CV disorders Flashcards
What defines heart failure?
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
What are the underlying causes of heart failure?
Secondary to cardiac damage (ischaemia, myopathy), hypertension, valve disease
What are the signs+symptoms of heart failure and what tests are used to diagnose it?
Exertional dyspnoea
Blood test: elevated brain natriuretic peptide (BNP)
Chest X-ray: cardiomegaly
What does the ECG of someone with heart failure look like?
Enlarged QRS
What treatment options are there for heart failure?
Drugs that reduce exertional pressure on the heart
Give the definitions of atrial fibrillation and wolff-parkinson-white syndrome
AF:Disorganised electrical activity and contraction
WPW:Additional accessory conduction pathway (the bundle of Kent) between the atria and ventricles
Give the underlying cause of AF
Spontaneously active cells throughout the atria
Give the underlying cause of WPW syndrome
Presence of additional accessory conduction pathway (the bundle of Kent) between the atria and ventricles
What are the signs and symptoms of AF and WPW
Palpitations & chest pain
What does an AF ECG look like?
Absent p waves and an irregularly irregular rhythm
What does a WPW syndrome ECG look like?
QRS pre-excitation & biphasic/ inverted T-wave of ECG
What is the treatment for AF
Strategies to maintain sinus rhythm (e.g. cardioversion, anti-arrhythmics, catheter ablation)
What is the treatment for WPW syndrome?
Benign-No treatment needed/given
What occurs in first degree heart block?
Slowing down of conduction through AV node
What occurs in second degree heart block
Reduced transmission from atria to ventricles
What occurs in third degree heart block
Complete block of current from atria to ventricles
What is the underlying cause of heart block
Damage (fibrosis, calcification, necrosis) to the conduction system (AV node or His Purkinje system)
What does a 1st degree heart block ECG look like
Increased PR interval
What does a 2nd degree heart block ECG look like
Increased P-R interval or ‘missing’ QRS complexes, depending on type of block
What does a 3rd degree heart block ECG look like?
p-waves not followed by QRS complexes
How do you treat heart block?
Discontinuation of AV-blocking drugs (e.g. beta-blockers, calcium channel blockers) or pacemaker implantation in severe cases
Define hypertension
-Clinical BP ≥ 140/90 mmHg & ambulatory
-BP daytime average ≥ 135/85 mmHg for prolonged period
What is the underlying cause of hypertension?
Primary (essential): unknown
Secondary: resulting from another medical condition (e.g. kidney disease, adrenal disease)
What investigations can you undertake to diagnose hypertension?
Blood pressure measurement: readings ≥ 135/85 mmHg
Define angina
Chest pain due to myocardial ischaemia caused by atherosclerosis
Define NSTEMI(Non-ST-elevated myocardial infarction)
Myocardial tissue damage due to prolonged ischaemia caused by atherosclerosis and artery blockage
Define STEMI(ST-elevated myocardial infarction)
Serious myocardial tissue damage due to prolonged ischaemia caused by severe atherosclerosis and complete artery blockage
What is the underlying cause of acute coronary syndromes (Angina, NSTEMI, STEMI)
Atherosclerotic lesions of the coronary artery causing ischaemia (angina), artery blockage (NSTEMI) and then complete artery blockage (STEMI)
What are the signs and symptoms of angina, NSTEMI and STEMI
Angina: chest pain on exertion (stable) or at rest (unstable)
NSTEMI: chest pain, sweating, nausea & vomiting
STEMI: radiating chest pain, sweating, nausea & vomiting
What would you find in the blood and on the ECG for an NSTEMI patient?
NSTEMI: ST-depression/no changes & high troponin levels
What would you find in the blood and on the ECG for a patient with STEMI?
STEMI: ST-elevation with reciprocal ST-depression & high troponin levels
How do you treat angina, STEMI and NSTEMI
Angina: Vasodilators
STEMI/NSTEMI: coronary stents, antiplatelets, vasodilators, anti-emetics, oxygen & pain-relief
