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PATHOPHYS > CARDIOVASCULAR SYSTEM > Flashcards

CARDIOVASCULAR SYSTEM Flashcards

1
Q

types of coronary artery disease manifestations

A 
Stable angina 
Unstable angina 
Atypical angina (Prinzmenal) 
MI
Atherosclerotic myocardiosclerosis 
Silent ischemia 
Sudden cardiac death
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2
Q

markers for heart attack

A
  1. troponin and ck (dont really use as much now)
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3
Q

dresslers syndrme

A

a type of pericarditis believed to occur after a MI- its the bodys immune response to clearing up the debris but soemtimes it goes over board

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4
Q

staging of hypertension

A

LSO
liable - co increases but normal TPR
stable - co normal but TPR increases
organ damage; compenstaed and decompensated

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5
Q

compenstaions of the body in hypertension

A

pee a lot
decrease HR
vasodilation

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6
Q

which recepetors in the heart are responsible for tachycardia

A

b1

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7
Q

most important screening tool for heart failure

A

BNP

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8
Q

whats BNP

A

its released in response to the stretching of the myocardium by ventricles

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9
Q

what level of ejection fraction indicates HF

A

<40%

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10
Q

causes of high output HF

A

AAPPTT
anemia
Arteriovenous malformation
Paget’s disease
Pregnancy
Thyrotoxicosis
Thiamine deficiency (wet Beri-Beri)

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11
Q

physical signs of pulmonary congestion

A

achypnoea
Bibasal fine crackles on auscultation of the lungs

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12
Q

symptoms of pulmonary cogestion

A

Shortness of breath on exertion
Orthopnoea
Paroxysmal nocturnal dyspnoea
Nocturnal cough (± pink frothy sputum)

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13
Q

what is high output HF

A

so this is where CO is normal ( EF) but its the metabolic needs of the individual are increased so essentially still HF

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14
Q

what is diasoltic heart failure and examples

A

reduced ability of the Ventricles to fill so theres somehting restricting it

Hypertrophic obstructive cardiomyopathy
Restrictive cardiomyopathy
Cardiac tamponade
Constrictive pericarditis

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15
Q

causes of heart failure

A

myocarditis
coranary artery disease
valvular problems - I.e
chronic hypertension
infiltration like hemochromatosis /sarcoidosis
dilated cardiomyopathy
chagas disease in south america

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16
Q

s3

A

(produced by large amounts of blood striking a compliant left ventricle)

occurs in diastole as the heart is filling

usually assocatied with systolic hF(picture)

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17
Q

s4

A

picture says its associated with dialstolic HF

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18
Q

systolic vs diastolc HF

A

s; EF is normal

d: EF not normal

s: s3

D: s4

19
Q

signs of RH failure

A

distened JVP
ASCITES
pleaural effusions (transudative)
heaptomegaly - abdominal pain
pitting edema of legs, sacrum

20
Q

new york HF class 3

A

marked limitation in physical activity, but comfort at rest. Minimal physical activity causes fatigue (less than ordinary).

21
Q

invetsigations for hf

A

BNP levels
ECHO, ECG , X RAY. (pulmondary markings)
BLOODS-
endocrine(hyperthyroidism), LFTS - heaptomgealy , kidneys values

22
Q

kerley b

A

associated with pulmonary edema

the interlobular septae are thickened

23
Q

x ray findings from HF

A

Alveolar oedema (with ‘batwing’ perihilar shadowing)
B: Kerley B lines (caused by interstitial oedema)
C: Cardiomegaly (cardiothoracic ratio >0.5)
D: upper lobe blood diversion
E: Pleural effusions (typically bilateral transudates)
F: Fluid in the horizontal fissure

24
Q

lifestyle modifaction for hF

A

stop smoking
fluid restriction
salt restriction

25
Q

drugs used in HF

A

ACE Inhibitors
BB
digoxin
diuretics loops
spironolactone
hydralazine - vasodilator increases blood flow to CO

dopamine - increases contractility

26
Q

INITIAL MANAGEMENT OF ACUTE HEART FAILURE (pumonary edema)

A

Sit the patient up
Oxygen therapy (aiming saturations >94% in normal circumstances)
IV furosemide 40mg or more (with further doses as necessary) and close fluid balance (aiming for a negative balance)
SC morphine - this is contentious with some studies suggesting that it might increase mortality by suppressing respiration

27
Q

side effects of bb

A

hypotension
erectile dysfucntion
psyhcological distrubances
bradycardia

28
Q

ace :(

A

dry cough
angioedema
HYPERKALEMIA
kindey damage

29
Q

Name 2 loops

A

furosemide and bumetanide

30
Q

usual first line in uk for hF

A

meds so ace inhibitor and BB

If doesnt work then move to spirancolactone

31
Q

cor pulmonale

A

Right sided heart failure secondary to long-standing pulmonary artery hypertension e.g COPD

32
Q

Which medical device can be used to bridge heart failure patients awaiting a heart transplant?

A

LVAD
- so end stage hF

33
Q

normal EF

A

50 -70

34
Q

Pulsus alternans

A

it’s quite rare and is a sign of left ventricular pathology failure, the pulse alternates between being strong and weak

35
Q

CRT

A

biventricular pacing) is a procedure for implanting a permanent biventricular pacemaker. This makes your ventricles (lower chambers in your heart) contract together instead of at different times.

36
Q

how to we classify pulmonary edema

A

cardiogenic

non cardiogenic - exo + endo

37
Q

mechanisms of systolic failure

A
  1. not enough force to pump
  2. overburden with volume

3.. overburden with pressure
- hypertension
-pulmonary hypertension
- aortic stenosis

38
Q

whats very specific in the defintion of heart failure

A

you have to say that the metabolic demands are not met! (because co could be reduced but patient is fine)

39
Q

frank starling principle

A

stroke volume will increases in response to increase volume of blood which will strech out the chamber and cause it to contract more strongly

40
Q

what is one explanation for the extra fluid in heart faulure

A

the RAAS gets activated due to poor co and more fluid gets conserved but leaky capillaries

41
Q

dukes major

A
  1. postive blood cultures (more than once)
  2. postive echo findings (vegetations, regurgitation , abscess)
42
Q

dukes minor

A

mb evidence but not fulfilling major
fever
immunological phenomena
risk factors for it

42
Q

dukes minorj

A

mb evidence but not fulfilling major
fever
immunological phenomena
risk factors for it

PATHOPHYS (14 decks)

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