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Kin 187 > CVD - Atrial Fibrillation > Flashcards

CVD - Atrial Fibrillation Flashcards

1
Q

What is CVD

A

Heart and blood vessel disease related to atherosclerosis

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2
Q

What is atherosclerosis

A

Condition that develops due to plaque build up in walls of arteries

Leading cause of death globally

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3
Q

Heart attack is

A

When blood flow to heart is blocked by a blood clot

Causes cardiac muscle to die

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4
Q

What are the two types of stroke

A

Ischemic stroke

Hemorrhagic stroke

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5
Q

What is ischemic stroke

A

Most common

When blood vessel to brain gets blocked

Causes brain cells to die

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6
Q

Hemorrhagic stroke is

A

When blood vessel within brain bursts

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7
Q

Heart failure (congestive) is

A

Heart is not pumping blood as well as it should

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8
Q

Cardiac Disease can be (2)

A

Arrhythmia

Heart valve problems

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9
Q

What is arrhythmia

A

Abnormal rhythm of the heart

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10
Q

Heart valve problems include

A

Stenosis

Regurgitation

Mitral valve prolapse

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11
Q

What are the different types of arrhythmias

A

Atrial fibrillation

Ventricular fibrillation

Bradycardia

Tachycardia

Conduction disorders

Premature contraction

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12
Q

What is atrial fibrillation

A

Upper heart chambers contract irregularly

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13
Q

What is ventricular fibrillation

A

Disorganised contraction of the lower heart chambers

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14
Q

Conduction disorders are

A

When the heart does not beat normally

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15
Q

What is the most common cardiac arrhythmias

A

Atrial fibrillation

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16
Q

Atrial fibrillation causes

A

Quivering or irregular heartbeat

Multiple reentrant circuits in the atria

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17
Q

What does multiple reentrant circuits in the atria lead to

A

Blood clots
Stroke
Heart failure
Other heart related complications

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18
Q

Atrial fibrillation can be seen as

A

Missing P waves

Electrical current does not flow

Av node often cant regulate the chaotic current

Irregular ventricular rate

When the beat is off and the blood supply can be unpredictable

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19
Q

Missing P wave indicates the

A

Absense of atrial depolarisation

SA node may not start the contraction

20
Q

Electrical current not flowing in atrial fibrillation is due to

A

Contractions being rapid and disorganised

21
Q

What happens as a result of AV node not being able to regulate the chaotic current

A

Ventricles beats more often

22
Q

Slow ventricle response is seen as

A

Long gaps

Small R height

23
Q

Moderate ventricular response is seen as

A

Upside down??

24
Q

Rapid ventricular response is seen as

A

Close together

Large R height

25
What are the ways we medically manage atrial fibrillation
Conversion back to normal sinus rhythm Controlling ventricular rate response Preventing blood clots
26
How do we converse back to normal sinus rhythm
Electrical cardioversion Radiofrequency ablation Maze procedure
27
What is electrical cardioversion
Low voltage electric current to reset heart rhythm back to normal sinus rhythm
28
What is radiofrequency ablation
Radio waves to manage arrhythmias, usually before pacemaker implant
29
What is maze procedure
Create scar tissue to block abnormal signal, direct electric signal through a controlled path to ventricles
30
How do we control ventricular rate response
Reducing overly high heart rate ``` Pharmacologic: Digoxin Beta blockers Calcium channel blockers Anti arrhythmic ```
31
What does digoxin do
Slow heart rate at atria to ventricle Inhibition of sodium potassium ATP
32
What does Beta blockers do
Slow HR Antagonists that block the receptors sites for Epi and NE on adrenergic beta receptors of SNS
33
What do Calcium channel blockers do
Slows HR Reduce strength of cardiac muscle contraction Prevent or reduce the opening of channels not allowing Ca++ get into cells
34
How do we prevent blood clots
Antiplatelets Anticoagulants Antithrombotic
35
What is the effect on exercise response
Rapid irregular ventricular heart rate Exercise capacity is reduced by 15-20%
36
Rapid irregular ventricular heart rate is because (during effect on exercise response)
HR is high at any workload Reduced SV due to limited atrial assistance during diastole HR response can be affected by comorbid conditions and medications - a smaller increase in heart rate and SBP as exercise increases
37
When can exercise testing be useful when certain things are considered (each drug)
Digoxin may control ventricular response - diffuse ST effects Verapamil may mask ischemia and decrease HR response to exercise Beta blockers may reduce exercise capacity and decrease submaximal and maximal HR and BP Age predicted HRmax targets are not valid Irregular ventricular response may make BP determination less precise or more difficult
38
Verapamil is what type of drug
Calcium channel blocker
39
When creating an exercise program what should be considered
Variability of the ventricular rate - Intensity should be prescribed with work rate or perceived exertion Comorbidities are needed in population with AF Oberve for exertional HYPOtension
40
What is really important to do during each session
Assess rhythm
41
What are the short benefits of exercise training in AF (<6months)
Reduced AF burden Reduced symptom severity
42
What are the long benefits of exercise training in AF
Increased AF freedom Reduced symptom severity
43
What is the FITT requirement for AF
3-5 days per week <= 95% peak HR 120 to 200 min/wk Aerobic exercise and/or resistance training
44
What are the overall potential benefits of AF
Reversed atrial remodeling Weight loss Improved BP control Improved glycemic control Reduced inflammation Improved autonomic tone
45
What is AF burden
Duration/numbers of longest AF episode | percentage of time
46
What is AF freedom
Absence of AF period

Kin 187 (21 decks)

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