CV Disorders Flashcards
What is the basic definition of HF?
Heart unable to maintain adequate circulation for metabolic requirements of body.
What is HFpEF?
HF with preserved EF.
EF ≥ 50%, ↓ diastolic function
What is HFrEF?
HF with reduced EF.
EF ≥ 40%, ↓ systolic function
What are the underlying causes of HF?
Secondary to cardiac damage (ischaemia, myopathy), hypertension, valve disease
Signs and symptoms of HF?
Exertional dyspnoea.
What tests can you do for HF?
Blood test: elevated brain natriuretic peptide (BNP)
CXR: cardiomegaly
Treatment options for HF?
Drugs that reduce the exertional pressure on the heart.
ECG findings for HF?
Not usually many.
Main one is an enlarged QRS complex.
Define atrial fibrillation.
Disorganised electric activity and contraction
Define Wolff-Parkinson-White.
Syndrome causing tachycardia & abnormal cardiac electrical conductance.
Underlying cause of AF?
Spontaneously active cells throughout the atria
Underlying cause of WPW?
Additional accessory conduction pathway (the bundle of Kent) between the atria and ventricles
Signs and symptoms of WPW and AF?
Palpitations and chest pain
What are the ECG findings for AF?
Absent p-waves & ‘irregularly irregular’ rhythm.
What are the ECG findings WPW?
QRS pre-excitation & biphasic/ inverted T-wave of ECG.
Treatment options for AF?
Strategies to maintain sinus rhythm (e.g. cardioversion, anti-arrhythmics, catheter ablation)
Treatment options for WPW?
Benign, no treatment required
Define a first-degree block
Slowing down of conduction through AV node
Define a second-degree block
Reduced transmission of signal from atria to ventricles
Define a third-degree block
Complete block of current from atria to ventricles
What is the underlying cause of a conduction block?
Damage (fibrosis, calcification, necrosis) to the conduction system (AV node or His Purkinje system)
What are the ECG findings for 1s, 2nd and 3rd degree blocks?
- Increased P-R interval
- Increased P-R interval or ‘missing’ QRS complexes, depending on type of block
- P-waves not followed by QRS complexes
Treatment options for a conduction block?
Discontinuation of AV-blocking drugs (e.g. beta-blockers, calcium channel blockers) or pacemaker implantation in severe cases.
Which type of conduction block is a medical emergency?
3rd Degree Block
No QRS Complex
Need to treat immediately
(quite rare)
Define hypertension
Clinical BP ≥ 140/90 mmHg & ambulatory BP daytime average ≥ 135/85 mmHg
What is the underlying cause of hypertension?
Primary (essential): unknown
Secondary: resulting from another medical condition (e.g. kidney disease, adrenal disease)
What investigation can you do to determine if a person has hypertension?
Blood pressure measurement: readings ≥ 135/85 mmHg
Treatment options for hypertension?
Lifestyle changes followed by anti-hypertensive medication
Define angina.
Chest pain due to myocardial ischaemia caused by atherosclerosis
Define non-ST-elevated MI.
Myocardial tissue damage due to prolonged ischaemia caused by atherosclerosis and artery blockage.
Define STEMI.
Serious myocardial tissue damage due to prolonged ischaemia caused by severe atherosclerosis and complete artery blockage
What is the underlying cause of angina, NSTEMI and 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 are the ECG findings for NSTEMI?
ST-depression/no changes & high troponin levels
What are the ECG findings for STEMI?
ST-elevation with reciprocal ST-depression & high troponin levels
What is the treatment option for angina?
Vasodilators
What are the treatment option for NSTEMI?
Coronary stents, antiplatelets, vasodilators, anti-emetics, oxygen & pain-relief
What are the treatment options for STEMI?
Coronary stents, antiplatelets, vasodilators, anti-emetics, oxygen & pain-relief (same as NSTEMI)
