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1st/2nd Year Revision > CVS conditions - general > Flashcards

CVS conditions - general Flashcards

1
Q

What is the pathology of heart failure?

A

Heart can’t pump at the required rate

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2
Q

What are the causes of heart failure?

A 
Ischaemia
Hypertension
Valvular disease
Pulmonary embolism
Myocarditis
Endocarditis
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3
Q

What are the signs of left sided heart failure?

A 
Dyspnoea
Orthopnoea
Fatigue
Lung crepitations
Pleural effusion
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4
Q

What are the signs of right sided heart failure?

A

Peripheral oedema
Abdominal distension
Increased JVP
Hepatomegaly

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5
Q

What investigations would be done if heart failure was suspected?

A

ECG
ECHO - diagnostic
Blood - BNP, FBC, U&Es, LFT, TFT
CXR

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6
Q

How is heart failure managed?

A 
Reduce risk factors 
GTN spray - symptomatic
ACEi - ramipril 
B-blocker - bisoprolol
Loop diuretic - furosemide
K sparing diuretic - spironolactone
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7
Q

What is involved in acute coronary syndrome?

A

Unstable angina
STEMI
NSTEMI

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8
Q

What is the pathology of acute coronary syndrome?

A

Thrombus from atherosclerosic plaque blocking a coronary artery

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9
Q

What is the cause of acute coronary syndrome?

A

Atherosclerosis

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10
Q

What are the symptoms of acute coronary syndrome?

A 
Central crushing chest pain
Potential radiation to neck/left arm
Sweating
Dyspnoea
Palpitations
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11
Q

What investigations would be done if acute coronary syndrome was suspected?

A

ECG - if ST elevation then STEMI, if ST depression/T wave inversion then NSTEMI/unstable angina
Troponin - increased in STEMI and NSTEMI

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12
Q

How is acute coronary syndrome treated?

A

Angina - reduce risk factors, GTN spray, B-blocker
STEMI - percutaneous coronary intervention (PCI if within 2hrs), thrombolysis (if after 2 hours)
NSTEMI - batman, b-blocker, aspirin, tricagrelor, morphine, anticoagulant, nitrates

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13
Q

What are the complications of acute coronary syndrome?

A 
Death
Rupture of heart septum
Oedema - heart failure
Arrhythmia
Aneurysm
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14
Q

What are the causes of hypertension?

A

Can be essential, secondary or malignant
Risk factors - obesity, smoking, alcohol, high salt diet, DM
Secondary causes - cushing’s, acromegaly, chronic renal failure

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15
Q

What is classified as essential hypertension?

A

140/90

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16
Q

What are the signs of hypertension?

A

Normally asymptomatic

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17
Q

What are the symptoms of malignant hypertension?

A

Severe hypertension
Headaches
Bilateral retinal haemorrhages and exudates
Papilloedema

18
Q

How is hypertension investigated?

A

Ambulatory blood pressure monitoring (ABPM)

19
Q

How is hypertension treated?

A

Confirm - ABPM
Address risk factors
<55 step 1 – ACEi/ARB (ramipril / candesartan)
>55 African step 1 – CCB (amlodipine)
Both step 2 – ACEi/ARB + CCB
Step 3 – ACEi/ARB + CCB + thiazide diuretic (indapamide)
Step 4 – resistant hypertension, refer to specialist

20
Q

What are the complications of hypertension?

A

IHD
Stroke
Haemorrhage
Heart failure

21
Q

What is the pathology of atrial fibrillation?

A

Disorganised atrial activity resulting in ventricular irregularities

22
Q

What are the causes of atrial fibrillation?

A 
AF affects Mrs SMITH
Sepsis
Mitral valve pathology
IHD
Thyrotoxicosis
Hypertension
23
Q

What are the symptoms of atrial fibrillation?

A 
Can be asymptomatic
Palpitations
SOB
Dizziness
Heart failure
Irregularly irregular pulse
Tachycardia
24
Q

How is atrial fibrillation investigated?

A

ECG - absent P waves, narrow QRS complexes, irregularly irregular ventricular rhythm
Bloods - FBC, U&Es, TFT, LFT
Cardiac enzymes

25
Q

How is atrial fibrillation treated?

A

Rate control - B-blocker (bisoprolol), Ca blocker (amlodipine)
If symptoms <48hrs cardioversion
Anticoagulant - warfarin

26
Q

What score is used to assess the risk of embolic stroke and the need for coagulation?

A

CHA2DAS2-VASc

27
Q

What are the causes of ventricular tachycardia?

A

IHD
MI
Cardiomyopathy
Drug toxicity

28
Q

What are the symptoms of ventricular tachycardia?

A

Palpitations
Chest pain
Syncope

29
Q

How is ventricular tachycardia investigated?

A

ECG - broad complexes

30
Q

How is ventricular tachycardia treated?

A

Amiodarone

31
Q

What system is used to classify heat failure?

A

New York classification of heart failure

32
Q

New York classification of heart failure

A

1 – heart disease present but no breathless from normal activities
2 – comfortable at rest, dyspnoea during normal activities
3 – less than ordinary activities causes dyspnoea
4 – dyspnoea at rest

33
Q

What are some side effects of ACEi?

A

Cough

34
Q

Who can’t have b-blockers?

A

Asthmatic - risk of bronchospasm

35
Q

What would be seen on an x-ray if the person had heart failure?

A 
ABCDE:
Alveolar oedema
Kerley B lines – interstitial oedema
Cardiomegaly
Dilated prominent upper lobe vessels
Pleural effusion
36
Q

What are other causes of ST elevation?

A 
Coronary vasospasm
Pericarditis
Left bundle branch block
Left ventricular hypertrophy
Ventricular aneurysm
37
Q

What is stable angina?

A

Symptomatic reversible myocardial ischaemia – narrowing of coronary artery

38
Q

What causes stable angina?

A

Atheroma

39
Q

What are the signs of stable angina?

A 
Constricting heavy pain to chest radiation to left arm and jaw – brought on by exertion
Relieved by 5 mins rest with GTN spray
3 – typical angina
2 – atypical angina
0/1 – not angina
40
Q

What investigations would be done if stable angina was suspected?

A

ECG – normal
CT coronary angiography
Bloods – FBC, U&Es, TFTs, lipids, HbA1c
Consider ECHO and CXR

41
Q

How is stable angina treated?

A

Address exacerbating factors
Secondary prevention – reduce risk factors, aspirin
Symptomatic – GTN spray
B-blocker or CCB
If medical fails – PCI, angioplasty, CABG

1st/2nd Year Revision (15 decks)

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