Cardiovascular Disorders Flashcards
Heart failure
Heart unable to maintain adequate circulation for metabolic requirements
Systolic heart failure
Reduced ejections fraction where it’s less than 40%
Left ventricle has weakened heart muscle and muscle is more dilated so less able to pump blood out
Diastolic heart failure
Preserved ejection fraction greater than 50% and reduced diastolic function. Stiff heart muscle in left ventricle means smaller area for blood to fill in but still reasonable amount of blood pumped out
You get left ventricular hypertrophy
Heart failure ecg symptoms and causes
Bugger QRS complex due to increased muscle mass to more electrical current
Caused by hypertension,valve disease or secondary to cardiac damage
Symptoms involve exertional dyspnoea and breathlessness
Heart failure examination and treatment’s
Blood test show elevated brain natriuretic peptide
Chest X ray shows cardiomegaly
Drugs that reduce exertional pressure on heart should be given
Electrical transmission disorders
Atrial arrhythmias eg atrial fibrillation and wolf Parkinson’s white
Conduction blocks
Atrial fibrillation
Uncoordinated aberrant electrical activity and contraction due to pacemaker cells forming in regions outside of SA and AV node- this prevents smooth transition of electrical current from SA to AV node
Un-coordinated pacemaker currents in the atria
ECG shows absent p waves and irregular rhythm
Treatment involves strategies to maintain sinus eg cardioversion anti arrhythmics and catheter ablation
Wolff Parkinson’s white
Syndrome causing tachycardia and abnormal cardiac electrical conductance
Additional accessory pathway forms (most commonly in left ventricle of heart)
ECG finds QRS pre excitation and a biphasic or inverted T wave as current is not stopped at av node
No treatment needed
Conduction blocks
First degree block-slowing down conduction through AV node. increased P-R interval on ecg
Second degree block-educed transmission of signal from atria to ventricle. ecg finds increased P-R or missing QRS complex
Third degree-complete blockage of current from atria to ventricles. Medical emergency as ventricles won’t contract as no depolarization.ecg funds p waves not followed by QRS complex
Underlying causes of electrical transmission disorders and treatments
Damage eg fibrosis calcification or necrosis to conduction system
Treatment includes pacemaker implants or discontinuation of AV blocking drugs eg beta blockers or calcium channel blockers
Vasculature disorders
Hypertension
Acute coronary syndromes such as angina ,non ST elevated myocardial infarction, ST elevated myocardial infarction
Hypertension
Clinical BP >140/90 mmHg and ambulatory BP daytime average >135/85 mmHg
Hypertension itself isn’t the issue, it’s the conditions it can lead to:
- Stroke
- Heart failure and myocardial infarction
- Kidney disease
These can in turn increase BP which creates a vicious cycle
Investigation involve Les bp measurements and treatment involves lifestyle changes
Angina
Chest pain due to myocardial ischaemia (reduced blood flow to heart muscles) caused by atherosclerosis. There are two types:chest pain on exertion (stable) or at rest (unstable)
Symptoms involve chest pain
May see ST depression on ecg
Give vasodilator
Non ST elevated myocardial infarction
Myocardial tissue damage due to prolonged ischaemia caused by atherosclerosis and artery blockage
Coronary artery gets partially occluded
Chest pain sweating and nausea
ECG shows ST depression and high troponin levels
Treatment includes stents,anti platelets,vasodilators,anti emetics,oxygen,pain relief
ST elevated myocamyocarditis infarction
Serious myocardial tissue damage due to prolonged ischaemia caused by severe atherosclerosis and complete artery blockage
Radiating chest pain sweating nausea and vomiting
ECG shows ST elevation with high troponin and reciprocal ST depression
Treatment involves stents,anti platelets,vasodilator,anti emetics,oxygen
