Cardiovascular Emergencies Flashcards
Diseases which increase cardiac preload / volume overload
Fluid overload, renal dysfunction, poor compliance with duietics, acute valvular regurgitation
Diseases which decrease cardiac preload / impair filling
Tachycardia, pericardial constrictive disease, restrictive cardiomyopathy, left ventricular hypertrophy, myocardial fibrosis, hyvolaemic shock
Diseases which increase afterload / pressure overload
Uncontrolled HTN and acute PE
Diseases which impair contractility / myocardial loss
Acute myocardial infarction, drug overdose, dilated cardiomyopathy, fever
Disease which cause high output failure
Fever,anaemia, thyrotoxicosis
What is the result of low cardiac output and hypotension on ischaemia
Sympathetic stimulation and RAAS causing tachycardia, vasoconstriction, Na/H2O retention. This causes O2 consumption of myocytes exacerbating ischaemia
What is the result of systemic hypoperfusion on fluid retention
Leads to lactic acidosis and pre-renal failure, which then exacerbates fluid retention.
Clinical presentations of heart failure
Decompensated, pulmonary oedema, cardiogenic shock, hypertensive HF, RHF, AHF associated with ACS
Different types of classifications of heart failure
Heart failure can be classified into perfusion and congestion, clinical presentation, NYHA functional class, LVEF
Way to work out the perfusion/congestion classification of HF
If there is evidence of raised filling pressures or congestion - no or yes
If there is evidence of systemic hypoperfusion - no or yes
Outcomes of perfusion / congestion classifications
No congestion or hypoperfusion - Warm and dry
Congestion but no hypoperfusion - warm and wet
Congestion and hypoperfusion - cold and wet
No congestion but hypoperfusion - cold and dry
Causes of myocardial injury
Acute myocardial ischaemia, acute myocardial ischaemia from O2 supply/demend imbalance, non ischaemic myocardial injury
Causes of acute myocardial injury from decreased supply
Coronary artery spasm, embolism, dissection, bradydysrhythmias, hypotension, shock, resp failure, severe anaemia
Causes of acute myocardial injury from increased demand
Sustained tachy-dysrhythmias, severe hypertension
Causes of non-ischaemic myocardial injury
HF, myocarditis, cardiomyopathy, catheter ablation, defibrilator shocks, cardiac contusion, sepsis, infectious diseases, CKD, infiltrative diseases, chemotherapeutic agents
