Circulatory System Disease Flashcards
What are the grades of heart murmurs?
- soft and barely noticeable
- soft but easily diagnosed with a stethoscope
- easily heard but no noticeable vibration
- loud with no noticeable vibration
- loud with some vibration
- loud with severe vibration, can be heard/felt without a stethoscope
congenital vs acquired heart disease?
congenital
- disease present at birth
- eg. patent ductus arterosis, valve dysplasia, septal defects, tetralogy of fallout, persistent right aortic arch
acquired
- a progressive condition
- eg endocarditis, cardiomyopathy, arrhythmias, pericardial disease, heart failure
Patent Ductus Arterosis
what is it? signs? treatment?
the ductus arteriosus fails to close at birth
- lungs become overloaded
- if not treated then left sided heart failure
signs
- loud heart murmur (grade 4-6)
- poor growth
- asymptomatic or in heart failure - lethargic/dyspnoea/coughing
treatment
- surgical closure of the vessel
- implantation of a coil to block
- prognosis is excellent with treatment
endocardial disease and valve dysplasia
what are they? signs? treatment? diagnostics?
dysplasia = malformation of the mitral or bicuspid valves
endocardial disease = narrowing of mitral or tricuspid valve
both cause blood to regurgitate back into atria
- workload increases and they enlarge
- causes congestion
signs
- loud heart murmur (grade 4-6)
- heart failure - lethargic/dyspnoea/coughing
diagnosis
- history - changes in behaviour/appetite etc
- thoracic radiographs
- ECC and ECG
- blood culture
treatment
- possible broad spectrum antibiotics following culture results
- treat for heart failure
Ventricular/atrial septal defects
what is it? signs? treatment?
holes in heart between atria or ventricles
- causes blood to flow abnormally
signs
- loud heart murmur
- asymptomatic or congested heart failure - lethargic/dyspnoea/coughing
treatment
- treat heart failure
Tetralogy of Fallot
what is it? signs? treatment?
a combintation of defects
- ventricular septal defect
- pulmonary stenosis
- compensatory right-sided hypertrophy
- overriding aorta
clinical signs
- heart failure - lethargic/dyspnoea/coughing/cyanosis
treatment
- need young otherwise prognosis low
- treat defects and heart failure
Persistent right aortic arch
what is it? signs? treatment?
malformation of major arteries of the heart
- traps the oesophagus
signs
- regurgitation of food
- malnourished
- aspiration pneumonia
treatment
- surgery to ligate and cut remnant
- feeding from a height - uses gravity to help
- liquid diet
hypertrophic cardiomyopathies
what is it? signs? diagnostics? treatment?
Thickening of the heart
- interferes with relaxation of the heart
- prevents normal filling
- poor diastolic function
- decreased cardiac output
- heart failure
signs
- heart murmur
- lethargic, dyspnoea, tachypnoea, tachycardia
- cyanosis
diagnostics
- ECC and ECG
- thoracic radiographs
- blood tests and pressure measuring
- clotting profiles - prone to clots
treatment
- beta blocks - cardiac relaxation
- pain relief
- antithrombotic and vasodilators
Dilated cardiomyopathy
what is it? signs? diagnostics? treatment?
dilation of the heart chambers
- poor systolic function
- decreased strength from decrease in muscle
- congestion and heart failure
signs
- anorexia/weight loss
- heart failure - lethargic/dyspnoea/coughing/cyanosis
- heart murmur
diagnostics
- ECC and ECG
- thoracic radiographs
treatment
- individual assessment
- heart failure
Arrhythmia
what is it? signs? diagnostics? treatment?
a disturbance of electrical activity within the heart
- can be primary or secondary
- broadly categorised
signs
- asymptomatic - only know when hear heart
- exercise intolerance/weakness/collapse
diagnostics
- blood tests
- ECC and ECG
- thoracic radiographs
treatment
- antiarrhythmics
- pacemaker
Pericardial Disease
what is it? signs? diagnostics? treatment?
an effusion accumulates in pericardial sacs
- restricts filling of right side of heart
- right-sided heart failure
signs
- heart failure - lethargic/dyspnoea/coughing/cyanosis
- distended abdomen
- exercise intolerance/collapse
diagnostics
- ECC and ECG
- thoracic radiographs
treatment
- relieving pressure around heart
- fluid removal and analysis
heart failure?
what is it? types? diagnostics?
circulatory failure
- abnormal communications between heart chambers
- unable to meet needs of the body
- congestion
types
- acute
- left-sided
- right-sided
diagnostics
- thoracic radiographs
- ECC and ECG
- blood tests
Acute heart failure
signs? treatment? nursing care?
signs
- reluctance to exercise
- collapse
- pale MMs/ cyanosis, slow CRT, weak pulse
- heart murmur
- cough/dyspnoea/tachypnoea
treatment
- thoracentesis/diuretic - if fluid build up
nursing care
- reduce stress and keep warm
- cage rest
- O2 therapy
- monitor vitals
Left-sided heart failure
signs? treatment? nursing care?
signs
- reluctant to exercise - fatigue/lethargy
- pale MMs/cyanosis
- heart murmur/tachycardia/dysrhythmias
- cough/dyspnoea/tachypnoea
treatment
- diuretics
- antiarythmics
nursing care
- reduce exercise, reduce obesity if applicable
- O2 therapy and keep warm
- monitor vitals
- low salt diet/palatable diet
Right-sided heart failure
signs? nursing care?
signs
- ascites/abdominal distention
- hepatomegaly/splenomegaly
- reluctance to exercise/fatigue/lethargy
- pale MMs/cyanosis
- heart murmur/tachycardia/dysrhythmias
- cough/dyspnoea/tachypnoea
nursing care
- medication - diuretics/ antiarrhythmics
- reduce exercise, reduce obesity if applicable
- O2 therapy and keep warm
- monitor vitals
- low salt diet/palatable diet
what is shock?
a state of acute circulatory collapse
- inability to transport sufficient oxygen
- organ failure
- death
what is hypovolaemic shock?
signs and treatment?
most common shock
secondary to significant loss of fluid
- dehydration/bleeding
signs
- tachycardia
- >CRT/pale MMs
- poor pulse quality/low blood pressure
- lethargic
- collapse
treatment
- stop cause - fluid replacement or haemorrhage control
- replace electrolytes
- oxygen supplementation
- warmth and calm
what is distributive shock?
signs and treatment?
body reaction
- often to allergy or infection
- eg anaphylactic, toxic or septic shock
causes release of inflammatory mediators which promote vasodilation
- body unable to control where blood is distributed
signs
- tachycardia
- red MMs/increased CRT
- poor pulse quality
treatment
- manage underlying cause - eg antibiotics
- IVFT - esp. electrolytes
- oxygen supplementation
- warmth
what is cardiogenic shock?
signs and treatment?
when the heart can no longer pump effectively
- often seen in degenerative heart conditions
- decreases venous return
signs
- lethargic/weak
- heart failure signs
- heart murmur and irregular pulse
treatment
- manage underlying cause
- IVFT
- oxygen supplementation
- warmth
- very close monitoring
what is obstructive shock?
signs and treatment?
the blood cannot get around body due to obstruction
- often vessels around the heart of the heart
- eg clot or vessel constricted
- reduces venous return
signs
- tachycardia
- pale MMs
- lethargic
- poor pulse quality
treatment
- manage underlying cause
- fluid and oxygen supplementation
- warmth
