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Section 4C CVD Conditions > CVD Conditions (Other) > Flashcards

CVD Conditions (Other) Flashcards

1
Q

What are cardiac arrythmias?

A

Any variation from a normal heart rhythm

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2
Q

What are the 2 different types of cardiac arrythmias?

A
  1. disorders of impulse formation (abnormal rate of impulse generation by pacemakers in the heart) - includes atrial and ventricular fibrillation, and sinus and ventricular tachycardia
  2. disorders of impulse conduction (abnormal conduction of impulses through conduction system) - includes first and second degree heart block
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3
Q

What is atrial fibrillation?

A

Irregular heart contractions caused by electrical signals originating from the AV node instead of the SA node

Implications:

  • loss of atrial kick
  • build up of stagnant blood in LA (can cause thrombus to develop)
  • inadequate CO causing hypoxia, hypotension and angina
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4
Q

What are the SSX of atrial fibrillation?

A

Symptoms:

  • palpitations
  • dyspnoea
  • fatigue
  • dizziness

Signs:
- irregularly irregular pulse

Complications:

  • thrombus formation in LA
  • decreased CO causing hypoxia, hypotension
  • heart failure
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5
Q

What medications are used to treat atrial fibrillation?

A
  1. Calcium channel blockers
    - controls HR by blocking entry of calcium into myocardium
  2. Beta blockers
    - controls HR by blocking B1 receptors in heart
  3. Amiodarone
    - controls rhythm
  4. Anticoagulants
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6
Q

What is pericarditis?

A

Inflammation of the pericardium

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7
Q

What are the SSX of pericarditis?

A

Symptoms:

  • sudden onset severe chest pain
  • pain referring to back & shoulder via phrenic nerve
  • pain aggravated by lying down & respiraton
  • dysphagia
  • restlessness / anxiety
  • fatigue

Signs:

  • friction rub at apex
  • tachycardia
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8
Q

What are the causes of pericarditis?

A

90% viral or idiopathic

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9
Q

What is pericardial effusion?

A

Buildup of fluid in pericardial cavity (between parietal and visceral layers of pericardium)

  • often caused by inflammation
  • can be a complication of pericarditis
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10
Q

What is endocarditis?

A

Inflammation of the endocardium

Infective:

  • most common
  • formation of “vegetations” composed of infective micro-organisms, inflammatory cells and fibrin
  • cause valvular and cardiac damage

Non-infective

  • less common
  • no vegetation formation
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11
Q

What is the aetiology of endocarditis?

A

Bacterial - staph, strep
Rhematic fever or rheumatic heart disease

Infection from dental / surgical procedure or IV

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12
Q

What are the SSX of endocarditis?

A
  • variable & not always present
  • chest pain
  • fever
  • fatigue
  • aches and pains
  • sore throat
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13
Q

What are the 2 major types of valvular disorders?

A

Stenosis - stiffening of valve increases resistance to normal blood flow

Regurgitation / incompetence - valve does not close properly, allowing backflow of blood

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14
Q

What are the 4 different valvular disorders, and their implications?

A

Aortic Stenosis:

  • stenosis of aortic valve
  • causes hypertophy, dilation and failure of LV

Mitral Stenosis:

  • stenosis of mitral valve
  • fluid overload of LA
  • causes LA hypertrophy, dilation and failure

Atrial Regurgitation:

  • aortic valve incompetence
  • backflow of blood from aorta to LV
  • fluid overload of LV
  • LV hypertrophy, dilation and failure

Mitral Regurgitation:

  • mitral valve incompetence
  • backflow of blood from LV to LA
  • LA hypertrophy, dilation, and failure

Outcomes for all 4:
- left sided heart failure

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15
Q

What is heart failure, and the 2 different types?

A

Heart failure = inability of heart muscle to maintain adequate cardiac output

Left sided - failure of LV, usually primary

Right sided - failure of RV, usually secondary

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16
Q

What are the two types of left sided heart failure?

A

Systolic:

  • LV hypertrophies in response to increased workload
  • LV eventually dilates and fails

Diastolic:

  • LV is stenotic and can’t expand enough to accomodate adequate blood volume
  • contractions are normal but adequate CO still not reached
17
Q

Which type of heart failure usually develops first?

A

Left sided

right sided develops as a secondary outcome of left sided failure

18
Q

What is the process of systolic heart failure (left or right)?

A
  1. Increased afterload for ventricle
  2. ventricle hypertrophies
  3. hypertrophy eventually causes dysfunction and decreased contractile strength in ventricle (because of the makeup of cardiac muscle)
  4. as contractile strength decreases, amount of blood remaining in ventricle at the end of contraction (ESV) increases
  5. ventricle dilates to accommodate increased ESV
  6. ventricle eventually fails
19
Q

How does left sided heart failure cause right sided heart failure to develop?

A
  1. As left ventricle fails and cannot adequately pump blood, backflow of blood builds up in the pulmonary circuit and causes pulmonary hypertension
  2. Pulmonary hypertension increases the afterload for the right ventricle
  3. Right ventricle hypertrophies, then dilates and fails (same steps as left sided heart failure)
20
Q

What are the symptoms of heart failure?

A

Classic triad:

  • profound fatigue
  • palpitations
  • dyspnoea

Other:

  • angina
  • pulmonary oedema
  • peripheral oedema
  • tachycardia
  • cyanosis
21
Q

What are the causes of heart failure?

A

Left sided:

  • valvular disorders
  • arrythmias
  • CHD (ischaemia of myocardium causing myocyte failure)
  • PE / atherosclerosis / HTN (increased afterload)

Right sided:

  • usually a result of left sided
  • pulmonary disease occluding pulmonary blood flow (ie: pneumonia, COPD, tuberculosis)
22
Q

What is the process of developing cardiogenic pulmonary oedema?

A
  1. left sided heart failure causes backflow of blood in pulmonary system
  2. hydrostatic pressure exceeds osmotic pressure in pulmonary system, forcing fluid into the interstitium and alveoli
  3. buildup of fluid in alveoli hinders gas exchange at the respiratory membrane
  4. hypoxia occurs
  5. hypoxia triggers vasoconstriction (to increase blood pressure and therefore O2 distribution), increasing BP and further congesting CPO
23
Q

What are SSX of cardiogenic pulmonary oedema?

A

Symptoms:

  • dyspnoea
  • pardoxysmal noctural dyspnoea
  • orthopnoea
  • cough with pink frothy sputum

Signs:

  • bilateral basal crackles
  • dullness at lung bases with percussion (fluid buildup)
24
Q

Describe an aortic dissection

A

Definition:

  • tear in tunica intima of aorta
  • Type A (aortic root / ascending aorta)
  • Type B (descending aorta)

Risk factors:

  • HTN (most common)
  • atherosclerosis
  • aortic aneurysm
  • aortic valve disease
  • blunt trauma
  • cocaine and amphetamines

SSX:

  • abrupt onset chest / upper back pain radiating to neck / back
  • pain is severe, sharp, ripping, tearing, knife like
  • dyspnoea
  • sudden difficulty speaking
  • different BP and pulse in arms bilaterally

Implications:

  • rapid hypotension
  • loss of consciousness and death

Mortality:
- 75% dead in first 24 hours

25
Q

Describe cardiomegaly

A

Definition:
- enlarged heart

Aetiology:

  • valvular pathology
  • chronic heart failure (hypertrophy or dilation of ventricles)
  • HTN (hypertrophy of LV)
  • CHD

SSX:

  • displaced apical beat (palpation / auscultation)
  • fatigue / dizziness
  • angina
  • tachycardia
  • thready pulse
  • decreased urination at day and increased urination at night
  • oedema
  • palpitations

Section 4C CVD Conditions (5 decks)

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