cardiovascular system Flashcards

1
Q

What diseases are ACS?

A

STEMI, NSTEMI, unstable angina

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2
Q

What is ACS?

A

Acute Coronary Syndrome
an umbrella term for multiple ischemic heart diseases

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3
Q

What is ischemia?

A

a reduction in blood flow, insufficient, due to a blockage

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4
Q

When do MIs happen?

A

When one of the branches of the coronary arteries becomes occluded, BP decreases leading to ischemia

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5
Q

What is coronary atherosclerosis?

A

When fatty build-up occurs inside of the arteries narrowing them

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6
Q

Acute MI signs/symptoms?

A

Chest pain (can be described as squeezing tightening, crushing), referred pain (to jaw, neck, arms), pallor, cold and clammy, nausea, weak thready pulse, dyspnea, tachy, hypotension, pain is not relieved w nitrates (GTN), feeling of impending doom.

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7
Q

How do you manage an MI?

A

TIME CRITICAL!, (STEMI -> PPCI (can be seen on ECG) NSTEMI -> ED (can’t see on ECG). aspirin (inhibits blood clots), GTN (is a vasodilator, tries to inc blood flow), Clopodogrel (anti-platelet), pain relief, O2 (only if hypoxic), fluids (if marked hypotension)

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8
Q

How to differentiate and identify a STEMI?

A

happens (L or R) from complete and prolonged occlusion of coronary artery.
Can be seen on ECG
Cardiac biomarker will be present (e.g. troponin)
To determine where happening depends on which ECG lead you can see the ST-elevation
( men <40 2.5mm, >40 2mm, women 1.5mm)

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9
Q

How do you differentiate and identify an NSTEMI?

A

NSTEMI is due to severe coronary artery narrowing, partial occlusion, microembolisation (small clot), thrombus (fatty build up)
Will not show on ECG
Will show cardiac biomarkers though

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10
Q

How do you identify and differentiate unstable angina?

A

Will not have cardiac biomarkers

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11
Q

What is angina and what are the two types?

A

Chest pain due to reduction in blood flow to cardiac muscles,
Unstable angina (ACS) and stable angina.

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12
Q

What is stable angina?

A

Ischemia! a deficiency in blood flow to cardiac tissue, it is myocardial ischemia that isn’t enough to induce cellular necrosis ( that is an MI).

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13
Q

What are the signs and symptoms of stable angina?

A

It is predictable, They will typically last 15> mins, caused by physical exertion, constricting discomfort (in neck, jaws, shoulders, arms), will be relieved by rest/GTN (a vasodilator to increase blood flow) (nitrates)
may cause nausea, gastrointestinal discomfort
Will appear on ECG as ST depression

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14
Q

What are the signs and symptoms of unstable angina?

A

the attacks are the same chest pain due to myocardial ischemia, however they are more unpredictable, they may not have a trigger and can continue while resting.

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15
Q

What is the management of Stable angina?

A

less stress/ physical exertion
GTN

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16
Q

What factors increase the risk of angina?

A

Anemia, Chronic stress, diabetes, high fats diet, too much alcohol, Hx of heart diseases, HF, high BP, high cholesterol, inflammation, enlarged heart, long-term exposure to second hand smoke, physical inactivity/obesity, men >45 women >55, smoking, drugs

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17
Q

What is the Heart Failure defined as?

A

The inability of the heart to pump a sufficient amount of blood to reach metabolic requirements

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18
Q

What are factors that increase likelyhood of HF?

A

(anything really that makes the heart work harder for a longer period of time). coronary artery disease (plaque build up), hypertension, vascular heart disease (umbrella term for lots of diseases which affect the heart), cardiomyopathy (congenital/viral) , myocarditis (inflammation of the heart), pericarditis (inflammation of lining of the heart), COPD, and systemic diseases, arrhythmia, kidney disease, diabetes, smoking, alcohol, drugs, medications such as cancer drugs (chemo), hypertension, cocaine.

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19
Q

What are the signs and symptoms of HF?

A

SOB, chest pain, palpitations, fatigue during activity, oedema (in legs, ankles, abdomen), weight gain, needing to urinate while resting at night, dry hacking cough, bloated, loss of appetite, nausea

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20
Q

What are the complications of congestive heart failure?

A

Irregular heart beat, sudden cardiac arrest, heart valve problems, fluid that collects in lungs, pulmonary hypertension, kidney damage, liver damage, malnutrition

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21
Q

Types of HF?

A

Left-sided HF, Right-sided HF, High-output HF (rare)
left-sided HF usually occurs first and is often the cause of right-sided HF

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22
Q

Left sided HF

A

fluid in your lungs

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23
Q

Right sided HF

A

fluid in legs and body

24
Q

What is prinzmetal angina?

A

Its a rare type of angina,

25
Q

Angina is the term used to describe what ?

A

chest pain caused by ischemia inadequate blood flow to the heart muscle, usually caused by coronary artery disease.
various descriptions of the pain: discomfort, tightness, pressure, heaviness, burning or squeezing.
these are an angina attack, they may feel as though they are having indigestion

26
Q

When does prinzmetal angina usually happen ?

A

When you are resting or relaxing, 12 am - 8 am

27
Q

Who does prinzmetal angina usually affect?

A

people who are younger and healthier than those who are normally affected by traditional angina.
its also found in people who have other conditions related to blood vessel spasm, e.g. migraine headaches and raynaurds phenomenon.

28
Q

What are the symptoms of prinzmetal angina?

A

Chest pain or discomfort, typically when resting between 12 am and 8 am,
the pain may move to your shoulder, arm or neck
recurrent episodes of pain that last 5-15 mins, typically following a specific pattern
associated symptoms also include, dizziness, nausea,
the symptoms are relieved when you take medication

29
Q

What is prinzmetal angina caused by?

A

the spasms of the coronary arteries, the lack of O2 caused the pain you feel, prolonged episodes can damage the heart tissue

30
Q

What causes coronary artery spasms?

A

vasoconstrictors (medications) e.g. migrate treatments, or decongestants
smoking tobacco
stress
exposure to cold
exercise
drugs, marjiuana, cocaine

31
Q

Management of treatment for prinzmetal angina?

A

Nitrates, Calcium channel blockers, Fluvastatin (may have a positive effect on the lining of the blood vessels)

32
Q

What is a systemic disease?

A

A disease that affects the entire body
e.g. flu (influenza) or anaphylaxis

33
Q

What is the treatment for anaphylaxis ?

A

epinephrine
(epi pen)
a shot you inject into thigh

34
Q

What is anaphylaxis ?

A

A hypersensitivity reaction, autoimmune condition, life threatening, in response to a trigger

35
Q

Signs and symptoms of anaphylaxis?

A

affect?
airway - DIB, SOB, inability to swallow
skin- hives, rash, itchy, inflammation
stomach - cramps, diarrhoea, nauseas + vomiting
heart - BP drop, feeling faint, increased HR, weak pulse

36
Q

Pathology of anaphylaxis?

A

1- antigen/allergen triggers antibodies
2- degranulation of mast cell release histamine and other mediators
3- histamine release causes:
- vasodilation, increase vascular permeability
- smooth muscle tone chances, bronchospasm
4- the histamine irritates nerves, makes itchy

37
Q

anaphaLACTIC reactions vs anaphaLACTOID?

A

During anaphylactic reactions, it is immune-mediated, the lgE antibody plays an important role,
allergen reacts with lgE antibody -> antibody-> causes degranulation of mast cells -> mast cells release histamine and other mediators

During anaphylactoid reactions it is NOT immune-mediated, the lgE antibody is not involved, does not cause degranulation of the mast cell -> the allergen directly causes release of histamine and other mediators from the mast cell

38
Q

What are the 4 stages of anaphylaxis, increasing in severity?

A

S1 - mild, rash , hives, redness itching
S2- moderate, more widespread, skin rash/ hives are spreading, mild swelling in lips or tongue
S3- anaphylactic shock - severe, signs of DIB, extensive swelling, weak pulse/dizziness
S4- life threatening, LOC, unable to breathe, need immediate med attention to avoid death.

39
Q

What is anaphylactic shock and its signs ?

A

when their BP drops dangerously low (light headed and confusion), rapid weak pulse, increased heart rate (the bronchial tissues that help carry air begin to swell - cause wheezing, SOB, LOC. sudden weakness, unconsciousness, cardiac arrest

40
Q

Signs and symptoms of anaphylaxis?

A
  • swollen throat and lips
  • SOB
  • hives
  • difficulty swallowing
  • red rash
  • abdo pain
  • chest tightness
  • cramps
  • diarrhoea
  • vomiting/nausea
    -wheezing
41
Q

What is biphasic anaphylaxis ?

A

when there is a second episode of symptoms after the first go away, (about 20% of people have this)

42
Q

What causes anaphylaxis?

A
  • food allergies
  • certain medications (e.g. penicillin, NSAID’s)
  • latex
  • insect stings
43
Q

risk factors for anaphylaxis ?

A

allergies
asthma
previous reaction
family history
exposure to farm chemicals
pollutants

44
Q

What is DVT (deep vein thrombosis)?

A

When a thrombus (blood clot) develops in a deep vein, because the veins are injured or the blood flowing is too stasis/sluggish) the clot may partially or fully occlude the blood flow through your vein

45
Q

Where do DVTs commonly occur?

A

lower leg, thigh or pelvis
however then can also happen in other body parts
e.g. arm, brain, intestines, liver or kidney

46
Q

What is the danger of DVT? it turns into?

A

the blood clot may break free and travel though the blood stream and turn into a PE (Pulmonary embolism)
when a travelling emboli becomes lodged in the blood vessels of the lung

47
Q

Signs and symptoms of acute DVT?

A

pooling of blood
chronic leg swelling / swelling of leg or arm and may be warmer than usual
increase pressure within your veins
the veins near surface may be larger than normal
abdo or flank pain
increased pigmentation or discolouration of skin , red
leg ulcers (a venous stasis ulcer)

48
Q

Risk factors increasing chance of DVT?

A

genetic condition
cancer/ chemotherapy
family history of DVT or previous self history
limited blood flow to deep vein because of injury/surgery/immobilisation
long periods of time not moving/immobility
pregnancy/recent birth
>40
obesity
autoimmune disease
smoking
vac rose veins
taking contraception
having central catheter/pacemaker
COVID-19

49
Q

DVT treatments?

A

anticoagulants, make blood harder to clot doest destroy clots

50
Q

What is sepsis ?

A

the bodys/extreme reaction to an infection, the body starts attacking the normal cells

51
Q

what are the risk factors for sepsis?

A

> 65, new borns, pregnant, weaker immune system, severe injuries (burns/wounds), catheters

52
Q

symptoms of sepsis?

A

fast HR, low BP, fever/hypothermia, shaking, clammy, SOB

53
Q

What is rheumatic fever?

A

it is an autoimmune disease, inflammation of Childs tissue and organs
the Childs immune system overreacts to untreated strep throat or scarlet fever infection

54
Q

Risk factors for rheumatic fever?

A

age 5-15, weaker immune system, family

55
Q

Symptoms of rheumatic fever?

A

aches, bumps under skin, chest pain, fever, headaches, constant fatigue, rash

56
Q

treatment for rheumatic fever?

A

anti-biotics, anti-inflamatory meds