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Random Cardio > Conditions Facts > Flashcards

Conditions Facts Flashcards

1
Q

What is the difference between systolic and diastolic heart failure?

A

systolic means the ventricles fail to contract, causing decreased cardiac output
diastolic means the ventricles cannot relax, causing increased filling pressure

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2
Q

What can cause systolic heart failure?

A

ischaemia, MI, cardiomyopathy

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3
Q

What can cause diastolic heart failure?

A

constrictive pericarditis, tamponade

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4
Q

How does left ventricular failure present?

A

(paroxysmal nocturnal) dyspnoea, poor exercise tolerance, nocturanl cough with pink frothy sputum, wheeze, weight loss

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5
Q

How does right ventricular failure present?

A

peripheral oedema, ascites, nausea, anorexia, tricuspid regurgitation

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6
Q

What can cause right ventricular failure?

A

LVF, pulmonary stenosis, lung disease

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7
Q

What investigations should be carried out for heart failure?

A

ECG, B-type natriuretic peptide, CXR

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8
Q

What will a chest X ray show for LVF?

A 
Alveolar oedema
B lines (Kerley B)
Cardiomegaly
Dilated prominent upper lobe vessels
Effusion of pleural category
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9
Q

How should heart failure be treated?

A 
Loop diuretic to relieve symptoms (furosemide)
ACE inhibitor
Beta blocker (carvedilol)
Spironolactone (potassium sparing)
Digoxin (not always)
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10
Q

Who should be treated for hypertension?

A

Those with blood pressure (sustained) of 160/100

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11
Q

What is maligant hypertension?

A

systolic > 200 and diastolic >130

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12
Q

What may you also get with malignant hypertension?

A

headaches, blurred vision

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13
Q

What is the first line therapy for over 55s?

A

calcium channel blocker (or thiazide)

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14
Q

What is the first line therapy for under 55s (non black)?

A

ACE inhibitors

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15
Q

What is the combination therapy for hypertension?

A

ACE inhibitor + calcium channel blocker

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16
Q

Which calcium channel blocker must be given with a beta blocker because it causes tachycardia?

A

amlodipine

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17
Q

How is rheumatic fever diagnosed?

A

evidence of recent strep infection plus 2 major criteria or 1 major and 2 minor

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18
Q

What are the major criteria for rheumatic fever?

A

carditis, arthirits, erythema, sydenham’s chorea

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19
Q

What are minor criteria for rheumatic fever?

A 
prolonged PR interval
arthralgia
previous rheumatic fever
fever
raised CRP or ESR
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20
Q

What is the treatment for rheumatic fever?

A 
bed rest
penicillin or benzylpenicillin 250-500mg 3 times per day for 5 days
Analgesia
Immobilise joints in arthiritis
haloperidol or diazepam for chorea
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21
Q

What are signs of mitral stenosis?

A

malar flush on cheeks, palpable first beat sounds, rumbling mid diastolic murmur

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22
Q

How should mitral stenosis be treated?

A

Anticoagulation with warfarin if with AF
Diuretics to reduce pre load and pulmonary venous congestion
If all else fails, balloon valvuloplasty or mitral valvotomy

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23
Q

Which murmur radiates to the axilla?

A

mitral regurgitation

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24
Q

What may be felt in mitral regurgitation?

A

right ventricular heave

25
Q

What may be felt in aortic stenosis?

A

left ventricular heave

26
Q

Is the prognosis badfor aortic stenosis?

A

Yes dreadful

27
Q

Which valve disease can be cause by Marfan’s?

A

aortic regurgitation

28
Q

What may be seen on a worsening aortic regurgitation?

A

T wave inversion in lateral leads

29
Q

Is there a collapsing pulse in aortic regurgitation?

A

Yes

30
Q

When may an aortic thrill be felt?

A

aortic stenosis

31
Q

Who are likely to be affected by tricupsid regurgitation?

A

IV drug users

32
Q

What are congenital causes of pulmonary stenosis?

A

Turner’s Syndrome, William’s Syndrome

33
Q

In pulmonary stenosis, where will the murmur radiate?

A

left shoulder

34
Q

What is pulmonary regurgitation caused by?

A

pulmonary hypertension

35
Q

What does valvulopasty involve?

A

balloon catheter inserted across valve and inflated

36
Q

Describe the signs of infective endocarditis.

A

fever, rigors, night sweats, malaise, weight loss, anaemia, CLUBBING, murmur

37
Q

How is endocarditis diagnosed?

A

Duke’s criteria:

2 major or 1 major and 3 minor or all 5 minor

38
Q

What are the major criteria for endocarditis?

A 
positive blood culture
positive echo (vegetation, abscess) or new valvular regurgitation
39
Q

What are the minor criteria for endocarditis?

A

predisposition e.g. IV drug user, cardiac lesion
Fever
Immunological signs

40
Q

What antibiotic should be used for staphylococci endocarditis?

A

flucoxacillin or gentamicin

41
Q

What antibiotic should be used for streptococci endocarditis?

A

benxylpenicillin/amoxycillin

42
Q

What antibiotic should be used for enteroococci endocarditis?

A

amoxicillin or gentamicin

43
Q

What happens to T waves in myocarditis?

A

t wave inversion

44
Q

What is cardiac tamponade?

A

accumulation or pericardial fluid raising intra-pericardial pressure

45
Q

What can cause cardiac tamponade?

A

pericarditis, aortic dissection, warfarin

46
Q

What is atrial septal defect?

A

hole between atria

47
Q

What cause cause ventricular septal defect?

A

congenital causes or post MI

48
Q

What is an aneurysm?

A

When artery dilates > 150% or its original diameter

49
Q

Via what artery should an aneurysm be stented?

A

femoral

50
Q

How does aortic dissection present?

A

sudden tearing chest pain that radiates to back, unequal blood pressure and pulses in each arm, acute limb ischaemia

51
Q

What is the difference between class A and B dissection?

A

class A involves the ascending aorta

52
Q

If a patient is in hypovolaemic shock, what is the first line intervention?

A

high flow oxygen via rebreather mask

53
Q

How long can compensatory mechanisms maintain blood pressure in hypovolaemia?

A

until >30% or blood volume is lost

54
Q

In an urgent scenarios, how should fluid be given to a hypovolaemic patient?

A

use 2 large cannulae in large veins

500mls of 0.9% quickly

55
Q

What can cause pulmonary hypertension?

A

hypoxia
increased flow through pulmonary circulation
blockage eg PE
loss (emphysema) of vascular bed
back pressure from LEFT sided heart failure

56
Q

What lung pattern does pulmonary oedema show?

A

restrictive

57
Q

What can cause pulmonary oedema?

A

increased hydrostatic pressure, cellular injury, pneumonia, adult respiratory distress syndrome

58
Q

Can myocarditis cause ST elevation?

A

Yes

59
Q

What levels of hypoalbuminaemia are required before significant oedema develops?

A

very low, well below 30

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