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Y3 CORE CONDITIONS > CARDIOVASCULAR SYSTEM > Flashcards

CARDIOVASCULAR SYSTEM Flashcards

1
Q

How many surgical patients get DVT?

a) 1-2%
b) 20-50%
c) 60-70%
d) 80-90%

A

b) 20-50%

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2
Q

name 3 symptoms presents on the calf of a DVT patient

A

tenderness
warmth
swelling
pitting oedema

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3
Q

give one systemic symptom which may be present for DVT

A

mild fever

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4
Q

What is Homan’s sign for DVT?

a) pain on knee flexion
b) pain on dorsiflexion
c) pain on knee extension
d) pain on plantarflexion

A

b) pain on dorsiflexion

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5
Q

why shouldn’t Homan’s sign be performed?

A

may dislodge clot

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6
Q

if pain is referred to the iliofemoral region, what does this mean in reference to motility of the clot?

A

more likely to dislodge

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7
Q

in complete occlusion due to DVT, what sign of peripheral hypoxia might you see in the leg?

A

cyanosis

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8
Q

what is post-phlebitis syndrome?

A

ulceration after complete occlusion following a DVT

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9
Q

give 2 iatrogenic risk factors for DVT

A

HRT

COCP

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10
Q

give two lifestyle risk factors for DVT

A

immobility

obesity

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11
Q

give 3 physiological risk factors for DVT

A

malignancy
pregnancy
thrombophilia
past DVT

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12
Q

what is a thrombus in contrast to a clot?

A

solid mass in circulation from living blood constituents in life (not dried, dead etc)

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13
Q

what are red thrombi made of?

a) red cell & fibrin
b) red cell & cholesterol
c) white cell & fibrin
d) white cell & cholesterol

A

a) red cell & fibrin

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14
Q

What is Well’s score used to calculate?

A

DVT risk

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15
Q

what would a Well’s score of 3 or more indicate?

A

high risk DVT

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16
Q 
What are these criteria used to calculate?
active cancer
previous DVT
recent immobilisation
swollen superficial veins
calf swelling >3cm
entire leg swelling
localised swelling
A

Well’s Score

DVT

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17
Q

what specific blood test would you use in the case of suspected DVT?

A

D-Dimer

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18
Q

what specific radiological test would you do in a suspected DVT?

A

compression ultrasound

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19
Q

give 2 differential diagnoses for DVT

A

ruptured baker’s cyst

cellulitis

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20
Q

what is the first drug you would give in treatment of DVT?

A

LMWH e.g. enoxaparin

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21
Q

when would INR indicate it would be safe to stop LMWH?

a) 2-3
b) 1-2
c) 4-5
d) 9-10

A

a) 2-3

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22
Q

name an anti-coagulant you might also give in the case of DVT

A

warfarin

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23
Q

name a factor Xa inhibitor that you might also give in the case of DVT

A

fondaparinux

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24
Q

give a complication of DVT

A

pulmonary embolism

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25
Q

how common is acute coronary syndrome?

a) 1/1000
b) 5/1000
c) 50/1000
d) 100/1000

A

b) 5/1000

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26
Q

name 2 rare causes of ACS

A

emboli
coronary spasm
coronary artery vasculitis

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27
Q

what differentiates between chest pain of unstable angina and of an MI?

A

unstable angina = 20mins

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28
Q

give two places that ACS chest pain radiate to?

A

left arm
neck
jaw

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29
Q

Give 4 symptoms of ACS

A

sweating
tachycardia
nausea
breathlessness

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30
Q

name 2 signs you might hear when listening to the heart on chest examination in ACS

A

4th heart sound
pan systolic murmur
pericardial friction rub

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31
Q

name a sign you might see when observing the neck of a patient with ACS

A

raised JVP

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32
Q

name a sign you might hear when listening to the lungs of someone with ACS

A

crepitation due to pulmonary oedema

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33
Q

how would you distinguish a silent MI from other ACSs?

A

no pain

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34
Q

which of these is NOT at risk of getting a silent MI?

a) old
b) diabetic
c) immobile

A

c) immobile

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35
Q

what is the difference between the tissue damage in a STEMI and a NSTEMI?

A 
STEMI = infarction
NSTEMI = ischaemia (reversible)
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36
Q

what are the three main causes of the arterial narrowing that can cause ACS?

A

rupture
thrombosis
inflammation

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37
Q

what is the end result of cells that are affected to artery narrowing of cells in ACS?

A

iscahemia
infarction
necrosis

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38
Q

what is the sinus rhythm in an inferior MI and why does this occur?

A

sinus bradycardia

vagal stimulation

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39
Q

what is a transmural MI?

A

necrosis through the thickness of the pericardium

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40
Q

name 7 risk factors for ACS

A 
age
male
obesity
smoking
hypertension
diabetes
cholesterol
sedentary lifestyle
family history
stress
LVHF
cocaine
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41
Q

why are ACS attacks more common in the morning?

A

blood pressure lower at night.

when it rises in the morning can dislodge a clot

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42
Q

what would high troponin and ACS symptoms indicate?

A

MI

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43
Q

what would normal troponin but ACS symptoms indicate?

A

unstable angina

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44
Q

what do the cardiac enzymes CK and CK-MB indicate in ACS?

A

myocyte death

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45
Q

when would you expect lactate dehydrogenase to rise after an MI?

a) minutes
b) hours
c) days
d) weeks

A

c) days

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46
Q

name 2 things you might see in a chest x-ray of someone with ACS

A

cardiomegaly
pulmonary oedema
widened mediastinum

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47
Q

give 4 differential diagnoses for ACS

A 
pericarditis
angina
pulmonary embolism
aortic dissection
myocarditis
pneumothorax
GORD
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48
Q

what is the mortality for MIs within 2 hours of onset?

a) 5%
b) 25%
c) 50%
d) 75%

A

c) 50%

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49
Q

what is the 4-way treatment plan for acute STEMIs?

A

aspirin 300mg
nitrate GTN spray
clopidogrel 300mg
oxygen

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50
Q

what surgical treatment would you recommend for an acute STEMI?

A

PCI angioplasty

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51
Q

what three drugs would you give in the case of an NSTEMI?

A

beta blockers
LMWH
nitrates

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52
Q

fill in the blanks for ACS rehabilitation advice:

no __ for 1 month, no __ __ for 2 months

A

sex

air travel

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53
Q

what 4 drug groups would you give long term following an MI?

A

anti-coagulant
statin
ACE inhibitors
beta blockers

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54
Q

name 3 acute serious cardiac complications of ACS

A

cardiac arrest
heart block
cardiac tamponade

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55
Q

name 2 causes of sudden death following MI

A

ventricular fibrillation

asystole

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56
Q

name 2 peripheral complications of MI

A

DVT

PE

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57
Q

which of these is a cardiac enzyme that will rise within hours of an MI?

a) ALT
b) AST
c) ALP
d) AZT

A

b) AST

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58
Q

what is Dressler’s syndrome?

A

immune mediated pericarditis

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59
Q

what immune mediated, post-MI condition do these symptoms indicate?
post MI: fever, pericardial effusion, anaemia, cardiomegaly
a) Dressler’s
b) Robert’s
c) Mallory-Weiss
d) SLE

A

Dressler’s symdrome

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60
Q

how is dressler’s syndrome treated?

a) self limiting, NSAIDs & steroids
b) self limiting, antibiotics & DVT prophylaxis
c) emergency, anti-coagulants & statins
d) emergency, antibiotics and DVT prophylaxis

A

a) self limiting, NSAIDs & steroids

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61
Q

what is the prevalence of angina pectoris in the UK?

a) 2%
b) 10%
c) 40%
d) 60%

A

a) 2%

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62
Q

what causes the pain of angina pectoris?

A

insufficient oxygen supply to meet heart’s demand

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63
Q

what causes the insufficient oxygen to the heart in angina pectoris?

A

atherosclerosis & narrowing of vessels

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64
Q

name 2 other causes of angina pectoris

A

anaemia
thyrotoxicosis
hyperlipidaemia

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65
Q

what environmental factors can precipitate angina pectoris?

A

exercise
cold
heavy meals

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66
Q

name 3 risk factors for angina pectoris

A

smoking
exercise
hypertension
diabetes

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67
Q

what is classical angina?

A

exercise provoked

disappears w rest

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68
Q

what is decubitus angina?

A

when lying

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69
Q

what is nocturnal angina?

A

wakes patient

vivid dreams

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70
Q

what is prinzmetal’s angina

A

at rest

without trigger

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71
Q

what ECG abnormality would you see in prinzmetal’s angina?

A

ST elevation during pain

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72
Q

in which gender is Prinzmetal’s angina more common?

A

female

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73
Q

what is cardiac syndrome X?

A

abnormal stress response to exercise with no artery abnormality

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74
Q

which gender is cardiac syndrome more common in?

A

female

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75
Q

what cardiac imaging might you do in suspected angina?

A

echocardiography

CT coronary angiography

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76
Q

name 4 drugs given to treat angina

A

aspirin 75mg
beta blockers
calcium channel blockers
GTN spray

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77
Q

name 2 surgical interventions that you might consider if angina is severe or doesn’t respond to drugs

A

PCI

CABG

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78
Q

which of these facts is wrong about prevalence of AF?

a) 5% in over 65s
b) 10% in over 70s
c) 15% in stroke patients
d) 20% of hyperthyroid patients

A

d) 20% of hyperthyroid patients

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79
Q

which of these doesn’t cause AF?

a) heart failure
b) MI
c) hypertension
d) hypothyroidism
e) mitral valve disease

A

d) hypothyroidism

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80
Q

which of these doesn’t cause AF?

a) PE
b) pneumonia
c) pneumothorax
d) alcohol
e) surgery
f) sepsis

A

c) pneumothorax

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81
Q

what is the characteristic pulse pattern of someone with AF?

A

irregularly irregular

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82
Q

give 3 possible symptoms of AF

A

palpitations
chest pain
dyspnoea
syncope

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83
Q

name 3 risk factors for AF

A

rheumatic heart disease
alcohol intoxication
hypertension
thyrotoxicosis

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84
Q

what electrolyte imbalances can predispose to atrial fibrillation?

A

hypokalaemia

hypermagnaemia

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85
Q

what is the normal heart rate for someone with AF

a) 40-60bpm
b) 60-80bpm
c) 120-180bpm
d) 180-200bpm

A

c) 120-180bpm

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86
Q

what electrical fault results in AF?

A

AVN intermittently responds causing irregular ventricular contraction

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87
Q

which of these isn’t a result of AF?

a) stasis of blood in heart chambers
b) neovascularisation
c) cardiac output drops

A

b) neovascularisation

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88
Q

how long does acute AF last?

A

less than 48 hours

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89
Q

what is paroxysmal AF?

A

recurrent sudden episodes

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90
Q

what is the difference between persistent and permanent AF?

A 
persistant = rhythm treatable
permanent = rhythm non-treatable
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91
Q

what ECG sign shows AF?

A

absent P waves

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92
Q

name 3 possible drugs given to control ventricular rate in acute AF

A

diltiazem
verapamil
digoxin
amoidarone

93
Q

why would you give warfarin in chronic AF?

A

reduce risk of stroke (anticoagulation)

94
Q

name 2 drugs used for first line treatment in chronic AF

A

beta blocker

calcium channel blocker

95
Q

name a complication of AF

A

stroke

96
Q

in what race is hypertension most common?

A

black africans

97
Q

in what gender is hypertension most common?

A

men

98
Q

what is the percentage of hypertension in the general population?

a) 5-10%
b) 20-30%
c) 50-60%
d) 75-85%

A

b) 20-30%

99
Q

what is the main cause of essential hypertension?

A

no underlying cause

100
Q

what is another element in the cause of essential hypertension?

A

genetics

101
Q

what happens to blood pressure in hypertension?

A

elevated

102
Q

name 2 non-circulatory symptoms of hypertension

A

headaches
sweating
shortness of breath

103
Q

what would radio-femoral delay in hypertension indicate?

A

aortic coarctation

104
Q

what would renal bruit in hypertension indicate?

A

renovascular disease

105
Q

name 4 lifestyle risk factors for hypertension

A

obesity
alcohol
salt intake
stress

106
Q

name 3 endocrine diseases which may predispose to hypertension

A 
conn's
cushion's
acromegaly
pheochromocytoma
diabetes
107
Q

name 2 physiological risk factors for hypertension

A

pregnancy

diabetes

108
Q

which of these describes hypertension

a) increase in peripheral vascular resistance
b) increase in coronary vascular resistance
c) increase in coronary vascular lumen width
d) increase in peripheral vascular lumen width

A

a) increase in peripheral vascular resistance

109
Q

how is hypertension graded?

A

1-3

3 is most severe

110
Q

what aldosterone disorder can cause hypertension?

A

primary aldosteronism

111
Q

what condition would hypokalaemia in hypertension indicate?

A

Conn’s

112
Q

what heart changes might be seen in an ECG for hypertension

A

left ventricular hypertrophy

113
Q

why is it important for the blood pressure not to be reduced too fast in treatment of hypertension?

A

baroreceptors in brain adapt to high pressure so reduction speedily may cause cerebral ischaemia

114
Q

what would be first line treatment for essential hypertension?

A

ace inhibitor

or angiotensin 2 receptor antagonist

115
Q

what would be first line treatment for someone over 55 or afro-carribean with hypertension?

A

thiazide diuretic and calcium channel blocker

116
Q

what defines cardiac failure?

A

heart not able to pump blood at rate required for normal metabolism

117
Q

disease of what arteries can cause cardiac failure?

A

coronary arteries

118
Q

what is the prevalence of under 85s and over 85s for heart failure in the UK?

a) 7/1000, 90/1000
b) 50/1000, 150/1000
c) 100/1000, 200/1000
d) 1/1000, 5/1000

A

a) 7/1000, 90/1000

119
Q

where would you get oedema in left ventricular failure in contrast with right ventricular failure

A 
left = pulmonary oedema
right = ankle/sacral
120
Q

what sided heart failure would be characterised by orthopnoea and paroxysmal nocturnal dyspnoea?

A

left

121
Q

in which sided heart failure would you find a displaced apex beat?

A

left

122
Q

in which sided heart failure might you find ascites?

A

right

123
Q

in which sided heart failure might you find a right ventricular parasternal heave?

A

right

124
Q

what is the name of the classification system for heart failure?

A

new york heart association

125
Q

name 5 things you might see on a chest X-ray for heart failure

A 
Alevolar oedema (bats wing)
Interstitial oedema (kerley B lines)
Cardiomegaly
Upper lobe Deviation
Pleural effusions
126
Q

what might an echocardiogram show for heart failure?

A

chamber distension

127
Q

what is forward heart failure in relation to the kidneys?

A

ventricle can’t maintain normal renal circulation

128
Q

Which system causes sodium and water retention in forward heart failure?

A

renin-angiotensin system

129
Q

what occurs to the atria in backwards heart failure?

A

ventricles can’t prevent atria from overfilling

130
Q

what occurs to the pulmonary system in backwards heart failure

A

back pressure on system

131
Q

when is the onset of acute heart failure?

A

sudden within minutes of MI or valvular collapse

132
Q

what 2 things cause onset of chronic heart failure

A

mitral stenosis which leads to RHF

chronic ischaemia

133
Q

which sided heart failure is most common?

A

left

134
Q

how would you define the circulating volume in congestive cardiac failure?

A

hypervolaemic

135
Q

what occurs to the lungs with congestive cardiac failure

A

pulmonary oedema

136
Q

what is cor pulmonale and what causes it?

A

right sided heart failure due to COPD

137
Q

what two words would you use to describe greater circulating fluid before and after entering the heart?

A

preload

afterload

138
Q

what happens to the ventricles during heart failure

A

dilation

139
Q

what 2 things happen to myocytes during heart failure?

A

hypertrophy & remodelling

140
Q

name 2 diuretics you could give in treatment for heart failure

A

furosemide
bendroflumethiazide
bumetanide

141
Q

name an ace inhibitor you could give in treatment of heart failure

A

ramipril

142
Q

name an angiotensin 2 receptor antagonist you could give in treatment of heart failure

A

losartan

143
Q

when would you use angiotensin two receptor antagonists in heart failure?

A

intolerance to ace inhibitors

144
Q

why are ace inhibitors used in the treatment of heart failure?

A

Relax blood vessels and lower blood pressure.
This improves blood flow.
Your heart is then able to pump more blood to the rest of your body without working harder.

145
Q

why are beta blockers used in heart failure?

A

to improve cardiac function

146
Q

when would you give a cardiac glycoside in heart failure? give an example

A

if AF present

digoxin

147
Q

why are vasodilators and nitrates used to treat heart failure?

A

to reduce preload and afterload

148
Q

intolerance to what 2 drugs would justify giving vasodilators and nitrates?

A

ace inhibitors

angiotensin 2 receptor antagonists

149
Q

when would you consider anticoagulation/antiplatelets in a heart failure patient?

A

risk of stroke

150
Q

what is mortality at 5 years for heart failure?

a) 5%
b) 25%
c) 50%
d) 75%

A

c) 50%

151
Q

risk of what other cardiac condition is increase by four times following heart failure?

A

stroke

152
Q

what two red flags would make you worry about infective endocarditis?

A

fever

new murmur

153
Q

what 4 hand and nail signs might you expect to see in infective endocarditis?

A

clubbing
laneway lesions
osler’s nodes
splinter haemorrhages

154
Q

what organ may be enlarged in septic infective endocarditis?

A

spleen

155
Q

which of these is not a results of immune-complex deposition in infective endocarditis?

a) haematuria
b) non-viral hepatitis
c) glomerulonephritis

A

b) non-viral hepatitis

156
Q

name 2 lifestyle risk factors for infective endocarditis

A

IVDU

poor dental hygiene

157
Q

name 2 physiological risk factors for infective endocarditis

A

new arrhythmias

congestive heart failure

158
Q

name an iatrogenic risk factor for infective endocarditis

A

prosthetic material in heart

159
Q

what is the most common causative organism for infective endocarditis?

A

Staph A

160
Q

name 2 other causative organisms for infective endocarditis

A

Coagulase negative Staph A

Streptoccous= Most common Strep Viridans

161
Q

what is Duke’s criteria?

A

diagnosis of infective endocarditis

162
Q

which of these is not a feature of Duke’s criteria

a) positive blood culture
b) fever
c) positive echo
d) new murmur
e) heart diameter
f) predisposing factors

A

e) heart diameter

163
Q

what is mortality rate for infective endocarditis without treatment?

A

100%

164
Q

what 2 antibiotics would you give for infective endocarditis

A

penicillin & gentamicin

165
Q

what 2 antibiotics would you give for MRSA infective endocarditis?

A

vancomycin & gentamicin

166
Q

name 2 complications of infective endocarditis

A

sepsis
infective emboli
abscess

167
Q

what hearing distortions are common with postural hypotension?

A

tinnitus

168
Q

what kind of syncope is present with postural hypotension?

A

vasovagal

169
Q

what occur to the blood pressure that is abnormal in postural hypotension?

A

suddenly falls on standing

170
Q

what condition is defined by a fall in the systolic by 20mmHg and diastolic by 10mmHg?

A

postural hypotension

171
Q

where does blood pool upon a change in body position in postural hypotension?

A

lower extremities

172
Q

how does pooling of blood in postural hypotension affect venous return? how does this affect cardiac output?

A

compromises venous return

decreases cardiac output and arterial pressure

173
Q

which group does postural hypotension NOT commonly affect?

a) elderly
b) those with low blood pressure
c) young children

A

c) young children

174
Q

what are the causes of postural hypotension?

4A’s, 2D’s, 2P’s

A 
anorexia
addison's
atherosclerosis
antidepressants
diabetes
ehler's Danklos
Parkinson's
phaechromocytoma
175
Q

what change to diet is encouraged in postural hypotension?

A

high salt

176
Q

what drug would you give in the case of anaemic postural hypotension?

A

erythropoietin

177
Q

name a common heart irregularity in a young person

A

supra ventricular tachycardia (SVT)

178
Q

name 3 symptoms associated with SVT

A

rapid
regular heart beat
chest pain
improves with rest

179
Q

how would you treat SVT?

A

beta blocker

ca-ch blocker

180
Q

What is congested heart failure?

A

It is both right and left heart failure. Blood returning to the heart get trapped in the IVC and SVC causing oedema.

181
Q

What affect does congested heart failure have on the kidney?

A

Causes them to retain water and sodium which causes further oedema.

182
Q

What are the condition that cause restrictive blood flow and therefore CHF?

A

Cardiac temponade

Constrictive pericarditis

183
Q

What conditions cause inadequate heart rate and therefore CHF?

A

Beta blockers
Post MI
heart block

184
Q

What is the New York heart Classification of heart failure?

A

Class I (no symptoms) – you don’t have any symptoms during normal physical activity

Cass II (mild) – you’re comfortable at rest, but normal physical activity triggers symptoms

Class III(moderate) – you’re comfortable at rest, but minor physical x triggers symptoms

Class IV (severe) – you’re unable to carry out any physical activity without discomfort and you may have symptoms even when resting ( symptomatically severe HF)

185
Q

What conditions causes increase pre-load in low output heart failure?

A

Mitral regurgitation and fluid overload

186
Q

What conditions causes increase after-load in low output heart failure?

A

Aortic stenosis and hypertension

187
Q

What are the two main causes of HF?

A

CAD and hypertension

188
Q

What is high output HF?

A

It is when the heart has a normal cardiac output however the demand of the body is greater than normal and therefore cannot meat the bodies demand

189
Q

What conditions cause high output HF?

A

Hyperthyriodism
Paget disease
Heart disease with anaemia or pregnancy

190
Q

What are the two types of LHF?

A

Systolic and diastolic heart failure

191
Q

What is systolic LHF?

A

There is a reduced ejection fraction and the cardiac output of the left heart cannot meat the demand of the body. Abnormal left ventricular contraction
EF = <40%

192
Q

What is diastolic LHF?

A

It is when the left side of the heart has a thickened heart muscle and cannot relax properly and therefore fill up normally. Increased filling pressure
EF= >50%

193
Q

What causes systolic LHF?

A 
MI
CAD
Hypertension
Aortic stenosis
Mitral regurgitation
IHD
Arrhythmia
194
Q

What causes diastolic LHF?

A 
Cardiac tamponade
Constrictive pericarditis
Pericarditis disease
Hypertension
Aortic stenosis that leads to hypertrophy
Hypertension can lead to hypertrophy
CAD
195
Q

What are signs and symptoms of RHF?

A 
Increase JVP
Hepato congestion leading to ascites
Peripheral oedema ( ankle and sacral)
Right ventricle parasternal heaves 
Pitting oedema 
Fatigue
196
Q

In which side heart failure would cause Haemoptysis and coughing up sputum that is frothy and pink?

A

Left

197
Q

What are the symptoms of LHF?

A 
Haemoptysis
Coughing up pink and frothy sputum
Fatigue
PND
Orthoponea
198
Q

What are the signs of LHF?

A 
S3 gallop
Tachycardia
Tachypnoea
Pleural effusion
Pleural oedema
Displaced apex beat
199
Q

What is the main cause of RHF?

A

Main cause of RHF is caused by LHF which causes increase in pressure in the lungs and then back to the right hand side of the heart increasing the work load

200
Q

What lung diseases causes RHF?

A

PE, Pulmonary hypertension and emphysema

201
Q

What type of stenosis causes RHF?

A

Mitral stenosis causes hypertrophy of atria and also increase in preload

202
Q

What type of regurgitation causes RHF?

A

Tricuspid regurgitation as it causes volume overload and dilation of the right ventricle.

203
Q

What birth defect leads to RHF?

A

Left to right shunt

204
Q

What type of stenosis is there in Fallots Tetralogy?

A

Pulmonary stenosis

205
Q

What is Ebstein’s anomaly?

A

Abnormality in tricuspid valves

206
Q

What is Rheumatic heart disease?

A

Valvular disease due to rheumatic fever

207
Q

What causes Rheumatic fever?

A

Untreated throat infection caused by Group A Streptoccocus

208
Q

What is the cause of mitral stenosis?

A

Mainly due to Rheumatic heart disease

Can be due to calfication

209
Q

Who is mitral stenosis commonly seen in?

A

Pregnancy

210
Q

What are the symptoms of mitral stenosis?

A 
Chest pain
Fatigue
Dyspnoea
palpitations
Haemoptysis
211
Q

Signs of mitral stenosis

A

Mid late diastolic murmur
Radiates to axillia
Malar flush

212
Q

What are the complications of Mitral stenosis?

A 
AF
Pulmonary Hypertension
HF
Left atrial dilation
Thromboembolism
213
Q

How do you diagnose mitral stenosis?

A 
CXR = L atrial enlargement
Echo = L atrial enlargement, thick+calcified mitral valve
214
Q

What is the most common valvular disease in western world?

A

Aortic stenosis

215
Q

What is the cause of aortic stenosis?

A

Calcification by age but made worse by dm and hypertension

216
Q

Symptoms of aortic stenosis?

A

HF, angina and syncope

217
Q

What are the signs of aortic stenosis?

A

Ejection systolic murmur that radiates from aortic area to carotid
Slow rising pulse
Narrow BP
Left ventricular heaves

218
Q

What are the complications of aortic stenosis?

A

Left ventricular hypertrophy and dilation
HF
Thromboembolism

219
Q

How is aortic stenosis diagnosed?

A

Cardiac chamber catheterisation –> definitive
ECG
Echo–> thickened valves and LV hypertrophy
Cxray–> cardiomegaly

220
Q

What is the most common valvular disease?

A

Mitral regurgitation

221
Q

What are the causes of mitral valve regurgitation?

A

Infective endocarditis
Mitral valve prolapse
Connective tissue disorder (marfans)
Rheumatic fever

222
Q

What type of murmur in mitral regurgitation?

A

Pan systolic murmur

223
Q

Where does mitral regurgitation radiate to?

A

Axilia

224
Q

What is mitral regurgitation complications?

A

Heart failure
Pulmonary oedema
LV hypertrophy
AF

225
Q

What is the main diagnosis of mitral regurgitation?

A

Echo which shows prolapsed valve

226
Q

What is treatment for mital regurgitation?

A
  • Vasodilators to reduce afterload
  • Treat HTN
  • Treat AF
  • Intra-aortic balloon pump if acute until surgery
  • Valve repair or replacement
227
Q

What is the cause of aortic regurgitation?

A
  • Idiopathic aortic root dilatation
  • Dilatation due to ageing, infection, HTN or inflammatory disease
  • Congenital bicuspid valve
  • Infective endocarditis
  • Aortic dissection
  • Trauma
228
Q

What sort of murmur is aortic regurgitation?

A

Early dialstolic murmur

229
Q

What is the characteristic of BP in aortic regurgitation?

A

Wide BP

Y3 CORE CONDITIONS (15 decks)

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