CVS Clinical Conditions

Question 1

What is oedema?

Answer 1

• Oedema is the excessive volume of fluid within the tissues (interstitial / intracellular) which can occur due to changes in capillary dynamics
• It is often seen in heart failure as there is increased capillary hydrostatic pressure

Question 2

What are ventricular ectopic beats?

Answer 2

• Ventricular ectopic beats are when an ectopic focus in the ventricle muscle prevents the spread of impulse via the fast His -purkinje system
• Hence, much slower depolarisation of ventricle (wide & bizzare QRS complex)

Question 3

What is claudication?

Answer 3

Claudication is pain in the muscles of the lower limb elicited by walking / exercise

Question 4

What is sepsis?

Answer 4

Sepsis is a serious life-threatening response to infection, can lead to septic shock

Question 5

What is thrombophlebitis?

Answer 5

Thrombophlebitis is an inflammatory process that causes a venous thrombosis to form, commonly in the legs:

• Superficial thrombophlebitis
• Deep vein thrombosis

Question 6

What is ventricular tachycardia?

Answer 6

• Ventricular tachycardia involves a run of ≥ 3 consecutive ventricular ectopics producing broad QRS complexes
• Persistent VT is a dangerous rhythm, requires urgent treatment and has a high risk of ventricular fibrillation

Question 7

What is transposition of the great arteries?

Answer 7

- Transposition of the great arteries is a congenital condition resulting in two unconnected parallel circulations instead of two circulations in series

• The left ventricle is connected to the pulmonary trunk, and the right ventricle to the aorta

Question 8

What is Tetralogy of the Fallot?

Answer 8

- Tetralogy of Fallot is a group of 4 abnormalities occurring together as the result of a single developmental defect which places the outflow portion of the interventricular septum too far in the anterior and cephalad directions

• The 4 abnormalities are: pulmonary stenosis, RV hypertrophy, VSD, overriding aorta

Question 9

What is coarctation of the aorta?

Answer 9

Coarctation of the aorta is the narrowing of the aortic lumen in the region of the ligamentum arteriosum (former ductus arteriosus)

Question 10

What is septic shock?

Answer 10

Septic shock is persisting hypotension requiring treatment to maintain blood pressure despite fluid resuscitation

Question 11

What is patent foramen ovale?

Answer 11

Patent foramen ovale is the persistence of the foramen ovale after birth, causing blood to flow from the left atrium back into the right

Question 12

What is mitral valve regurgitation?

Answer 12

Mitral valve regurgitation is the prolapse of the mitral valve, resulting in the backflow of blood from the left ventricle, possibly causing left ventricle hypertrophy

Question 13

What are varicose veins?

Answer 13

Varicose veins are tortuous, twisted, or lengthened veins

Question 14

What is Hypoplastic Left Heart Syndrome?

Answer 14

Hypoplastic left heart syndrome (HLHS) is a rare congenital heart defect in which the left heart is severely underdeveloped resulting in inadequate right to left flow in utero

Question 15

What is a deep vein thrombosis?

Answer 15

• A deep vein thrombosis is the formation of a thrombus within a deep vein, most commonly the deep calf veins
• It produces an inflammatory response (calor, dolor, rubor, tumor, functio laesa)

Question 16

What is mitral valve stenosis?

Answer 16

Mitral valve stenosis is the narrowing of the mitral valve, obstructing blood flow into the left ventricle, possibly causing right ventricle hypertrophy, atrial fibrillation and oesophageal compression

Question 17

What is rest pain?

Answer 17

• Rest pain is pain in the foot that comes on when the patient goes to bed and is relieved by hanging the foot out of the bed
• The ischaemia is so severe that at rest the foot skin, muscles, bones are ischaemic at rest, if left untreated then will progress to gangrene/ulceration

Question 18

What is atrial fibrillation?

Answer 18

• Atrial fibrillation is a condition where impulse arise from multiple atrial foci, leading to chaotic atrial depolarisation wherein atria quiver rather than contract
• It carries risk of thrombosis

Question 19

What is angina?

Answer 19

• Angina is a condition arising due to insufficient O₂ supply to the heart for a limited duration caused by artheromatous plaque formation in the coronary arteries
• It results in heart tissue Ischaemia which presents as chest pain

Question 20

What is patent ductus arteriosus?

Answer 20

Patent ductus arteriosus is a condition involving the persistence of the ductus arteriosus after birth, causing blood to flow from the aorta into the pulmonary arteries

Question 21

What is heart failure?

Answer 21

Heart failure is a state in which the heart fails to maintain an adequate circulation for the needs of the body despite an adequate filling pressure

Question 22

What is congestive (biventricular) heart failure?

Answer 22

• Congestive heart failure is a chronic progressive condition in which the heart’s function as a pump is inadequate to meet the body’s needs
• Both the right and left sides of the heart fail to pump adequately, hence, the signs and symptoms of both right and left heart failure develop

Question 23

What is cardiogenic shock?

Answer 23

Cardiogenic shock is the acute failure of the heart to maintain cardiac output (pump failure)

Question 24

What is pericarditis?

Answer 24

• Pericarditis is the inflammation of the pericardium often secondary to a viral illness
• It commonly occurs in men and adults

Question 25

What is cardiac tamponade?

Answer 25

**Cardiac tamponade** is when blood/fluid builds up in pericardial space, restricting the filling of both sides of the heart and limiting the end diastolic volume

Question 26

What is Coronary Heart Disease?

Answer 26

**CHD** is a condition in which atherosclerotic plaques accumulate in the coronary arteries

Question 27

What is aortic valve stenosis?

Answer 27

**Aortic valve stenosis** is the narrowing of the aortic valve, obstructing blood flow into the aorta and possibly causing left ventricle hypertrophy, syncope and angina

Question 28

What is haemodynamic shock?

Answer 28

**Haemodynamic shock** is an acute condition of inadequate blood flow throughout the body due to a catastrophic fall in arterial blood pressure

Question 29

What is pericardial effusion?

Answer 29

**Pericardial effusion** is when excess fluid accumulates in the pericardial cavity, compressing the heart due to the inextensible fibrous pericardial layer

Question 30

What is aortic valve regurgitation?

Answer 30

**Aortic valve regurgitation** is the prolapse ofte aortic valve, resulting in the backflow of blood from the aorta, possibly causing left ventricle hypertrophy

Question 31

What is peripheral arterial disease?

Answer 31

**Peripheral arterial disease** is a common condition, in which a build-up of fatty deposits in the arteries restricts blood supply to leg muscles

Question 32

What is distributive shock?

Answer 32

- **Distributive shock** is low resistance shock (normovolaemic) due to profound peripheral vasodilation (decrease in TPR) - Blood volume is constant, but volume of the circulation has increased

Question 33

What is STEMI?

Answer 33

- **ST segment elevation Myocardial infarction** is a condition occurring due to complete occlusion of lumen by thrombus - Muscle injury extends ‘full thickness’ from endocardium to epicardium and ST segment elevation is observed in leads facing area

Question 34

What is hypertension?

Answer 34

**Hypertension** is the sustained increase in blood pressure

Question 35

What is hypovolaemic shock?

Answer 35

**Hypovolaemic shock** is a state of shock due to reduced blood volume, most commonly due to haemorrhage

Question 36

What is an ostium secundum atrial septal defect?

Answer 36

**Ostium secundum atrial septal defect** occurs when the ostium secundum fails to close completely while the heart is developing, causing an opening to develop in the centre of the wall separating the two atria

Question 37

What is ventricular fibrillation?

Answer 37

- **Ventricular fibrillation** is the abnormal, chaotic and fast ventricular depolarisation due to impulses from multiple ventricular ectopic foci - The ventricles quiver as there is no co-ordinated contraction, no cardiac output and is a state of cardiac arrest

Question 38

What is an acute coronary syndrome?

Answer 38

- An **acute coronary syndrome** is a condition wherein acute myocardial ischaemia occurs due to atherosclerotic coronary artery disease - Atheromatous plaques rupture with thrombus formation causing an acute increased occlusion leading to ischaemia

Question 39

What are AV conduction blocks?

Answer 39

A **heart block** is a delay/ failure of conduction impulses from the atrium to the ventricles via the AVN and bundle of His

Question 40

What is anaphylaxis?

Answer 40

**Anaphylaxis** is a severe allergic reaction