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SHF 204 Systemic conditions > Cardiovascular System > Flashcards

Cardiovascular System Flashcards

1
Q

Review signs and symptoms of CVS disease

A
  • Chest P/discomfort
  • Breathlessness
  • Palpitations
  • Fatigue
  • Dizziness and syncope
  • Sleep disturbance- can’t lie flat
  • Oedema – lower limb, sacrum- reduced circulatory flow
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2
Q

Angina

A

Reduced blood flow to heart

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3
Q

Angina types

A

Stable
Unstable
Variant
Refractory

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4
Q

Stable angina

A

Most common
Usually occurs during activity
Relieved by rest or medication
Predictable, short term episodes
Occurs due to mismatch between blood supply and metabolic demand, causes regional wall abnormalities

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5
Q

Unstable angina

A

Unpredictable
Medical emergency, occurs at rest
More severe symptoms
Inc duration (20 mins)
Heart starved of O2= potential heart attack

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6
Q

Variant angina

A

Not due to CAD
Caused by spasm in coronary arteries that temporarily reduces blood flow
Tends to occur in cycles, typically rest
Relieved by medicine

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7
Q

Refractory angina

A

Episodes are frequent despite medication + lifestyle changes

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8
Q

Angina causes

A
  • Caused by dec blood flow to heart
  • Symptom of CAD
  • Can be result of aortic stenosis
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9
Q

Population affected by angina

A

60+

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10
Q

Angina risk factors

A

Family Hx of heart disease
Aging

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11
Q

Clinical presentation of angina

A
  • Often described as squeezing, pressure, heaviness, tightness or P in chest
  • May feel like heavy weight on chest
  • P may be felt in arms, neck, jaw, shoulders and back
  • Dizziness, fatigue, nausea, shortness of breath, sweating
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12
Q

Prognosis of angina

A
  • Angina medication- glycerol tri-nitrate
  • Lifestyle changes- lose wight, healthy due
  • Rest
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13
Q

DDX angina

A
  • Acute myocarditis
  • Severe pulmonary hypertension
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14
Q

Myocardial infarction

A
  • Heart attack occurs when flow of blood to heart is reduced or blocked
  • Myocardial cells don’t have a blood supply, requires lots of O2 as in constant use
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15
Q

Population affected by myocardial infarction

A

Male 45+

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16
Q

Risk factors of myocardial infarction

A
  • Age- men aged 45, women aged 55
  • Tobacco use
  • High blood pressure
  • Obesity
  • Diabetes
  • Family Hx
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17
Q

Clinical presentation of myocardial infarction

A
  • Variable
  • Chest P- pressure, tightness, P, squeezing or aching
  • Cold sweat
  • Fatigue
  • Heartburn or indigestion
  • Dizziness
  • Shortness of breath
  • Women can have silent infarctions= no symptoms
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18
Q

Prognosis of myocardial infarction

A

Inc risk post first acute infarction

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19
Q

DDX myocardial infarction

A
  • Stable angina
  • Myocarditis
  • Aortic stenosis
  • Aortic dissection
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20
Q

Pericarditis types

A

Acute
Recurrent
Incessant
Chronic constrictive

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21
Q

Acute pericarditis

A

Begins suddenly, doesn’t last longer than 3 weeks, future episodes can occur

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22
Q

Recurrent pericarditis

A

Occurs about 4-6 weeks after episode with no symptoms in between

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23
Q

Incessant pericarditis

A

Lasts about 4-6 weeks but less than 3 months, continuous symptoms

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24
Q

Chronic constrictive pericarditis

A

Usually develops slowly and lasts longer than three months

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25
Q

Pericarditis causes

A
  • Swelling and irritation of thin, saclike tissue surrounding heart (pericardium)
  • Often result of viral infection that causes chest cold or pneumonia
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26
Q

Pericarditis population

A

Men 20-50

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27
Q

Risk factors of pericarditis

A
  • Previous heart attack
  • Autoimmune disease
  • Trauma
  • Viral infection
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28
Q

Clinical presentation of pericarditis

A
  • Chest P most common
  • Usually feels sharp or stabbing
  • Some people have dull, achy or pressure-like chest P
  • Spreads to left shoulder + neck
  • Get worse when coughing, lying down and taking deep breath
  • Fatigue and general feeling of weakness
  • Leg swelling
  • Specific symptoms depend on type
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29
Q

Prognosis of pericarditis

A
  • Px with acute idiopathic or viral pericarditis generally have good long-term prognosis
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30
Q

DDX pericarditis

A
  • Myocardial infarction
  • Pulmonary embolism
  • Congestive heart failure
  • Pneumonia
  • Vasculitis
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31
Q

Aortic dissection

A
  • Serious condition in which tear occurs in layer of aorta
  • Blood rushes through tear causing inner and middle layers of aortic to dissect
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32
Q

Aortic dissection causes

A
  • Uncontrolled high blood pressure
  • Atherosclerosis
  • Aortic aneurysm
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33
Q

Population aortic dissection

A

Men 60-70

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34
Q

Risk factors aortic dissection

A
  • Turner syndrome
  • Marfan syndrome
  • Other connective tissue disorder
    Weaken vessels, predispose to aneurysms (linked to dissection)
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35
Q

Aortic dissection clinical presentation

A
  • Feeling of tearing P followed by sudden low back P
  • Loss of consciousness
  • Shortness of breath
  • Weak pulse in one arm or thigh compared with other
  • Leg P
  • Difficulty walking
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36
Q

Prognosis of aortic dissection

A
  • If detected early the chance of survival increases significantly
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37
Q

DDX aortic dissection

A
  • Cardiac tamponade
  • Cardiogenic shock
  • Myocardial infarction
  • Pulmonary embolism
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38
Q

Valvular heart disease

A
  • One or more valve doesn’t work properly
  • Causes poor blood flow through the heart to the body
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39
Q

Valvular disease cause

A
  • Congenital
  • Infection
  • Degenerative conditions
  • Stenosis- thickened valves or calcified  obstructs flow
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40
Q

Valvular disease population

A

+65

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41
Q

Valvular disease risk factors

A
  • Older age
  • Hx of certain infections
  • High blood pressure
  • Congenital heart disease
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42
Q

Valvular disease presentation

A
  • Might not have symptoms for many years
  • Heart murmur
  • Chest P
  • Fatigue
  • Shortness of breath
  • Swelling in ankles and feet
  • Dizziness
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43
Q

Prognosis of valvular disease

A
  • Depends on type and severity of disease
  • Sometimes requires surgery to repair or replace valve
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44
Q

DDX of valvular disease

A

Hypertrophic obstructive cardiomyopathy

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45
Q

Congestive heart failure

A
  • Chronic, progressive condition that affects pumping power of your heart muscle
  • CHF specifically refers to stage in which fluid builds up within heart and causes it to pump inefficiently
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46
Q

Congestive heart failure cause

A
  • Develops when ventricles cant pump enough blood to the body
  • Eventually, blood and other fluids can back up inside lungs, abdomen, liver, lower body
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47
Q

Population congestive heart disease

A

45-64

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48
Q

Risk factors of congestive heart failure

A
  • CAD
  • Diabetes
  • High blood pressure
  • Obesity
  • Valvular heart disease
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49
Q

Congestive heart failure clinical presentation

A
  • Primary- fatigue, swelling in ankles/lower limb, weight gain, inc need to urinate
  • Worsening- irregular heartbeat, cough that develops from congested lungs, wheezing, shortness of breath
  • Severe- chest P that radiates into upper arm, rapid breathing, skin appears blue, fainting
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50
Q

Congestive heart failure prognosis

A
  • Can be life threatening, needs urgent medical attention
  • Congestive heart failure drugs
  • ACE inhibitors- open narrowed blood vessels to improve flow
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51
Q

Aneurysm

A
  • Abnormal bulge in wall of blood vessel
  • Can rupture, causing internal bleeding (fatal)
  • Aortic, abdominal aortic, thoracic aortic, brain, peripheral aneurysm
52
Q

Aneurysm cause

A
  • High blood pressure/hypertension over many years  damage/weakening of blood vessels
  • Atherosclerosis- weakens blood vessels
53
Q

Aneurysm population

A

30-60
More common in women

54
Q

Aneurysm risk factors

A
  • High blood pressure
  • Size, location, growth
  • Family Hx
55
Q

Aneurysm presentation

A
  • Dependent on location
  • Brain- can lurk without symptoms, can rupture and leak (haemorrhagic stroke- medical emergency), most don’t rupture, severe headache, nausea, blurred/double vision, seizure, photosensitivity. Unruptured- P above/behind eye, dilated pupil, change in vision, numbness of one side of face
  • Aortic- back P, cough, weak/scratchy voice, shortness of breath, tenderness in chest
  • Abdominal- dizziness, P in lower back, sweaty/pale/clammy skin, fast heartbeat, shortness of breath
  • Peripheral- pulsating lump that can be felt, leg P/cramping with exercise, ulcers of toes/fingers, radiating P, gangrene/tissue death
56
Q

Aneurysm prognosis

A
  • Some have below risk of rupture
  • Doctor required to identify size/risk of rupture
  • Rupture= fatal (especially in brain)
57
Q

Hypertrophic changes

A
  • Heart muscles become thickened
  • Makes it harder for blood to be pumped around body
58
Q

Hypertrophic changes cause

A
  • Genetic mutation that causes muscle thickening
  • Typically affects septum, can block blood flow between chambers
59
Q

Hypertrophic changes population

A
  • Can be diagnosed at any age
  • Hypertrophy may be present at birth or in childhood, however much more common to appear normal
60
Q

Hypertrophic risk factors

A
  • Inherited- people with one parent with hypertrophic cardiomyopathy have a 50% chance of developing
  • Should be screened
61
Q

Hypertrophic clinical presentation

A
  • Often goes undiagnosed due to lack of symptoms
  • Shortness of breath, chest P, changes to hearts electrical system  life-threatening irregular heart rhythm/sudden death
  • Chest P during exercise
  • Fainting post exercise
  • Heart murmur
  • Sense of palpitations
  • Shortness of breath
62
Q

Hypertrophic prognosis

A
  • Multiple complications (e.g., heart failure, syncope, mitral valve disease, blocked blood flow)
  • No prevention but important to identify condition early to start treatment ASAP
63
Q

Atrial fibrillation

A
  • Irregular and often very rapid heart rhythm
  • Can lead to irregular blood clots
  • Inc risk of stroke, heart failure and other complications
  • 100-175 BPM (normal- 60-100)
64
Q

Types of atrial fibrillation

A

Occasional
Persistent
Long standing persistent
Permanent

65
Q

Occasional atrial fibrillation

A

come and go, usually lasting for a few mins to hours, symptoms can last up to a week and episodes can happen repeatedly, symptoms may go away on own

66
Q

Persistent atrial fibrillation

A

normal rhythm not regained independently, meds, cardioversion treatment may be used to restore

67
Q

Long standing persistent atrial fibrillation

A

continues and lasts longer than 12 months

68
Q

Permanent atrial fibrillation

A

regular rhythm cant be restored, medications needed to control HR and prevent clots

69
Q

Causes of atrial fibrillation

A
  • CAD
  • Heart attack
  • Congenital defect
  • Heart valve problem
  • High blood pressure
  • Previous heart surgery
70
Q

Risk factors of atrial fibrillation

A
  • Age- older= higher risk
  • Heart disease
  • High blood pressure
  • Thyroid disease- trigger irregular rhythm
  • Excessive alchol- inhibits fibrillation
  • Obesity
  • Family Hx
71
Q

Clinical presentation of atrial fibrillation

A
  • Some asymptomatic
  • Sensations of fast, fluttering or pounding heartbeat
  • Chest P
  • Dizziness
  • Fatigue
  • Shortness of breath
72
Q

Prognosis of atrial fibrillation

A
  • A-fib isn’t usually life-threatening, but it is serious and needs treatment to prevent stroke
  • Medication, therapy to reset rhythm, catheter blocks faulty heart signals
  • Prevention- healthy lifestyle choices reduces risk of heart disease
73
Q

Palpitation causes

A
  • Stress
  • Depression
  • Strenuous exercise
  • Stimulants- e.g., caffeine, nicotine, cocaine
  • Hormone changes
74
Q

Risk factors of palpitations

A
  • Stress
  • Anxiety disorders or panic attacks
  • Pregnancy
  • Hyperthyroidism
75
Q

Palpitation clinical presentation

A
  • Feeling of fast-beating, fluttering or pounding
  • May be felt in throat or neck as well as chest
  • Can occur during rest or activity
76
Q

Palpitation prognosis

A
  • Usually harmless, rarely a symptom of a more serious condition
77
Q

Dysponea

A
  • Left ventricle failure results in dysponea due to oedema in lungs, alveoli and intestinal fluid  lungs become stiff  more respiratory effort required for proper ventilation
    Causes shortness of breath
78
Q

Dysponea risks

A
  • Heart disease
  • Respiratory infection
  • Cancer, especially lung
  • Asthma
  • Obesity
79
Q

Dysponea clinical presentation

A
  • Shortness of breath, intense tightening of chest
80
Q

Dysponea progonsis

A
  • Bronchodilators can open airways
  • Steroids reduce swelling
  • P medication
81
Q

Syncope

A
  • Occurs when you faint because your body overreacts to certain triggers, such as sight of blood
  • Triggers HR and blood pressure to drop suddenly
  • Leads to reduced blood flow to the brain  brief loss of consciousness
82
Q

Syncope cause

A
  • Occurs when part of nervous system that regulates HR and blood pressure malfunctions to a trigger
  • HR slows and blood vessels in legs dilate
  • Allows blood to pool in legs, which lowers blood pressure
  • Combined drop in blood pressure and slowed HR quickly reduces blood flow to your brain  fainting
  • Common triggers- heat exposure, standing for long period of time, seeing blood, having blood drawn, fear of bodily injury
83
Q

Syncope population

A
  • Most common in children and young adults
84
Q

Syncope risk factors

A
  • Over heating
  • Dehydration
  • Heavy sweating
  • Sudden changes of body position- blood pooling in legs
85
Q

Syncope presentation

A
  • Pale skin
  • Light-headedness
  • Tunnel/blurred vision
  • Nausea
  • Feeling warm
  • Cold, clammy sweat
  • During episode- dilated pupils, slow, weak pulse, and jerky movements
86
Q

Syncope prognosis

A
  • Usually harmless and requires no treatment
  • Potential to injure yourself during syncope episode
  • Doctor may recommend tests to rule out more-serious causes, such as heart disease
  • Cant prevent- lie down and lift legs if feeling faint
87
Q

Oedema

A
  • Excess fluid in interstitial space
88
Q

Causes of oedema

A
  • Non-pitting- due to lymphatic blockage, cant get rid of excess water, typically cancer or lymphatics
  • Pitting- venous, typically CV, kidney or liver
  • Unilateral- deep vein thrombosis, soft tissue infection, trauma, immobility, lymphatic obstruction
  • Bilateral- heart failure, chronic venous insufficiency, drugs (e.g., NSAIDs), inferior vena cava obstruction, immobility
  • Pregnancy
89
Q

Oedema population

A
  • Older adults
  • Pregnant women
90
Q

Oedema risks

A
  • Being pregnant
  • Certain medication
  • Having long-lasting illness, e.g., congestive heart failure
  • Having surgery that involves a lymph node
91
Q

Oedema presentation

A
  • Swollen lower limbs (can affect anywhere in body)
  • Pitting- leaves dimple
  • Puffiness
  • Stretched or shiny skin
  • If left too long legs may turn brown, haemosiderin- toxin in blood comes to surface to try and be removed
92
Q

Oedema prognosis

A
  • See a doctor if shortness of breath, irregular heartbeat, chest P
  • Mild usually goes away- compression socks, raising affected arm/leg higher than heart
93
Q

Claudication

A
  • Too little blood flow to muscles during exercise, causes P due to lack of exercise
  • Most often this P occurs in legs after walking at a certain pace
94
Q

Claudication cause

A
  • Symptom of disease, most often peripheral artery disease (narrowing of arteries in limbs that restricts blood flow)
  • Damage to peripheral arteries usually due to atherosclerosis (plaque blocks arteries)
95
Q

Claudication population

A
  • Diabetics
  • Older people
96
Q

Claudication risks

A
  • Family Hx of atherosclerosis
  • 50+ if smoke or have diabetes
  • 70+
  • Diabetes
  • High blood pressure
  • High cholesterol
97
Q

Claudication presentation

A
  • P, ache, discomfort or fatigue in muscles during exercise
  • P likely in calves, thighs, buttocks, hips or feet
  • P relived after rest
  • Can develop over time and cause P at rest as well as cool skin, skin discolouration, wounds that don’t heal
98
Q

Claudication prognosis

A
  • Speak to doctor
  • Identify underlying condition
99
Q

Deep vein thrombosis

A
  • Occurs when blood clot forms in one or more deep veins in body, usually legs
100
Q

DVT cause

A
  • Anything that prevents blood from flowing or properly clotting
  • Damage to vein from surgery or inflammation and damage due to infection or injury
101
Q

DVT population

A
  • Over 40
  • People with Hx of DVT/blood clots
102
Q

DVT risks

A
  • Age- 60+
  • Lack of movement
  • Injury or surgery
  • Pregnancy
  • Birth control
  • Obesity
103
Q

DVT presentation

A
  • Leg swelling
  • Leg P, cramping or soreness that often starts in calf
  • Change in skin colour of leg- such as red or purple
  • Warmth
104
Q

DVT prognosis

A
  • Complications include pulmonary embolism, phospholipidic syndrome and treatment complications
  • See a doctor if shortness of breath, feeling lightheaded, fainting, rapid breathing, coughing up blood
105
Q

Hypertension

A
  • High blood pressure
  • Heart needs to work harder to pump blood
  • 130/80 mm Hg or higher
  • Normal- 120/80
  • Elevated- 120-129/below 80
  • Stage 1 hypertension- 130-139/80-89
  • Stage 2- 140 or higher/90 or higher
  • Above 180/120 mm Hg is hypertensive emergency or crisis
  • Need 3 months of consistent readings to diagnose
106
Q

Hypertension causes

A
  • Primary- no identifiable cause, develops gradually over many years, plaque builds up in arteries
  • Secondary- underlying condition, tends to appear suddenly and cause higher blood pressure than primary (adrenal gland tumour, congenital heart defect, kidney disease, etc)
107
Q

Hypertension population

A
  • Older people
  • Obese people
108
Q

Hypertension risk factors

A
  • Age (inc with age)
  • Family Hx
  • Obesity
  • Lack of exercise
  • Tobacco use
  • High sodium
109
Q

Hypertension presentation

A
  • Most asymptomatic
  • Headaches
  • Shortness of breath
  • Nose bleeds
110
Q

Hypertension prognosis

A
  • Untreated can lead to inc risk of heart attack, stroke, and other serious health problems
111
Q

Stroke

A
  • Occurs when blood supply to brain is interrupted or reduced
  • Prevents brain tissue from getting oxygen and nutrients
  • Brain cells die in minutes
112
Q

Stroke cause

A
  • Ischemic- blocked artery- most common
  • Haemorrhagic- leaking or bursting of vessel- result of other condition such as uncontrolled high blood pressure, overtreatment with blood thinners, trauma
  • Transient ischemic attack- mini stroke, doesn’t cause permanent damage, temporary block of blood supply
113
Q

Stroke population

A
  • 55+
  • African Americans
  • Men
  • Hormones- birth control
114
Q

Stroke risk

A
  • Obesity
  • Physical inactivity
  • Heavy or binge drinking
  • High blood pressure
  • High cholesterol
  • Diabetes
115
Q

Stroke presentation

A
  • Trouble speaking
  • Paralysis of numbness of face, arm or leg
  • Problems seeing in one or both eyes
  • Headache
  • Trouble walking
116
Q

Stroke prognosis

A
  • Seek immediate attention
  • FAST- face, arms, speech, time
117
Q

Peripheral vascular disease

A
  • Narrowed arteries reduce blood flow to arms or legs
  • Not enough blood received to keep up with demand
  • Can cause leg P when walking
  • Usually sign of build up of fatty deposits
118
Q

Peripheral vascular disease cause

A
  • Usually due to atherosclerosis
  • Blood vessel inflammation
  • Injury to arms or legs
  • Radiation exposure
  • Changes in muscles or ligaments
119
Q

Peripheral vascular disease population

A
  • Older age
  • Obese
120
Q

Peripheral vascular disease risk

A
  • Family Hx
  • High blood pressure
  • High cholesterol
  • Increasing age (65+)
  • Obesity (BMI over 30)
121
Q

Peripheral vascular disease presentation

A
  • Mild or no symptoms- mainly leg P whilst walking
  • Coldness in lower leg or foot
  • Numbness or weakness
  • P cramping in one or both hips, thighs, calf muscles after certain activities
  • Shiny skin on legs
  • Skin colour changes
  • Hair loss/slow growth on legs
  • Sores on toes, feet or legs that won’t heal
122
Q

Peripheral vascular disease

A
  • Inform doctor if in P, numbness or other symptoms of PVD
  • Complications are critical limb ischemia (causes tissue death, symptoms are open sores on limbs that don’t heal) and stroke/heart attack
  • Prevention- don’t smoke, healthy/active lifestyle, low saturated fat diet
123
Q

Vasculitis

A
  • Inflammation of blood vessels
  • Causes walls of blood vessel to thicken, reducing pathway through vessel, restricting blood flow to tissues leading to damage
124
Q

Vasculitis cause

A
  • Not fully understood
  • Some related to genetics
  • Infections- e.g., hep C + B
  • Blood cancers
  • Immune system diseases- e.g., RA, lupus, scleroderma
  • Reactions to certain drugs
125
Q

Vasculitis risks

A
  • Age- giant cell arthritis rarely occurs before 50
  • Family Hx- Behcet’s disease, granulomatosis
  • Lifestyle- smoking, use of recreational drugs
  • Medication- e.g., minocycline, allopurinal, etc
  • Infections- hep B + C
  • Sex- women
126
Q

Vasculitis presentation

A
  • Fever
  • Headache
  • Fatigue
  • Weight loss
  • General aches and P
  • Other parts of body which may be affected:
    1. Digestive system- P after eating
    2. Ears- ringing
    3. Eyes- red appearance with itch/burn
    4. Hands or feet- numbness and weakness
    5. Lungs- shortness of breath
    6. Skin- bleeding under skin can show up as red spots
127
Q

Vasculitis prognosis

A
  • Complications can lead to organ damage, blood clots and aneurysms, vision loss and blindness, infections

SHF 204 Systemic conditions (6 decks)

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