cv 1 Flashcards
what is heart failure (x3)
Heart unable to maintain adequate circulation for metabolic requirements of body
Preserved ejection fraction (HFpEF): EF ≥ 50%, ↓ diastolic function
Reduced ejection fraction (HFrEF): EF ≥ 40%, ↓ systolic function
underlying causes
Secondary to cardiac damage (ischaemia, myopathy), hypertension, valve disease
Signs & symptoms
Exertional dyspnoea
how to test and teh result
Blood test: elevated brain natriuretic peptide (BNP)
Chest X-ray: cardiomegaly
Treatment options
Drugs that reduce the exertional pressure on the heart
what causes a Reduced ejection fraction (HFrEF) ‘systolic’
weakedned heart muscle
more dilated
less able to pump blood out of left ventricle
Preserved ejection fraction (HFpEF)/diastolic heart failuer
small area for blood in left ventricle
reasonable amount pumped out
what is a common ecg finding for heart failure
but not always there
enlarged qrs
due to increased muscle mass of the heart
causing an increase electric current
what is Atrial fibrillation
Disorganised electric activity and contraction
pacemaker cells
Wolff-Parkinson-White
Syndrome causing tachycardia & abnormal cardiac electrical conductance
what causes atrial fibrillation
Spontaneously active cells throughout the atria
cause of WPW
additional accessory conduction pathway (the bundle of Kent) between the atria and ventricles
how are both of them shown
palpitations and chest pains
how is AF shown on an ecg
absent p-waves & ‘irregularly irregular’ rhythm.
WPW
QRS pre-excitation & biphasic/ inverted T-wave of ECG
treating AF
strategies to maintain sinus (e.g. cardioversion, anti-arrhythmics, catheter ablation)
treating WPW
benign, no treatment required
what is 1st degree heart block
slowing down of conduction through AV node
longer p r intevral
Second-degree block
reduced transmission of signal from atria to ventricles
Third-degree block
complete block of current from atria to ventricles
what causes AF and WPW
Damage (fibrosis, calcification, necrosis) to the conduction system (
AV node or His Purkinje system)
how is a 1st degree heart block shown on an ecg
increased P-R interval
2nd degree
increased P-R interval or ‘missing’ QRS complexes, depending on type of block
Third-degree block
: p-waves not followed by QRS complexes
Treatment options
Discontinuation of AV-blocking drugs (e.g. beta-blockers, calcium channel blockers) or pacemaker implantation in severe cases
what is hypertension
Clinical BP ≥ 140/90 mmHg & ambulatory BP daytime average ≥ 135/85 mmHg
what is it caused by
Primary (essential): unknown
Secondary: resulting from another medical condition (e.g. kidney disease, adrenal disease)
how is it diagnosed
Blood pressure measurement: readings ≥ 135/85 mmHg
how do you treat it
Lifestyle changes followed by anti-hypertensive medication
prob with hypertension
increase risk of stroke
heart failure
myocardial infarction
kidney disease
define angina
chest pain due to myocardial ischaemia caused by atherosclerosis
what is Non-ST-elevated myocardial infarction (NSTEMI)
Myocardial tissue damage due to prolonged ischaemia caused by atherosclerosis and artery blockage
ST-elevated myocardial infarction (STEMI)
Serious myocardial tissue damage due to prolonged ischaemia caused by severe atherosclerosis and complete artery blockage
link all 3 conditions together
Atherosclerotic lesions of the coronary artery causing ischaemia (angina), artery blockage (NSTEMI) and then complete artery blockage (STEMI)
signs and symtoms of angina
chest pain on exertion (stable) or at rest (unstable)
NSTEMI
chest pain, sweating, nausea & vomiting
STEMI
radiating chest pain, sweating, nausea & vomiting
NSTEMI ecg and blood findings
ST-depression/no changes & high troponin levels
STEMI ECG and blood findings
ST-elevation with reciprocal ST-depression & high troponin levels
how do you treat angina
vasodilators
how to treat NSTEMI
coronary stents, antiplatelets, vasodilators, anti-emetics, oxygen & pain-relief
STEMI
coronary stents, antiplatelets, vasodilators, anti-emetics, oxygen & pain-relief
ecg for angina
not a lot of changes on ecg
angina descirbes pain
