CVS Breakdown Week 1 to 5 Flashcards
Week 5
MURMURS
- Definition: Murmurs are abnormal heart sounds caused by turbulent blood flow.
- Causes: Narrowed or leaky valves, high blood flow states, or heart defects.
- Inspiration Effect: Right-sided murmurs get louder.
- Expiration Effect: Left-sided murmurs get louder.
- Valsalva Effect: Straining makes most murmurs quieter, except HCM and MVP.
- Handgrip Effect: Louder murmurs from leaky valves, quieter murmurs from narrow valves.
Week 5
HEART SOUNDS
- S3 Sound: Happens after S2; normal in young people but abnormal in heart failure.
- S4 Sound: Happens before S1; always abnormal, linked to stiff ventricles.
Week 5
VALVE LESIONS
- Aortic Stenosis: Systolic murmur, harsh sound heard at the right chest, radiates to neck.
- Aortic Regurgitation: Diastolic blowing sound, heard at left chest, radiates down.
- Mitral Stenosis: Diastolic rumble with snap, heard at heart apex.
- Mitral Regurgitation: Constant, high-pitched murmur at heart apex, radiates to armpit.
Week 5
AORTIC STENOSIS (AS)
- What is it: Narrow valve stops blood from leaving the heart.
- Symptoms: Chest pain, fainting, shortness of breath.
- Treatment: Surgery for severe cases.
Week 5
MITRAL STENOSIS (MS)
- What is it: Narrow valve blocks blood from the atrium to the ventricle.
- Symptoms: Difficulty breathing, fatigue, and coughing blood.
- Treatment: Balloon procedure or surgery.
Week 5
AORTIC REGURGITATION (AR)
- What is it: Valve doesn’t close properly, letting blood flow backward.
- Symptoms: Pounding heartbeat, tiredness, and breathlessness.
- Treatment: Medications or valve surgery.
Week 5
MITRAL REGURGITATION (MR)
- What is it: Blood flows backward from the ventricle to the atrium.
- Symptoms: Fatigue, heart palpitations, and breathing problems.
- Treatment: Valve repair or replacement.
Week 4
ECG BASICS
1. Intervals:
- Intervals:
o PR Interval: Start of atrial contraction to start of ventricular contraction.
o QT Interval: Start of ventricular contraction to end of ventricular relaxation.
Week 4
ECG BASICS
1. ECG Components:
- ECG Components:
o P Wave: Atrial contraction.
o QRS Complex: Ventricular contraction.
o T Wave: Ventricular relaxation.
Week 4
HOW TO INTERPRET ECGs
1. Key Steps:
- Key Steps:
o Rate: Measure heartbeats per minute.
o Rhythm: Check if beats are regular or irregular.
o Axis: See the heart’s electrical direction.
o Hypertrophy: Look for bigger chambers (e.g., tall waves).
o Ischemia: Spot signs of poor blood flow (e.g., ST changes).
Week 4
ECG BASICS
1. How is a 12-lead ECG set up?
- How is a 12-lead ECG set up?
o Limb Leads (I, II, III): Compare electrical signals between limbs.
o Augmented Leads (aVR, aVL, aVF): Measure one limb’s signal compared to others.
o Chest Leads (V1-V6): Detect heart’s electrical signals from chest views.
Week 4
HOW TO INTERPRET ECGs
1. Sinus Rhythms:
- Sinus Rhythms:
o Normal Rhythm: Regular beats, rate 60–100 bpm.
o Bradycardia: Beats slower than 60 bpm.
o Tachycardia: Beats faster than 100 bpm.
Week 4
TACHYARRHYTHMIAS (FAST HEART RHYTHMS)
1. What are they?
- What are they?
o Heart rate above 100 bpm; symptoms include palpitations and fainting.
Week 4
TACHYARRHYTHMIAS (FAST HEART RHYTHMS)
1. Ventricular Tachycardia (VT):
- Ventricular Tachycardia (VT):
o ECG: Wide QRS, fast and regular.
o Cause: Heart disease, low electrolytes.
Week 4
TACHYARRHYTHMIAS (FAST HEART RHYTHMS)
1. Ventricular Fibrillation (VF):
- Ventricular Fibrillation (VF):
o ECG: Chaotic, no clear waves.
o Cause: Serious heart damage.
Week 4
TACHYARRHYTHMIAS (FAST HEART RHYTHMS)
1. Atrial Fibrillation (AF):
- Atrial Fibrillation (AF):
o ECG: No P waves, irregular beats.
o Cause: Age, high blood pressure.
Week 4
TACHYARRHYTHMIAS (FAST HEART RHYTHMS)
1. Atrial Flutter:
- Atrial Flutter:
o ECG: Sawtooth pattern.
o Cause: Heart structure issues.
Week 4
BRADYARRHYTHMIAS (SLOW HEART RHYTHMS)
1. What are they?
- What are they?
o Heart rate below 60 bpm; symptoms include fainting, tiredness.
Week 4
TACHYARRHYTHMIAS (FAST HEART RHYTHMS)
1. Supraventricular Tachycardia (SVT):
- Supraventricular Tachycardia (SVT):
o ECG: Narrow QRS.
o Cause: Stress, caffeine.
Week 4
BRADYARRHYTHMIAS (SLOW HEART RHYTHMS)
1. Heart Blocks:
- Heart Blocks:
o 1st Degree Block: Long PR interval; slow signal through AV node.
o 2nd Degree Type I (Wenckebach): PR gets longer until one beat drops.
o 2nd Degree Type II: Dropped beats without warning.
o 3rd Degree Block: No connection between atrial and ventricular beats.
Week 4
ARRHYTHMIA DIAGNOSIS AND COMPLICATIONS
1. How to diagnose arrhythmias:
- How to diagnose arrhythmias:
o ECG, Holter monitor, or long-term devices (e.g., loop recorder).
Week 4
ARRHYTHMIA DIAGNOSIS AND COMPLICATIONS
1. Complications:
- Complications:
o Fast rhythms: Can cause low blood pressure or clots.
o Slow rhythms: Can lead to fainting or cardiac arrest.
Week 4
MANAGEMENT AND LIFESTYLE
1. Medications:
- Medications:
o Sodium blockers: Slow conduction.
o Potassium blockers: Slow relaxation.
o Calcium blockers: Reduce heart muscle strength.
o Beta blockers: Lower heart rate.
Week 4
MANAGEMENT AND LIFESTYLE
1. Procedures:
- Procedures:
o Defibrillation: Shock to restart normal rhythm.
o Pacemaker: Controls heartbeats.
o Ablation: Removes faulty tissue.
Week 3
CAPILLARIES
1. What are capillaries?
What are capillaries?
* Smallest blood vessels, allowing exchange of substances between blood and tissues.
Week 4
MANAGEMENT AND LIFESTYLE
1. Lifestyle Tips:
- Lifestyle Tips:
o Fix heart risks (e.g., high blood pressure).
o Avoid triggers like alcohol.
o Stay healthy with good diet and exercise.
Week 3
CAPILLARIES
2. Key features:
Key features:
* Single thin cell layer for exchange.
* No smooth muscle in walls.
* Basement membrane supports the structure.
* Pores or fenestrations for selective permeability.
Week 3
CAPILLARIES
3. Processes across capillary walls:
- Processes across capillary walls:
* Diffusion: Moves solutes (e.g., O₂, glucose) down concentration gradients.
* Osmosis: Water moves toward higher solute concentrations.
Week 3
CAPILLARIES
5. Lymphatic system role:
- Lymphatic system role:
* Collects extra fluid (~10%) from interstitial space.
* Prevents swelling (edema) and maintains fluid balance.
Week 3
CAPILLARIES
* Bulk Flow:
CAPILLARIES
* Bulk Flow:
o Filtration: Fluid out of capillaries (arterial end).
o Reabsorption: Fluid back into capillaries (venous end).
Week 3
EDEMA
3. Signs and symptoms of edema:
Signs and symptoms of edema:
* Swollen limbs, pitting (press leaves a dent).
* Pulmonary edema: Shortness of breath.
* Ascites: Fluid in abdomen (distended belly).
Week 3
CAPILLARIES
4. Factors affecting exchange:
- Factors affecting exchange:
* Capillary hydrostatic pressure (CHP): Pushes fluid out.
* Blood colloid osmotic pressure (BCOP): Pulls fluid in.
* Interstitial pressures (IFHP, IFCOP): Affect outward/inward movement.
Week 3
EDEMA
1. What is edema?
- What is edema?
* Fluid buildup in interstitial spaces causing swelling.
Week 3
EDEMA
2. Causes of edema:
- Causes of edema:
* ↑ Hydrostatic Pressure: E.g., heart failure, venous blockage.
* ↓ Oncotic Pressure: Low proteins (e.g., albumin) from malnutrition or liver/kidney issues.
* ↑ Capillary Permeability: From trauma, inflammation.
* Lymph Obstruction: E.g., cancer, infections, post-surgery.
Week 3
HEART FAILURE
1. Definition:
Definition:
* Heart can’t pump blood effectively to meet the body’s demands.
Week 3
HEART FAILURE
2. Types of dysfunction:
- Types of dysfunction:
* Systolic failure (reduced contraction).
* Diastolic failure (reduced filling).
Week 3
HEART FAILURE
3. Risk factors:
- Risk factors:
* High blood pressure, coronary artery disease, diabetes.
* Obesity, smoking, sedentary lifestyle.
Week 3
HEART FAILURE
4. Symptoms:
Symptoms:
* Breathlessness, fatigue, swollen limbs, chest discomfort.
Week 3
HEART FAILURE
5. Stages (AHA/ACC):
- Stages (AHA/ACC):
* A: Risk only (e.g., diabetes, no disease).
* B: Structural issues, no symptoms.
* C: Symptoms + structural issues.
* D: Severe disease, needing advanced care.
Week 3
HEART REMODELING
1. What is cardiac remodeling?
- What is cardiac remodeling?
* Changes in heart size, shape, or function after stress (e.g., MI, hypertension).
Week 3
HEART REMODELING
2. Types of remodeling:
- Types of remodeling:
* Concentric: Thick walls due to pressure overload (e.g., hypertension).
* Eccentric: Dilated chambers due to volume overload (e.g., valve regurgitation).
Week 3
HEART REMODELING
3. Complications:
- Complications:
* Concentric: Stiff heart (diastolic heart failure), arrhythmias.
* Eccentric: Weak heart (systolic failure), progressive dilation.
Week 3
SHOCK
1. What is shock?
- What is shock?
* Poor tissue perfusion causing cellular and organ failure.
Week 3
SHOCK
2. Types of shock:
- Types of shock:
* Hypovolemic: Low blood volume (e.g., bleeding, dehydration).
* Cardiogenic: Heart pump failure (e.g., MI).
* Distributive: Poor blood flow distribution (e.g., sepsis).
* Obstructive: Blood flow blockage (e.g., pulmonary embolism).
Week 3
SHOCK
3. Stages of shock:
- Stages of shock:
* Compensated: Body tries to adjust (cold hands, faster pulse).
* Progressive: BP drops; confusion, less urine output.
* Irreversible: Severe damage and multi-organ failure.
Week 3
MANAGING CONDITIONS
1. Acute heart failure:
- Acute heart failure:
* Oxygen therapy, diuretics for fluid removal.
* Vasodilators or inotropes for better heart function.
Week 3
MANAGING CONDITIONS
2. Chronic heart failure:
- Chronic heart failure:
* Medications: ACE inhibitors, beta blockers, SGLT2 inhibitors.
* Lifestyle: Low salt, regular activity, weight control.
Week 1
Topic 1: Anatomy
Thoracic Cavity
Thoracic Cavity
1. Contents: Includes lungs, heart, esophagus, thymus, major blood vessels, lymph nodes.
Week 3
MANAGING CONDITIONS
3. Cardiogenic shock:
MANAGING CONDITIONS
3. Cardiogenic shock:
* Oxygen, inotropes, fluids (carefully), mechanical support if needed.
Week 1
Topic 1: Anatomy
Mediastinum
Mediastinum
1. Boundaries: Central space of the thoracic cavity, bordered by lungs. Divided into superior, anterior, middle, and posterior mediastinum.
2. Contents:
o Superior: Thymus, major vessels like aorta and SVC, trachea, esophagus.
o Middle: Heart, pericardium, main bronchi.
o Posterior: Esophagus, thoracic duct, descending aorta.
Week 1
Topic 3: Cardiac Cycle
1. Key terms:
- Key terms:
o Stroke Volume (SV): Amount of blood pumped per beat.
o End-Diastolic Volume (EDV): Blood in ventricle before contraction.
o Ejection Fraction: Percentage of EDV pumped out.
Week 1
Topic 1: Anatomy
Pericardium
Pericardium
1. Structure: Double-layered sac; fibrous (outer) and serous (inner).
2. Functions: Protects the heart, reduces friction during heartbeats, prevents over-distension.
3. Blood supply and innervation:
o Arteries: Pericardiacophrenic and coronary arteries.
o Innervation: Phrenic nerve and vagus nerve.
Week 1
Topic 2: Clinically Relevant Anatomy
Palpation
Palpation
1. Key areas: Apex beat felt at left mid-clavicular line (5th intercostal space).
Week 1
Topic 1: Anatomy
Heart
Heart
1. Structure: Four chambers (right atrium/ventricle, left atrium/ventricle); surrounded by pericardium.
2. Great vessels: Aorta, pulmonary arteries/veins, venae cavae.
3. Blood flow: Right side pumps blood to lungs; left side pumps to body.
4. Coronary arteries: Supply blood to heart muscle, branching into circumflex and LAD.
5. Comparison: Left heart thicker (pumps to body), right heart thinner (pumps to lungs).
Week 1
Topic 2: Clinically Relevant Anatomy
Positioning
Positioning
1. Heart Position: Located centrally in thorax, tilted slightly left.
2. Major vessels: Aorta, venae cavae, pulmonary arteries/veins near heart.
Week 1
Topic 2: Clinically Relevant Anatomy
Auscultation
1. Sites:
Auscultation
1. Sites:
o Aortic valve: Right 2nd intercostal space.
o Pulmonary valve: Left 2nd intercostal space.
o Tricuspid valve: Lower left sternum.
o Mitral valve: Heart apex.
Week 1
Topic 4: The Heart as a Pump
Myocardium and Cardiomyocytes
Myocardium and Cardiomyocytes
1. Structure: Thick heart muscle; individual cells connected by gap junctions.
2. Function: Contracts in coordination for pumping blood.
Week 1
Topic 3: Cardiac Cycle
1. Phases:
- Phases:
o Systole: Heart contracts, pumping blood out.
o Diastole: Heart relaxes, chambers fill with blood.
Week 1
Topic 4: The Heart as a Pump
Cardiac Output
Cardiac Output
1. Definition: Blood volume pumped by heart per minute.
2. Determinants: Heart rate and stroke volume.
Week 1
Topic 3: Cardiac Cycle
1. Wigger’s Diagram: Graph showing pressure, volume, and heart sounds during the cardiac cycle.
Graph showing pressure, volume, and heart sounds during the cardiac cycle.
Week 1
Topic 4: The Heart as a Pump
Venous Return
Venous Return
1. Factors: Blood pressure, muscle contractions, respiratory movements, valve function.
Week 1
Topic 5: A Closer Look at Valves
- Valves:
o Atrioventricular: Mitral and tricuspid.
o Semilunar: Aortic and pulmonary. - Functions: Prevent blood backflow during heartbeats.
- Heart sounds: First sound (S1): AV valves closing; second sound (S2): Semilunar valves closing.
- Valvular dysfunction: Leads to regurgitation or stenosis.
Week 1
Topic 6: Cardiac Conduction Pathway
Cardiac Conduction Pathway
1. Key Structures: SA node, AV node, bundle of His, Purkinje fibers.
2. Electrical Spread: Begins in SA node, stimulates atria, reaches AV node, and spreads through ventricles.
Week 1
Topic 7: Excitation-Contraction Coupling
Electrical Phases
Electrical Phases
1. Action Potential:
o Resting membrane potential → depolarization → repolarization → refractory period.
2. Mechanical Link: Electrical activity triggers muscle contraction (e.g., repolarization → ventricular relaxation).
Week 1
Topic 7: Excitation-Contraction Coupling
Ventricular Action Potential
Ventricular Action Potential
Phases: Includes plateau phase for sustained contraction
Week 1
Topic 7: Excitation-Contraction Coupling
Pacemaker Action Potential
Pacemaker Action Potential
1. SA Node: Automatic firing regulates heartbeat.
Week 1
Topic 8: Autonomic Control of Cardiac Conduction
Autonomic Control of Cardiac Conduction
1. Sympathetic Effects: Speeds up heart rate; uses noradrenaline to enhance conduction.
2. Parasympathetic Effects: Slows down heart rate; uses acetylcholine.
3. Factors Influencing Conduction: Electrolyte levels, medications, autonomic balance.
Week 2
TOPIC 1: ANATOMY OF BLOOD VESSELS
1. Types of Arteries:
Types of Arteries:
* Conducting arteries (elastic): Large; include the aorta and carotid arteries. Function: Absorb pressure changes with elastic recoil.
* Distributing arteries (muscular): Medium; regulate blood flow to organs.
* Small arteries/arterioles: Control blood flow into capillary beds; major role in resistance.
Week 2
TOPIC 1: ANATOMY OF BLOOD VESSELS
2. Types of Veins:
Types of Veins:
* Venules: Small, collect blood from capillaries.
* Medium veins: Contain valves to prevent backflow.
* Large veins: E.g., IVC, SVC; return blood to the heart.
Week 2
TOPIC 1: ANATOMY OF BLOOD VESSELS
3. Arterial vs. Venous Walls:
Arterial vs. Venous Walls:
* Arteries: Thick walls, more elastic tissue and smooth muscle.
* Veins: Thin walls, larger lumens, and valves.
Week 2
TOPIC 2: PRESSURE, VOLUME, RESISTANCE, AND FLOW
1. Relationships in Blood Flow:
Relationships in Blood Flow:
* Blood flow = Pressure / Resistance.
* ↑ Pressure = ↑ Flow (if resistance unchanged).
Week 2
TOPIC 2: PRESSURE, VOLUME, RESISTANCE, AND FLOW
2. Preload & Afterload:
Preload & Afterload:
* Preload: Blood volume filling ventricles before contraction.
* Afterload: Pressure ventricles must work against to eject blood.
Week 2
TOPIC 2: PRESSURE, VOLUME, RESISTANCE, AND FLOW
3. Cardiac Output (CO):
- Cardiac Output (CO):
* CO = Stroke Volume (SV) × Heart Rate (HR).
* Determinants: Contractility, preload, afterload, HR.
Week 2
TOPIC 3: MEAN ARTERIAL PRESSURE (MAP)
- Formula: MAP = CO × Total Peripheral Resistance (TPR).
- Parameters:
* CO (HR × SV), TPR, stroke volume, and HR. - Basal Vascular Tone: Constant partial contraction of blood vessels.
Week 2
TOPIC 4: EXTRINSIC REGULATORS OF ARTERIAL SMOOTH MUSCLE
- Main Roles: Regulate blood pressure and blood flow.
- Effects on Smooth Muscle:
* Sympathetic System: Constricts vessels via noradrenaline.
* Adrenaline: Can dilate (beta-2 receptors) or constrict (alpha receptors).
* Vasodilators: E.g., atrial natriuretic peptide reduces blood pressure.
Week 2
TOPIC 5: INTRINSIC REGULATORS OF ARTERIAL SMOOTH MUSCLE
- Key Factors:
* Oxygen (O₂): Low levels dilate vessels.
* Carbon dioxide (CO₂): High levels dilate vessels (e.g., in brain).
* Nitric Oxide (NO): Vasodilation; lowers BP.
* Endothelin-1: Vasoconstriction; raises BP. - Autoregulation:
* Local tissue adjusts blood flow based on needs (e.g., brain, kidneys).
Week 2
TOPIC 7: MEDIUM-LONG TERM REGULATION OF BP
- RAAS:
* Key structures: Kidneys (renin), lungs (ACE), adrenal glands (aldosterone).
* Renin converts angiotensinogen to angiotensin I → ACE converts to angiotensin II → increases BP by constricting vessels and retaining sodium. - Salt Intake Effect: High salt → Increases blood volume → Raises BP.
Week 2
TOPIC 6: SHORT-TERM REGULATION OF BLOOD PRESSURE
- Baroreceptors:
* Found in carotid sinus and aortic arch; sense changes in BP. - Reflex Pathway: Baroreceptors → Brainstem → Autonomic adjustments (sympathetic/parasympathetic systems).
Week 2
TOPIC 8 & 9: HYPERTENSION & DIAGNOSIS
- Types of Hypertension:
* Primary (essential): No clear cause.
* Secondary: Due to other conditions (e.g., kidney disease). - Risk Factors: Age, obesity, smoking, sedentary lifestyle, family history.
- Diagnosis: BP > 140/90 mmHg on multiple occasions.
Week 2
TOPIC 11: HYPERTENSION COMPLICATIONS AND LIFESTYLE
- Complications:
* Heart: LV hypertrophy, heart failure.
* Kidneys: Nephropathy.
* Brain: Stroke.
* Eyes: Retinopathy. - Lifestyle Modifications:
* Reduce salt, quit smoking, regular exercise, maintain healthy weight.
Week 2
TOPIC 10: PHARMACOLOGY OF ANTIHYPERTENSIVES
1. Main Drugs:
- Main Drugs:
* ACE Inhibitors: Block angiotensin II production.
* Beta Blockers: Lower HR and contractility.
* Calcium Channel Blockers: Relax arteries.
* Thiazide Diuretics: Remove excess fluid to lower BP.
