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Systemic Conditions > CVS > Flashcards

CVS Flashcards

1
Q

S+S

A
  • Chest P/discomfort
  • Breathlessness
  • Palpitations
  • Fatigue
  • Dizziness and syncope
  • Sleep disturbance- can’t lie flat
  • Oedema – lower limb, sacrum- reduced circulatory flow
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2
Q

Non cardiac causes of chest P- gastroesophageal

A

Perforation may be caused by forceful vomiting and disease. Sudden, severe constant P from neck to oesophagus, neck swelling

Spasm- confused with cardiac condition as its relieved with nitrates, not related to exertion (like cardiac P), swallowing extremely hot or cold substances often causes this which leads to chest P

Reflux- burning sensation, referred to as heartburn, aggravated by lying down or after meals, chronic cough or dysphagia

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3
Q

Non cardiac causes of chest P- pulmonary

A

Pleuritic in nature- P varies with respiratory cyvle, exacerbated during inspiration and coughing
Typically sharp and unilateral
Usually caused by lower resp tract infection

Spontaneous pneumothorax- results in sharp chest P, that may radiate to ipsilateral shoulder, can be caused by underlying condition, typical Px is talk, thin, male, smoker

Pulmonary embolism- acute acute of dyspnea, pleuritic chest P, severe hypoxia and risk factors such as recent surgery, underlying malignancy, bedridden/sedentary state

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4
Q

Non cardiac causes of chest P- MSK

A

Costochondritis, rib fracture, myalgia
Palpation of chest may reproduce symptoms

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5
Q

Non cardiac causes of chest P- herpes zoster

A

Burning sensation, unilateral dermatomal distribution
Physical exam findings may be lacking as P often occurs before onset of vascular lesion |(blister), making diagnosis difficult

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6
Q

Angina

A

Reduced blood flow to heart

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7
Q

Angina types

A

Stable
Unstable
Variant
Refractory

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8
Q

Stable angina

A

Most common, usually occurs during activity, relived by rest or medication, predictable, short term episodes. Occurs due to mismatch between blood supply and metabolic demand, causes regional wall abnormalities

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9
Q

Unstable angina

A

Unpredictable, medical emergency, occurs at rest, more severe symptoms, inc duration (20 mins), heart starved of O2= potential heart attack

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10
Q

Variant angina

A

Not due to CAD, caused by spasm in coronary arteries that temporarily reduces blood flow, tends to occur in cycles, typically rest, relived by medicine

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11
Q

Refractory angina

A

Episodes are frequent despite medication + lifestyle changes

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12
Q

Angina causes

A
  • Caused by dec blood flow to heart
  • Symptom of CAD
  • Can be result of aortic stenosis
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13
Q

Angina population

A

60+

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14
Q

Angina risks

A

Family Hx of heart disease
Aging

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15
Q

S+S angina

A
  • Often described as squeezing, pressure, heaviness, tightness or P in chest
  • May feel like heavy weight on chest
  • P may be felt in arms, neck, jaw, shoulders and back
  • Dizziness, fatigue, nausea, shortness of breath, sweating
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16
Q

Angina prognosis

A
  • Angina medication- glycerol tri-nitrate
  • Lifestyle changes- lose wight, healthy due
  • Rest
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17
Q

Myocardial infarction

A
  • Heart attack occurs when flow of blood to heart is reduced or blocked
  • Myocardial cells don’t have a blood supply, requires lots of O2 as in constant use
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18
Q

MI population

A

Male 45+
W 55

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19
Q

MI risks

A
  • Age- men aged 45, women aged 55
  • Tobacco use
  • High blood pressure
  • Obesity
  • Diabetes
  • Family Hx
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20
Q

S+S MI

A
  • Variable
  • Chest P- pressure, tightness, P, squeezing or aching
  • Cold sweat
  • Fatigue
  • Heartburn or indigestion
  • Dizziness
  • Shortness of breath
  • Women can have silent infarctions= no symptoms
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21
Q

MI prognosis

A

nc risk post first acute infarction

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22
Q

Aortic dissection

A
  • Serious condition in which tear occurs in layer of aorta
  • Blood rushes through tear causing inner and middle layers of aortic to dissect
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23
Q

Aortic dissection causes

A
  • Uncontrolled high blood pressure
  • Atherosclerosis
  • Aortic aneurysm
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24
Q

Aortic dissection population

A

Men 60-70

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25
Q

AD risks

A
  • Turner syndrome
  • Marfan syndrome
  • Other connective tissue disorder
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26
Q

Aortic Dissection S+S

A
  • Feeling of tearing P followed by sudden low back P
  • Loss of consciousness
  • Shortness of breath
  • Weak pulse in one arm or thigh compared with other
  • Leg P
  • Difficulty walking
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27
Q

AD prognosis

A
  • If detected early the chance of survival increases significantly
    Synthetic graft to reconstruct aorta
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28
Q

Valvular heart disease

A
  • One or more valve doesn’t work properly
  • Causes poor blood flow through the heart to the body
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29
Q

Valvular disease cause

A
  • Congenital
  • Infection
  • Degenerative conditions
  • Stenosis- thickened valves or calcified  obstructs flow
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30
Q

Valvular disease population

A

65+

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31
Q

VD risks

A
  • Older age
  • Hx of certain infections
  • High blood pressure
  • Congenital heart disease
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32
Q

VD S+S

A
  • Might not have symptoms for many years
  • Heart murmur
  • Chest P
  • Fatigue
  • Shortness of breath
  • Swelling in ankles and feet
  • Dizziness
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33
Q

VD prognosis

A
  • Depends on type and severity of disease
  • Sometimes requires surgery to repair or replace valve
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34
Q

Aneurysm

A
  • Abnormal bulge in wall of blood vessel
  • Can rupture, causing internal bleeding (fatal)
  • Aortic, abdominal aortic, thoracic aortic, brain, peripheral aneurysm
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35
Q

Aneurysm cause

A
  • High blood pressure/hypertension over many years  damage/weakening of blood vessels
  • Atherosclerosis- weakens blood vessels
36
Q

Aneurysm population

A

30-60
Women

37
Q

Aneurysm risks

A
  • High blood pressure
  • Size, location, growth
  • Family Hx
38
Q

Aneurysm S+S

A
  • Dependent on location
  • Brain- can lurk without symptoms, can rupture and leak (haemorrhagic stroke- medical emergency), most don’t rupture, severe headache, nausea, blurred/double vision, seizure, photosensitivity. Unruptured- P above/behind eye, dilated pupil, change in vision, numbness of one side of face
  • Aortic- back P, cough, weak/scratchy voice, shortness of breath, tenderness in chest
  • Abdominal- dizziness, P in lower back, sweaty/pale/clammy skin, fast heartbeat, shortness of breath
  • Peripheral- pulsating lump that can be felt, leg P/cramping with exercise, ulcers of toes/fingers, radiating P, gangrene/tissue death
39
Q

Aneurysm prognosis

A
  • Some have below risk of rupture
  • Doctor required to identify size/risk of rupture
  • Rupture= fatal (especially in brain)
40
Q

Hypertrophic changes

A
  • Heart muscles become thickened
  • Makes it harder for blood to be pumped around body
41
Q

Hypertrophic cause

A
  • Genetic mutation that causes muscle thickening
  • Typically affects septum, can block blood flow between chambers
42
Q

Hypertrophic changes population

A
  • Can be diagnosed at any age
  • Hypertrophy may be present at birth or in childhood, however much more common to appear normal
43
Q

Hypertrophic risks

A
  • Inherited- people with one parent with hypertrophic cardiomyopathy have a 50% chance of developing
  • Should be screened
44
Q

Hypertrophic S+S

A
  • Often goes undiagnosed due to lack of symptoms
  • Shortness of breath, chest P, changes to hearts electrical system  life-threatening irregular heart rhythm/sudden death
  • Chest P during exercise
  • Fainting post exercise
  • Heart murmur
  • Sense of palpitations
  • Shortness of breath
45
Q

Hypertrophic prognosis

A
  • Multiple complications (e.g., heart failure, syncope, mitral valve disease, blocked blood flow)
  • No prevention but important to identify condition early to start treatment ASAP
46
Q

Palpitation causes

A
  • Stress
  • Depression
  • Strenuous exercise
  • Stimulants- e.g., caffeine, nicotine, cocaine
  • Hormone changes
47
Q

Palpitation risks

A
  • Stress
  • Anxiety disorders or panic attacks
  • Pregnancy
  • Hyperthyroidism
48
Q

Palpitation S+S

A
  • Feeling of fast-beating, fluttering or pounding
  • May be felt in throat or neck as well as chest
  • Can occur during rest or activity
49
Q

Palpitation prognosis

A
  • Usually harmless, rarely a symptom of a more serious condition
50
Q

Dysponea

A
  • Left ventricle failure results in dysponea due to oedema in lungs, alveoli and intestinal fluid  lungs become stiff  more respiratory effort required for proper ventilation
51
Q

Dysponea risks

A
  • Heart disease
  • Respiratory infection
  • Cancer, especially lung
  • Asthma
  • Obesity
52
Q

Dysponea S+S

A
  • Shortness of breath, intense tightening of chest
53
Q

Dysponea prognosis

A
  • Bronchodilators can open airways
  • Steroids reduce swelling
  • P medication
54
Q

Syncope

A
  • Occurs when you faint because your body overreacts to certain triggers, such as sight of blood
  • Triggers HR and blood pressure to drop suddenly
  • Leads to reduced blood flow to the brain  brief loss of consciousness
55
Q

Syncope cause

A
  • Occurs when part of nervous system that regulates HR and blood pressure malfunctions to a trigger
  • HR slows and blood vessels in legs dilate
  • Allows blood to pool in legs, which lowers blood pressure
  • Combined drop in blood pressure and slowed HR quickly reduces blood flow to your brain  fainting
  • Common triggers- heat exposure, standing for long period of time, seeing blood, having blood drawn, fear of bodily injury
56
Q

Syncope population

A

Children and young adults

57
Q

Syncope risks

A
  • Over heating
  • Dehydration
  • Heavy sweating
  • Sudden changes of body position- blood pooling in legs
58
Q

Syncope presentation

A
  • Pale skin
  • Light-headedness
  • Tunnel/blurred vision
  • Nausea
  • Feeling warm
  • Cold, clammy sweat
  • During episode- dilated pupils, slow, weak pulse, and jerky movements
59
Q

Syncope prognosis

A
  • Usually harmless and requires no treatment
  • Potential to injure yourself during syncope episode
  • Doctor may recommend tests to rule out more-serious causes, such as heart disease
  • Cant prevent- lie down and lift legs if feeling faint
60
Q

Oedema

A
  • Excess fluid in interstitial space
61
Q

Causes of pitting oedema

A

Congestive heart failure, venous insufficiency, kidney disease
Blood pressure meds, NSAIDs, steroids, oestrogen (birth control), DVT

62
Q

Causes of non-pitting oedema

A

Lymphatics
Lymphedema- lymphatic fluid builds up–> swelling. Secondary= breast cancer, etc
Myxedema- usually due to hypothyroidism–> inc accumulation of fluid in legs, feet, mouth, etc

63
Q

Non-pitting oedema treatment

A

Resolve underlying condition
Exercise inc lymphatic flow
Elevation- inc circulation

64
Q

Pitting oedema grades

A

Grade 1- 1-2mm, immediate rebound
2- 3-4mm, 15s rebound or less
3- 5-6mm, 60s
4- 8mm, 2-3 mins

65
Q

Pitting oedema treatment

A

Mild- resolve on own- elevation
Severe- medicine- furosemide
Chronic- long term management of underlying condition (compression socks)

66
Q

Oedema population

A

Older adults
Pregnant women

67
Q

Oedema risks

A
  • Being pregnant
  • Certain medication
  • Having long-lasting illness, e.g., congestive heart failure
  • Having surgery that involves a lymph node
68
Q

Oedema S+S

A
  • Swollen lower limbs (can affect anywhere in body)
  • Pitting- leaves dimple
  • Puffiness
  • Stretched or shiny skin
  • If left too long legs may turn brown, haemosiderin- toxin in blood comes to surface to try and be removed
69
Q

Oedema prognosis

A
  • See a doctor if shortness of breath, irregular heartbeat, chest P
  • Mild usually goes away- compression socks, raising affected arm/leg higher than heart
70
Q

DVT

A
  • Occurs when blood clot forms in one or more deep veins in body, usually legs
71
Q

DVT cause

A
  • Anything that prevents blood from flowing or properly clotting
  • Damage to vein from surgery or inflammation and damage due to infection or injury
72
Q

DVT population

A
  • Over 40
  • People with Hx of DVT/blood clots
73
Q

DVT risks

A
  • Age- 60+
  • Lack of movement
  • Injury or surgery
  • Pregnancy
  • Birth control
  • Obesity
74
Q

DVT presentation

A
  • Leg swelling
  • Leg P, cramping or soreness that often starts in calf
  • Change in skin colour of leg- such as red or purple
  • Warmth
75
Q

DVT prognosis

A
  • Complications include pulmonary embolism, phospholipidic syndrome and treatment complications
  • See a doctor if shortness of breath, feeling lightheaded, fainting, rapid breathing, coughing up blood
76
Q

Hypertension

A
  • High blood pressure
  • Heart needs to work harder to pump blood
  • 130/80 mm Hg or higher
  • Normal- 120/80
  • Elevated- 120-129/below 80
  • Stage 1 hypertension- 130-139/80-89
  • Stage 2- 140 or higher/90 or higher
  • Above 180/120 mm Hg is hypertensive emergency or crisis
  • Need 3 months of consistent readings to diagnose
77
Q

Hypertension cause

A
  • Primary- no identifiable cause, develops gradually over many years, plaque builds up in arteries
  • Secondary- underlying condition, tends to appear suddenly and cause higher blood pressure than primary (adrenal gland tumour, congenital heart defect, kidney disease, etc)
78
Q

Hypertension population

A
  • Older people
  • Obese people
79
Q

Hypertension risks

A
  • Age (inc with age)
  • Family Hx
  • Obesity
  • Lack of exercise
  • Tobacco use
  • High sodium
80
Q

Hypertension S+S

A
  • Most asymptomatic
  • Headaches
  • Shortness of breath
  • Nose bleeds
81
Q

Hypertension prognosis

A
  • Untreated can lead to inc risk of heart attack, stroke, and other serious health problems

Lifestyle changes- cut down on salt, fat. inc activity
Under 55- ACE inhibitors
Over 55- calcium channel blockers

82
Q

Stroke

A
  • Occurs when blood supply to brain is interrupted or reduced
  • Prevents brain tissue from getting oxygen and nutrients
  • Brain cells die in minutes
83
Q

Stroke cause

A
  • Ischemic- blocked artery- most common
  • Haemorrhagic- leaking or bursting of vessel- result of other condition such as uncontrolled high blood pressure, overtreatment with blood thinners, trauma
  • Transient ischemic attack- mini stroke, doesn’t cause permanent damage, temporary block of blood supply
84
Q

Stroke population

A
  • 55+
  • African Americans
  • Men
  • Hormones- birth control
85
Q

Stroke risk

A
  • Obesity
  • Physical inactivity
  • Heavy or binge drinking
  • High blood pressure
  • High cholesterol
  • Diabetes
86
Q

Stroke presentation

A
  • Trouble speaking
  • Paralysis of numbness of face, arm or leg
  • Problems seeing in one or both eyes
  • Headache
  • Trouble walking
87
Q

Stroke prognosis

A
  • Seek immediate attention
  • FAST- face, arms, speech, time

Systemic Conditions (8 decks)

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