cardiovascular disorders

Question 1

what is heart failure

Answer 1

the heart is unable to maintain adequate circulation for metabolic requirements of body

Question 2

what is decreased systolic function

Answer 2

reduced ejection fraction
EF > or equal to 40% = decreased systolic function
weakened heart muscle - left ventricle
less able to pump

Question 3

what is decreased diastolic function

Answer 3

preserved ejection fraction
EF > or equal to 50% decreased diastolic function
diastolic heart failure
smaller area for blood in left ventricle but still gets pumped out

Question 4

underlying causes for heart failure

Answer 4

secondary to cardiac damage

ischaemia, myopathy, hypertension, valve disease

Question 5

signs and symptoms for heart failure

Answer 5

exertional dyspnoea

Question 6

tests for heart failure

Answer 6

blood test

elevated brain natriuretic peptide (BNP) and chest X ray - cardiomegaly

Question 7

treatments for heart failure

Answer 7

drugs reducing exertional pressure on heart

Question 8

what does an enlarged QRS complex show

Answer 8

heart failure

due to increased muscle mass on heart > increased electrical current

Question 9

what is atrial fibrillation

Answer 9

disorganised electric activity and contraction
uncoordinated activity
absence of p wave caused from electrical stimulation from SAN to AV node

Question 10

what is Wolff-Parkinson-White (WPW)

Answer 10

syndrome causing tachycardia and abnormal cardiac electrical conductance
accessory pathway (most common in left ventricle) causes pre-excitation of QRS

Question 11

what are underlying causes for atrial fibrillation

Answer 11

spontaneously active cells throughout the atria - uncoordinated pacemaker currents in the atria

Question 12

what are underlying causes for WPW

Answer 12

additional accessory conduction pathway (the bundle of Kent) between the atria and the ventricles

Question 13

what are some signs and symptoms for atrial arrythmias

Answer 13

paliptations and chest pain

Question 14

absent p waves and irregularly irregular rhythm shows..

Answer 14

atrial fibrillation

Question 15

what does QRS pre excitation and biphasic/inverted T wave on ECG show

Answer 15

Wolff-Parkison-white

Question 16

what are some treatment options for atrial fibrillation

Answer 16

strategies to maintain sinus rhythm (eg cardioversion, anti-arrhythmics, catheter ablation)

Question 17

what are some treatment options for WPW

Answer 17

benign - no treatment required

Question 18

what is 1st degree block

Answer 18

slowing down of conduction through AV node (blockage at AV node) due to current slowing down AV node

Question 19

what is 2nd degree block

Answer 19

reduced transmission of signal from atria to ventricles

Question 20

what is 3rd degree block

Answer 20

complete block of current from atria to ventricles

Question 21

what are the underlying causes for conduction block

Answer 21

damage (fibrosis, calcification, necrosis) to the conduction system (AV node of His purkinje system)

Question 22

what does increased PR interval on ECG show

Answer 22

1st degree block

Question 23

what does increased PR interval or missing QRS complexes

Answer 23

2nd degree block

Question 24

what do p waves not followed by QRS complexes show

Answer 24

3rd degree block

Question 25

what are treatments for conduction block

Answer 25

discontinuation of AV blocking drugs (eg beta blockers, calcium channel blockers) or pacemaker implantation in severe cases

Question 26

what is hypertension

Answer 26

clinical BP > or equal to 140/90 mmHg and ambulatory BP daytime average > or equal to 135/88 mmHg for prolonged period

Question 27

what are the underlying primary and secondary causes of hypertension

Answer 27

primary - unknown | secondary - resulting from another medical condition (kidney disease, adrenal disease)

Question 28

what are some treatments for hypertension

Answer 28

lifestyle changes followed by anti hypertensive medication

Question 29

what are some acute coronary syndromes

Answer 29

angina non ST elevated myocardial infarction (NSTEMI) ST elevated myocardial infarction (STEMI)

Question 30

what is angina

Answer 30

chest pain due to myocardial ischaemia caused by atherosclerosis

Question 31

what is NSTEMI

Answer 31

non ST elevated myocardial infarction myocardial tissue damage due to prolonged ischaemia caused by atherosclerosis and artery blockage - small occlusion of coronary artery

Question 32

what is a STEMI

Answer 32

ST elevated myocardial infarction serious myocardial tissue damage due to prolonged ischaemia caused by severe atherosclerosis and complete artery blockage/occlusion

Question 33

what are underlying causes for angina

Answer 33

atherosclerotic lesions of the coronary artery causing ischaemia

Question 34

what are underlying causes for NSTEMI

Answer 34

artery blockage

Question 35

what are underlying causes for STEMI

Answer 35

complete artery blockage

Question 36

what does an ST depression/no changes and high troponin levels indicate

Answer 36

NSTEMI

Question 37

what does ST elevation with reciprocal ST depression and high troponin levels indicate

Answer 37

STEMI

Question 38

what are treatments for angina

Answer 38

vasodilators

Question 39

what are treatments for NSTEMI

Answer 39

``` coronary stents antiplatelets vasodilators antiemetics oxygen and pain relief ```

Question 40

what are some treatments for STEMI

Answer 40

``` coronary stents antiplatelets vasodilators antiemetics oxygen and pain relief ```

Question 41

how can you show one heartbeat/interval/HR on an ECG

Answer 41

from one point to another eg RR interval

Question 42

what does hypertrophy of the left ventricle show up as on an ECG

Answer 42

larger QRS complex | larger ventricle = larger electrical signal

Question 43

what is most likely caused by angiotensin 2 (potent vasoconstrictor)

Answer 43

increased afterload resulting from the impaired ventricular function in heart failure is most likely caused by angiotensin 2 afterload is determined by blood pressure increased blood pressure = increased afterload

Question 44

what also causes vasoconstriction but is less potent than angiotensin 2

Answer 44

noradrenaline

Question 45

can pregnant women use ACEs

Answer 45

NO

Question 46

if an accessory pathway was found in the right atrium and ventricle instead of the left atrium and ventricle for WPW would the ECG traces be the same

Answer 46

yeees

Question 47

what does AV block prolong

Answer 47

the PR interval

Question 48

what does no QRS indicate

Answer 48

2nd degree heart block

Question 49

what wave shows ventricular repolarisation/relaxation

Answer 49

T wave