening of intermittent claudication may be due

A

thromboembolism

22
Q

Integumentary cardiac signs and symptoms

A

Pressure ulcers
Loss of body hair
Cyanosis (lips and nail beds)

23
Q

General cardiac signs and symptoms

A

Weakness
Fatigue
Weight change
Poor exercise tolerance

24
Q

Central Nervous System cardiac signs and symptoms

A

Headaches
Impaired vision
Dizziness or syncope

25
Q

Respiratory cardiac signs and symptoms

A

Labored breathing

Productive cough

26
Q

GI cardiac signs and symptoms

A

Nausea and vomiting

Ascites (abdominal distension)

27
Q

Genitourinary cardiac signs and symptoms

A

Urinary frequency
Nocturia
Concentrated Urine
Decreased urinary output

28
Q

Musculoskeletal cardiac signs and symptoms

A 
Chest, shoulder, neck, jaw, or arm pain
Myalgias
Muscular fatigue
Muscle atrophy
Edema
Claudication
29
Q

Atherosclerosis (CAD)

A

Narrowing or blockage of coronary arteries
Causes myocardial infarction
More than 750,000 people annually with significant cardiac symptoms due to CAD.

30
Q

Modifiable CAD risk factors:

A

physical inactivity, smoking, HTN, elevated cholesterol

31
Q

Non-modifiable CAD risk factors

A

age, male sex, family Hx, race

32
Q

Contributing CAD risk factors:

A

obesity, discriminatory medicine, response to stress, personality, diabetes, hormonal status, alcohol consumption

33
Q

Clinical manifestations of CAD:

A

Common sequelae include peripheral vascular disease, angina pectoris, MI or heart attack, or sudden death
Heart failure, conduction disturbances, chronic arrhythmias, aneurysm, and intestinal infarction may also occur

34
Q

Indications for Discontinuing or Modifying Exercise

A

New-onset anginal chest pain
Easily provoked angina
Increasing episodes, intensity, or duration of angina (unstable angina)
Discomfort in the upper body, including chest, arm, neck, or jaw
Fainting or lightheadedness
Severe dyspnea
Severe fatigue or muscle pain
Nausea or vomiting
Back pain during exercise
Bone or joint pain during or after exercise
Severe leg claudication

35
Q

Clinical signs for discontinuing or modifying exercise:

A

Pallor; peripheral cyanosis; cold, moist skin
Staggering gait, ataxia
Confusion or blank stare in response to inquires
Resting heart rate > 130 beats/min, 100 degs F
Fall in systolic BP with increase in workload (specifically 10 mm Hg drop below previous BP)
Rise in systolic BP over 250 mm Hg or diastolic pressure over 120 mm Hg

36
Q

Chronic stable angina

A

classic, exertional angina that occurs at predictable levels of physical or emotion stress and responds promptly to rest or nitroglycerin

37
Q

New onset angina

A

angina that has developed over the last 60 days

38
Q

Nocturnal angina

A

may awaken a person with same sensation as during exertion. Usually associated with exertion cause by increased heart rate associated with dreams or CHF

39
Q

Postinfarction angina

A

occurs after MI when residual ischemia triggers an episode

40
Q

Preinfarction or unstable angina

A

unpredictable and characterized by an abrupt change in the intensity and frequency of symptoms or decreased threshold of stimulus. Usually lasts longer than 15 mins and is a symptom of worsening cardiac ischemia

41
Q

What pattern does angina pectoris follow?

A

L arm and down ulnar border of the arm to the fingers
any dermatome from C3 to T4, presenting at back of the neck, lower jaw, teeth, left upper back, interscapular area, the abdomen, and occasionally down the R arm

42
Q

What intensity should CHF patients be exercised at?

A

moderate intensity (40-60% of VO2 max) for 2 to 6 minutes, then rest for 2 minutes

43
Q

Modifiable hypertension risk factors:

A

high sodium intake, obesity, hypercholesterolemia and high triglycerides, smoking, chronic alcohol abuse, continuous emotional stress, sedentary lifestyle

44
Q

Non modifiable hypertension risk factors:

A

positive family history, age (advanced), sex (male), race (black)

Medical Lectures (11 decks)

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