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CDM > cardiovascular pathology part 2 > Flashcards

cardiovascular pathology part 2 Flashcards

1
Q

Ischemic heart disease results from…

A

Myocardial ischemia

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2
Q

cause of ischemic heart disease

A

coronary Atherosclerosis, reduction of blood flow to coronary arteries

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3
Q

4 clinical syndromes of IHD

A

Angina pectoris
* Myocardial infarct
* Chronic IHD with Heart Failure
* Sudden cardiac death (SCD)

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4
Q

Chronic IHD with Heart Failure

A

progressive congestive heart failure as a
consequence of accumulated ischemic myocardial damage

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5
Q

mechanisms seen in IHD

A

pump failure - myocardium contraction is weakened, or relaxation is insufficient

flow obstruction - vessel obstruction, valve failure

regurgitation - backflow of blood causing volume overload

shunted flow- blood is diverted through acuired defecrt

failure of cardiac conduction
- arrhythmias cause inefficient myocardial contraction
rupture of heart/blood vessel - trauma or dissection

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6
Q

transmural infarction

A

involves the full thickness of the ventricular wall

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7
Q

Subendocardial infarction

A

involves the inner third of the ventricular wall

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8
Q

multifocal infarction

A

involves only small vessels in the myocardium

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9
Q

angina pectoris

A

Recurrent attacks of substernal chest discomfort caused by transient myocardial ischemia

(stable/unstable)

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10
Q

myocardial infarct

A

Death of cardiac muscle due to prolonged severe ischemia (Heart Attack)

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11
Q

Sudden cardiac death

A

unexpected death from cardiac causes either without symptoms or within 12-24 hours of symptom onset

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12
Q

initial assessments for admissions to A&E

A

Clinical History (previous Hx)
Physical examination (vital sign monitoring)
Resting 12-lead ECG (unstable patterns)
Blood Test (cardiac enzymes)
Chest x-ray

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13
Q

NICE guidelines (NG185) 2020: Acute coronary syndromes

A

covers the early and longer-term (rehabilitation) management of acute coronary syndromes. including (STEMI), (NSTEMI) and unstable angina

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14
Q

NICE guidelines (NG185) 2020: Acute coronary syndromes - reperfusion therapy (Angiography with follow-on PCI)

A
  • Offer if pt presentation is within 12 hours of onset symptoms
  • consider coronary angiography for those with acute STEMI presenting for 12hrs +, after onset symptoms
  • Consider radial (in preference to femoral) arterial access
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15
Q

NICE guidelines (NG185) 2020: Acute coronary syndromes - reperfusion therapy (Fibrinolysis)

A

offer to those with acute STEMI within 12 hours of onset of symptoms if pci cannot be delivered within 120mins

  • When treating people with fibrinolysis, give an antithrombin at the same time.

-Offer an electrocardiogram (ECG) to people with acute STEMI treated with fibrinolysis, 60 to 90 minutes after administration

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16
Q

Fibrinolysis drugs function

A

dissolve blood clots

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17
Q

Congestive heart failure (CHF)

A

Heart is unable to pump blood at a rate sufficient enough to meet metabolic demands

18
Q

Congestive heart failure (CHF) etiology

A

CAD, Cardiomyopathy, Post MI, obesity, kidney failure

19
Q

Congestive heart failure (CHF) physiological effects

A

dilation of heart, contractility and stroke volume increases

mechanical work causes damages - increased myocytes causing hypertrophy. muscle stiffness and loss of elasticity

volumes activates neuro systems, release of chemicals to adjust filling volumes and pressures which increases heart rate

20
Q

congestive heart failure Left sided: characterised by:

A
  • passive congestion
  • Blood pooling in pulmonary circulation
  • Stasis (inactivity) of blood in left heart chambers
  • Inadequate perfusion of tissues
21
Q

congestive heart failure 2 types

A

systolic - pump failure - ejection failure

diastolic - LV cannot relax, filling failure

22
Q

congestive heart failure Right-sided: characterised by:

A

caused by left-sided CHF

venous congestion

23
Q

left sided heart failure symptoms

A
  • fatigue
  • tachycardia
  • tachypnea (rapid breathing)
  • pulmonary congestion
  • cough and wheezing
  • cyanosis
24
Q

right-sided CHF

A
  • Blood pooled in the lungs from LCHF causes blood travelling from PA from RV to be backed up in RV
  • Pressure in RV is raised-Increased workload
  • Muscle of RV becomes damaged over time unable to force blood into PA
  • Blood pools in RV, forced back eventually to RA and SVC/IVC
    -Eventual organ failure due to lack of oxygen being transported to organs
25
Q

radiographic appearances

A

cardiomegaly

congestion

pulmonary oedema

26
Q

radiographic appearances

A

cardiomegaly

congestion

pulmonary oedema

27
Q

stage 1 of CHD redistribution

A

Pulmonary capillary wedge pressure (13-18mmHg)

redistribution pulmonary vessels

cardiomegaly

broad vascular pedicle

28
Q

stage 2 of CHD interstial oedema

A

PCWP 18-25mmHg
Kerley lines

peribronchial cuffing

Hazy contour of vessels

thickened interlobar fissure

29
Q

stage 3 of CHD Alveolar odema

A

PCWP > 25mmHg

Consolidation

air bronchogram

Cottonwool appearance

pleural effusion

30
Q

CHF referred imaging test

A

Echocardiography

31
Q

Echocardiography procedure

A

…..

32
Q

Echocardiography pt prep

A
33
Q

Echocardiography pt consideration

A
34
Q

Echocardiography pt instructions

A
35
Q

transthoracic echocardiography (TTE) consists of

A

five standardised windows which are obtained in a standardised sequence

36
Q

transthoracic echocardiography obtains views from

A

left parasternal, apical, subcostal, and suprasternal notch windows and The right parasternal window

37
Q

transthoracic echocardiography evaluates

A

Heart chambers
* Heart valves
* Papillary muscles
* Blood vessels
* Blood flow
* Blood volume overload

38
Q

alternative imaging techniques for further imaging (nice guidelines - CHF in adults ng106)

A

cardiac MRI, radionuclide angiography if a poor image is produced by transthoracic echocardiography

39
Q

what is cardiac MRI

A

cardiac MRI is a non-invasive test used to image the heart and diagnose conditions

40
Q

cardiac mri function

A

produces detailed images and helps to study the structure and function of the heart muscle. it also helps to find causes of pt heart failure or identify tissue damage

41
Q

Radionulide Angiography

A

specialises in showing the functionality of the hearts chambers, with the use of a radioactive tracer

42
Q

transoesophageal echocardiogram

A

ultrasound test for your heart. shows heart structure and function

provides detailed imaging

checks problems with valves, clots, aorta problems or heart infection

CDM (7 decks)

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