Cardiovascular Disorders Flashcards
What is the definition of heart failure?
Heart unable to maintain adequate circulation for metabolic requirements of the body
What is HFpEF?
Heart Failure with Preserved Ejection Fraction
What function of the heart if impaired in HFpEF?
Diastolic function of the heart
What type of muscle development is found in HFpEF?
Concentric muscle development
What heart function is reduced in HFrEF?
Systolic function
what is HFrEF?
Heart Failure with Reduced Ejection Fraction
If a patient has an ejection fraction > or equal to 50%, what condition do they hae?
Heart Failure with Preserved Ejection Fraction - HFpEF
If a patient has an ejection fraction > or equal to 40%, what condition do they have?
heart Failure with Reduced Ejection Fraction - HFrEF
What type of muscle development is seen in HFrEF?
Eccentric muscle development - this is where the heart muscle weakens and bcomes more dilated
What is seen on a chest X-Ray in a patient with Heart Failure?
Cardiomegaly - increased size of the heart
What is seen on a blood test with patients with Heart Failure?
Raised BNP - Brain Natriuretic Peptide
What is the main symptom of Heart Failure?
Exertional Dysponea - Breathlessness on exertion
How is heart failure diagnosed?
Echocardiography and Raised Natruietic Peptides
What might be seen on an ECG with a heart failure patient?
Enlarged QRS complex due to hypertrophy of the ventricles
What is the definition of atrial fibrillation?
Abherrent and disorganised electrical activity and contraction within the heart, as currents are generated from all over the atria
What is the underlying cause of atrial fibrillation?
Spontaneously active pacemaker cells in the atria that have developed in regions outside the nodes
What physical symptoms can Atrial Fibirllation Result in?
Palpitations and chest pain
What would be seen on an ECG of a patient with Atrial Fibrillation?
Missing p wave - irregularly irregular rhythm
What causes Wolff-Parkinson-White syndrome?
The activation of n accessory conduction pathway which does not go through the AV node
What are the two ECG findings on patients with Wolff Parkinson White syndrome?
Biphasic T Wave and Pre-exitation of the ventricles
What causes the Biphasic T wave found in Wolff Parkinson White syndrome?
Currents going in both directions
What causes the pre-excitation wave found on an ECG trace in patients with WPW?
Ventricular depolarisation before the QRS complex
What is the accessory pathway in WPW called?
The bundle of Kent
What are physical symptoms accociated with WPW syndrome?
Palpitations and chest pains
What does WPW syndrome cause?
Tachycardia (increased heart rate) and abnormal cardiac electrical conductance
What is the definition of an AV Block?
Impaired electrical conduction through the AV node
What ECG findings would you expect in Type 1 AV Block?
Increased PR Interval
What is the definition of a First-Degree AV Block?
slowing down of conduction through AV node
What is the definition of a Second-Degree AV Block?
Reduced transmission of signal from atria to ventricles
What would be seen on an ECG of a patient with Second-Degree AV Block?
Increased PR Interval or missing QRS Complexes, depending on the block type
What is the definition of a Third-Degree AV Block?
Complete block of current from atria to ventricles
What would be seen on an ECG Trace of a patient with Third-Degree AV Block?
P Waves not followed by QRS Complexes
What is the underlying cause of a conduction block?
Damage (fibrosis, calcification or necrosis) to the conduction system - Bundle of His or AV Node
What are the treatment options for AV Block?
Discontinuation of AV-blocking drugs (e.g. beta-blockers, calcium channel blockers) or pacemaker implantation in severe cases
What are the treatment options for Atrial Fibrillation?
strategies to maintain sinus rhythm (e.g. cardioversion, anti-arrhythmics, catheter ablation)
What are the treatment options for WPW Syndrome?
Benign so no treatment
What is the clinical definition of Hypertension?
Clinical BP ≥ 140/90 mmHg & ambulatory BP daytime average ≥ 135/85 mmHg for prolonged period
What is the difference between primary and secondary hypertension?
Primary - When the cause is unknown
Secondary - When hypertension results from another medical condition eg Adrenal Gland Disease
What investigations are done to diagnose hypertension?
Blood Pressure Measurement, reading above 135/85 mmHG
What are the treatment options for Hypertension?
Lifestyle changes followed by anti-hypertensive medications
What are some anti-hypertensive mdications which can be used?
ACE Inhibitors
Calcium Channel Blockers
Angiotensin II Receptor Blockers
What is an angina?
Chest pain due to myocardial ischaemia caused by athersclerosis
What is a NSTEMI?
A Non ST Elevated Myocardial Infarction
What is a STEMI?
ST Elevated Myocardial Infarction
What is the definition of an NSTEMI?
Myocardial tissue damage due to prolonged ischaemia caused by atherosclerosis and artery blockage
What is the definition of an STEMI?
Serious myocardial tissue damage due to prolonged ischaemia caused by severe atherosclerosis and complete artery blockage
What is the underlying cause of STEMI and NSTEMIs?
Atherosclerotic lesions of the coronary artery causing ischaemia (angina), artery blockage (NSTEMI) and then complete artery blockage (STEMI)
What re the signs and symptoms of engine?
Chest pain on exertion (Stable angina) or at rest (Unstable angina)
What are the signs and symptoms of NSTEMI?
Chest pain, sweating, nausea and vomiting
What are the Signs and Symptoms of STEMI?
radiating Chest pain, sweating, nausea and vomiting
What is the difference in chest pain experienced by patients with a STEMI compared to a NSTEMI?
STEMI = Radiating chest pain
What is found raised in the blood in both STEMI and NSTEMI patients?
Troponin Levels
What is seen on an ECG Trace in patients with STEMI?
ST-Elevation and reciprocal ST-Depression
What treatment is used for angina?
Vasodilators
What are the treatment options for NSTEMI and STEMI?
coronary stents, antiplatelets, vasodilators, anti-emetics, oxygen & pain-relief
What will hypertrophy of the left ventricle look like on an ECG Trace?
Enlarged QRS Complex
What will be seen on an ECG trace in patients with Atrial flutter?
Saw-Tooth configuration of the ECG
What is the RR Interval used to measure?
The Heart Rate
Which hormone has the largest affect on vasoconstriction?
Angiotensin II
Why is endothelin a potent but not the most effective vasoconstrictor in the heart?
Endothilin is stored in small quantities and is not released very often - when it does it has a mainly local effect on the blood vessels, not a large systematic effect like Angiotensin II does
Between vasoconstriction and blood volume, which has has the greatest impact on blood pressure?
Vasoconstriction
What is afterload determined by?
The blood pressure
Who are ACEi and ARBs not recommended for?
Pregnant Women
What anti-hypertensive medication is the most preferred?
Calcium Channel Blockers
What does a high BNP Indicate?
Heart Failure
Which hormone systems does lowered ventricular function activate?
RAAS - Renin Angiotensin Aldosterone System
Sympathetic - Adrenaline and Noradrenaline
AVP - ADH
What is he effect of increased Na+ and Water retention?
Increased blood volume and therefore increased preload
what does increased vasoconstriction lead to?
A higher blood pressure and therefore increased afterload
What happens to cardiac work with changes in preload and afterload?
If both preload and afterload increase, so does cardiac work
What do Neprilysin Inhibitors affect?
Cardiac work
what is Digoxin?
A Na+ K+ pump imhibitor so affects cardiac work
What is Ivabradine?
A funny Current inhibitor so directly impacts cardiac work