case SBA questions Flashcards
describe features of chest pain that would increase your suspicion that it is cardiac in origin
- Central or left
- Crushing in nature
- Radiating to the left arm or jaw
- Associated with any of the following: palpitations, sweating, nausea
- Associated with exercise in a predictable fashion, then improves after several minutes of rest
- Improves with nitrates
- Non-tender chest wall
- No association with inspiration
what are the five main risk factors associated with ischaemic heart disease?
- Smoking
- Diabetes mellitus
- Hypertension
- Hypercholesterolaemia
- Physical inactivity
define ischaemia
reduction/restriction of blood flow (and therefore oxygen) in a part of the body
describe conditions that can arise as a result of atheroma
- Ischaemic heart disease
- Cerebrovascular disease – including carotid atheroma and embolus causing transient ischaemic attack and stroke, vertebral artery occlusion and vascular dementia
- Peripheral vascular disease
- Aortic aneurysm
- Renal artery stenosis
- Mesenteric ischaemia
describe how an ‘inferior’ myocardial infarction can cause heart block
inferior myocardial infarction = infarction of the right coronary artery territory
- right coronary artery supplies the inferior aspect of the heart anatomically
- when blocked causes ischaemic changes in the inferior electrocardiogram leads (II, III, aVF)
- AV node is usually supplied by the right coronary artery and when infarcted can lead to heart block
which structure of the conducting system of the heart passes through the septomarginal trabecula?
right bundle branch
why might inspiration “split” the second heart sound?
aortic valve closes before pulmonary valve due to increased venous return to the right side of the heart (leading to slightly longer ventricular emptying time)
which is the most severe congenital heart defect?
Transposition of great arteries
which structure forms the flexible membranous component of the septum in atrial septation?
septum primum
name the part of the embryonic germ layers from which the heart develops
splanchnic mesoderm
describe the surgical significance of the transverse pericardial sinus
The sinus facilitates the clamping of the pulmonary trunk and aorta in coronary bypass grafting
which component of the cardiac conduction system is responsible for the PR interval?
AV node
where is the AV bundle located?
membranous interventricular septum
what may result due to abnormal reabsorption of the septum primum?
patent foramen ovale
