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Z YEAR 1 BRS cardiology > Cardiovascular disorders > Flashcards

Cardiovascular disorders Flashcards

1
Q

What are cardiomyopathies?

A

disorders that affect the cardiomyocytes or cardiac muscle function

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2
Q

What is heart failure? What are examples?

A 
•Reduced ejection fraction
•Preserved ejection fraction
-Dilated Cardiomyopathy
-Take tsubo syndrome 
-Hypertrophic cardiomyopathy
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3
Q

What is definition of heart failure?

A
  • Heart unable to maintain adequate circulation for metabolic requirements of body
  • Preserved ejection fraction (HFpEF): EF ≥ 50%, ↓ diastolic function (increase muscle mass in left ventricular) - not pharmacy - can’t relax as well
  • Reduced ejection fraction (HFrEF): EF ≥ 40%, ↓ systolic function (thinning) - pharmacy - not strength to pump as well left ventricle more dilated and
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4
Q

What is the underlying cause of heart failure?

A

•Secondary to cardiac damage (ischaemia, myopathy), hypertension, valve disease

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5
Q

What is the effects of cardiac output and life expectancy with hart failure?

A
  • ↓ cardiac output, venous blood accumulation

* Poor prognosis: 50% mortality rate < 5 years

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6
Q

What are the symptoms on heart failure?

A

•Symptoms - breathlessness, fatigue & fluid retention caused by cardiac dysfunction

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7
Q

What are ECG findings in heart failure?

A
  • Non-specific: multiple potential ECG abnormalities linked to potential cause: e.g. Hypertrophy or Atrial Fibrillation
  • Diagnosis: echocardiography & elevated natriuretic peptides
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8
Q

What is the definition of dilated cardiomyopthay?

A

•Cardiomegaly and dilation; systolic dysfunction with hypo-contraction

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9
Q

What is the underlying cause of dilated cardiomyopathy?

A

•Cause is frequently unknown; 20% - 50% is familial; secondary to anterior MI (ischaemic)

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10
Q

What are the effects of cardiac output and life expectancy of dilated cardiomyopathy?

A
  • ↓Q, ejection fraction < 40%

* End-stage annual mortality of 10% to 50%

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11
Q

What are the investigations of dilated cardiomyopthay?

A
  1. General
    •Dyspnoea, fatigue. Genetic testing.
  2. ECG findings
    •No specific features, abnormalities similar to LVH
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12
Q

What is the definition of hypertrophic cardiomyopathy?

A

•Unexplained left ventricular hypertrophy – primarily affects the interventricular septum

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13
Q

What is the underlying cause of hypertrophic cardiomyopathy?

A

•Usually familial, autosomal dominant inheritance.

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14
Q

What are the effects of cardiac output and life expectancy on hypertrophic cardiomyopathy?

A
  • ↓Q

* Can cause sudden cardiac death during exercise

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15
Q

What investigations would be taken out in hypertrophic cardiomyopathy?

A
  1. General
    •Dyspnoea, fatigue. Genetic testing.
  2. ECG findings
    •No specific features, abnormalities similar to LVH
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16
Q

What are the definition of tako tsubo?

A

•Left ventricular dysfunction where the apex balloons & symptoms mimics MI
•‘Broken heart’ syndrome
-Left ventricular enlargement in articular way

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17
Q

What is the underlying cause of tako tsubo?

A

•Stressful event, mainly affects women

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18
Q

What is the effect of cardiac output and life expectancy in tako tsubo?

A
  • ↓Q, ejection fraction ~ 40%.

* 5% mortality

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19
Q

What are the investigations in tako tsubo syndrome?

A
  1. General
    Chest pain, ↑ cardiac biomarkers. Normal blood vessels
  2. ECG findings
    ST segment elevation
    Mimics myocardial infarction (but not markers)
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20
Q

What are conduction abnormalities?

A

disorders that affect bioelectrical transmission along the heart

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21
Q

What are atrial arryhtmias?

A
  • Atrial fibrillation

* WPW

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22
Q

What are ventricular arrhythmias?

A
  • Ventricular fibrillation

* Torsade de pointes

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23
Q

What are tachycardias?

A
  • Sinus

* Atrial

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24
Q

What are conduction block?

A
  • AV block (types 1, 2 & 3)

* Bundle branch block

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25
Q

What is atrial on ECG?

A

Atrial

•P-wave – atrial contraction. Normal – followed by a QRS complex

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26
Q

What is conduction on ECG?

A

Conduction

•P-R interval – conduction through AV node. Normal – between 120-200 milliseconds (msec)

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27
Q

What is ventricular on ECG?

A
  • QRS complex – ventricular depolarisation. Normal – less than 120 msec
  • ST segment – plateau phase. Normal – at baseline
  • QT interval – total duration of ventricular depolarisation & repolarisation
  • R-R interval – duration between ventricular depolarisations (heart beat)
28
Q

What is positional on ECG?

A

•Cardiac axis – Normal – between -30 to +90 degrees

29
Q

What is the definition of atrial arrhythmias?

A

•Disorganised electric activity and contraction

30
Q

What is the underlying cause of atrial arrhythmias?

A

•Spontaneously active cells throughout the atria (can be associated with pulmonary veins)

31
Q

What are the effects of cardiac output and life expectancy on atrial arrhythmias?

A
  • Modest decline in Q

* ↑ risk of heart failure & stroke

32
Q

What are the investigations of atrial fibrillation?

A

General
•Palpitations, chest pain
ECG findings
•Absent p-waves, ‘irregularly irregular’ rhythm, fibrillatory waves

33
Q

What is the definitions of Wolff Parkinson White?

A

•Syndrome causing tachycardia & abnormal cardiac electrical conductance

34
Q

What is the underlying cause of Wolff Parkinson White?

A

•Due to an accessory conduction pathway (the bundle of Kent) between the atria and ventricles

35
Q

What is the effects of cardiac output and life expectancy of Wolff Parkinson White?

A
  • Q unchanged

* Normal life expectancy

36
Q

What are the investigations of Wolff Parkinson White?

A

General
•Palpitations, chest pain
ECG findings
•Pre-excitation - QRS complex of ECG & biphasic/ inverted - T-wave of ECG

37
Q

What is the definition of ventricular arrhythmias?

A
  • Arrythmia originating from His-Purkinje system or ventricular myocytes
  • Ventricles contract at rates of between 150-400 bpm
38
Q

What is the underlying cause of ventricular arrhythmias?

A

•Structural heart disease, MI or congenital

39
Q

What are the effects of cardiac output and life expectancy with ventricular arrhythmias?

A
  • Can lead to complete loss of Q

* Seconds to minutes

40
Q

What are the investigations in ventricular arrhythmias?

A

General
•Syncope
ECG findings
•Irregular deflections, difficult to identify PQRST waves

41
Q

What do the different QRS complex?

A
  • Taller: more muscle mass within ventricles

- Wider: Slower conduction along those ventricles

42
Q

What is the definition of torsade de pointes?

A

•Polymorphic ventricular tachycardia that occurs due to a long QT interval

43
Q

What is the underlying cause of torsade de pointes?

A

•Congenital or acquired QT prolongation à reduced repolarisation

44
Q

What are the effects of cardiac output and life expectancy of torsade de pointes?

A
  • ↓Q

* Automatically resolves or progresses to deadly Vfib

45
Q

What are the investigations of torsade de pointes?

A

General
•Chest pain, syncope
ECG findings
•Characteristic ‘twisting around the point’

46
Q

What is definition of Tachycardias – Sinus (STach) & Atrial (ATach)?

A
  • Atrial rate of between 100-250 bpm.
  • STach – P-waves followed by QRS complexes
  • ATach – P-waves not always followed by QRS complexes
47
Q

What is the underlying cause of Tachycardias – Sinus (STach) & Atrial (ATach)?

A
  • STach – Physiological

* ATach – Ectopic source of atrial beat

48
Q

What is the effects of cardiac output and life expectancy of Tachycardias – Sinus (STach) & Atrial (ATach)?

A
  • Unchanged or slightly ↓Q

* Little impact on life-expectancy

49
Q

What is the investigations for Tachycardias – Sinus (STach) & Atrial (ATach)?

A

ECG findings
•STach – Normal
•ATach – Solitary p-waves, dependent on level of block

50
Q

What is the Conduction block - AV block definition?

A
  • Impaired electrical conduction through AV node

* Type I (Wenckebach or Mobitz I); type II (Mobitz II) & third-degree (complete) AV block

51
Q

What is the underlying cause of Conduction block - AV block?

A
  • Fibrosis or calcification of conduction system

* Type I - AV node; types II & III - His Purkinje system

52
Q

What is the effect of cardiac output in Conduction block - AV block?

A

•Usually ↓Q

53
Q

What are the investigations in Conduction block - AV block?

A

ECG findings
•Type I: ↑ P-R interval
•Type II: ↑ P-R interval -> 1 beat loss of AV conduction
•Type III: Complete/persistent loss of conduction from the atria to the ventricles

54
Q

What is Conduction block - bundle branch block?

A
  • Impaired electrical conduction in the right or left branches or fascicles of the bundles of His
  • Right bundle branch block (RBBB)
55
Q

What is the underlying cause of Conduction block - bundle branch block?

A

Underlying cause
•LBBB – consequence of ischaemia or heart disease
•RBBB – benign & asymptomatic

56
Q

What is the effect on cardiac output of Conduction block - bundle branch block?

A

•LBBB – Usually ↓Q

57
Q

What are the investigations in Conduction block - bundle branch block?

A

ECG findings
•RBBB & LBBB – Widening QRS complex > 120 msec
•Fascicle blockage (hemi-block) – Alterations in cardiac axis: posterior -> LAD & anterior -> RAD

58
Q

What are Vascular: disorders that affect the blood vessels?

A 
-Hypertension
•Primary
•Secondary
-Myocardial infarction
•NSTEMI
•STEMI
59
Q

What is the definition of hypertension?

A

•Clinic BP ≥ 140/90 mmHg & ambulatory BP daytime average ≥ 135/85 mmHg

60
Q

What is the underlying cause of hypertension?

A

•Primary cause unknown. Various secondary causes

61
Q

What are the effects of cardiac output & life expectancy of hypertension?

A
  • Will potentially ↓Q

* Increases likelihood of heart disease or end-organ damage

62
Q

What are the investigations in hypertension?

A

General
•Asymptomatic, requires BP monitoring
ECG findings
•No specific features

63
Q

What is the definition of myocardial infarction?

A

•MI – Acute coronary syndrome resulting in cardiac tissue damage to coronary artery blockage

64
Q

What is the definition of angia?

A

•Angina - Pain or discomfort that typically radiating from the chest at rest (unstable) or brought on by physical exertion or emotional stress (stable)

65
Q

What is the underlying cause of MI and angia?

A

•Myocardial ischaemia/cell death due to coronary artery disease

66
Q

What are the effects of cardiac output and life expectancy of MI and angia?

A

Effects of cardiac output & life expectancy
•Dependent on site but most likely ↓Q
•High mortality if untreated

67
Q

What are the investigations of MI and angia?

A

Investigations
ECG findings
•ST segment elevation (STEMI) or normal (NSTEMI)

Z YEAR 1 BRS cardiology (10 decks)

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