Heart & Blood vessels Flashcards
How would you describe cardiac disease and give 4 examples?
Disease of the heart.
1) Heart Failure
2) Valvular heart disease (wide/narrow)
3) Pericarditis, myocarditis and endocarditis (infections)
4) Cardiomyopathy (intrinsic disease)
How would you describe vascular disease and give 4 examples?
Disease of the blood vessels.
1) Aneurysms (dilation)
2) Hypertension
3) Diabetic vascular disease
4) Venous disease (e.g. DVT, viscose)
How would you describe congenital heart disease?
Disease present from birth
Definition of heart failure?
A condition whereby the body is unable to pump the blood around the body that is required for normal functioning
How can you detect heart failure radiologically?
Using an echocardiogram - this can detect ejection fraction (the % of blood which is ejected from the ventricles) If below 40% = heart failure
What causes heart failure?
Anything that reduces the supply and/or increases the demand on the heart. (think: CO = HR X SV) Reducing supply: 1) Ischaemic heart disease 2) Congenital heart disease 3) Cardiomyopathy 4) Arrhythmias Increasing demand: 1) Hypertension 2) Anaemia
Explain what causes the different symptoms of heart failure?
In order for the heart to cope with the demands of the body, the myocytes in the heart will increase in size (hypertrophy). However, there is only a certain amount of blood that can to be pumped. So, the blood starts to back up into: 1) Pulmonary circuit 2) Peritoneal cavity and 3) Peripheral veins
What symptom and sign is caused from the blood backing up into the pulmonary circuit?
Symp: Pulmonary oedema
Sign: Breathlessness, increased respiratory effort and crackles in chest (indicating fluid)
What sign is caused from the blood backing up into the peritoneal cavity?
Sign: Asites (swelling of the abdomen)
What symptom and sign is caused from the blood backing up into the peripheral veins?
Symp: Peripheral oedema
Sign: ankle swelling
What are the 3 different classifications of heart failure?
1) Chronic (needs treating) Vs. Acute (treated in the community)
2) Left (lungs) Vs. Right (ankles)
3) Severity
Treatment for heart failure?
Treat the underlying cause. However, you couldn’t do this with acute heart failure. This needs to be treated with O2 or diuretics
What are the names of the different valves in the heart?
Right: Tricuspid & Pulmonary valve
Left: Bicuspid & Aortic valve
What 3 conditions occur in vascular heart disease and their definition?
Stenosis: When the valves narrow which impedes on their forward flow
Regurgitation: When the valves don’t close up properly so blood flows backwards and forwards
Vegetation: Abnormal growth on the tissue
What causes stenosis?
1) Vegetation
2) People can be born with an abnormality - in which they don’t appear to have all of the chordae which would normally hold the valves in place
(this is a chronic process)
What causes regurgitation?
1) Vegetation
2) Damage to the supporting structures (i.e. chordae or the papillary muscles - attached to the chordae)
(this can be a chronic or an acute process)
What causes vegetation?
1) Bacteria
2) Inflammation
3) Clot
What is known as the ‘The Cardiac Staircase’?
When 1 valve is affected, this puts pressure on the other valves and so this can then affect other valves
What are the symptoms for vascular heart disease?
Same as heart failure (pulmonary oedema, peripheral oedema, asites)
What are the specific symptoms for aortic stenosis?
THE CLASSIC TRIAD:
1) Angina
2) Shortness of breath
3) Collapse
What are the signs for vascular heart disease?
Same as heart failure (breathlessness, crackles, ankle swelling, abdominal swelling)
PLUS:
Murmurs (not the normal ‘lub-dub’ sound)
What are pericarditis, myocarditis and endocarditis?
Diseases of a specific layer of the heart
Pericardium:
Outer layer of the heart
Myocardium:
Muscle layer
Endocardium:
Inside layer of the heart and its valves
Explain the differences between right and left sided endocardium?
Left sided: Most common Right sided: Common with IV drug users Left sided: Streptococci Right sided: Staphaureus Left sided: Affects abnormal valves Right sided: Affects normal valves
Describe what is meant by Prophlaxis?
Giving patients that are at risk of endocarditis antibiotics before they undertake any procedures that are likely to introduce any other kind of bacteria into their body
What are the symptoms of endocarditis?
(same as heart failure and sepsis) PLUS: - fever - malaise - weight loss
What are the signs of endocarditis?
(same as heart failure) PLUS: - splinter haemorrhage - finger clubbing - Osler's nodes (hands) - Roth's spots (eyes)
What is the classification of endocarditis and describe?
Acute (sweating - needs medical attention) and sub acute (where the vegetation will be growing slowly on the endocardium)
What are the causes for both pericarditis and myocarditis?
1) Infection (viral/bacteria)
2) Carcinoma
3) Uraemia (when the kidneys don’t filter the waste products our of the blood correctly)
4) Myocardial Infarction
What are the symptoms for both pericarditis and myocarditis?
Chest pain
What are the signs for both pericarditis and myocarditis?
On ECG - ‘bucket-shaped’ S-T wave
What treatment is used for pericarditis and myocardititis?
Anti-inflammatory drugs or leave it along to treat itself
What are the 3 main types of cardiomyopathy?
1) Dilated cardiomyopathy
2) Hypertrophic cardiomyopathy
3) Restrictive cardiomyopathy
How do you describe dilated cardiomyopathy?
All of the heart chambers will dilate. Resulting in a thin and floppy heart
How do you describe hypertrophic cardiomyopathy?
The cells in the heart will increase in size, resulting in a large and muscular heart.
What 2 problems occur from hypertrophic cardiomyopathy?
1) Abnormal diastolic filling
2) Intermittent obstruction to the left ventricular outflow - because the septum has increased in size and the bicuspid valve catches on it, which impedes on the outflow of blood through the aorta
What is the main cause for all 3 types of cardiomypathy?
50% genetic
What are the 3 other causes for dilated cardiomyopathy?
1) Alcohol
2) Pregnancy
3) Myocardititis
What are the 3 other cause for restrictive cardiomyopathy?
1) Amyloidosis
2) Radiation
3) Chemotherapy
What is the main cause for hypertrophic cardiomyopathy?
Genetic
What are the 6 symptoms of cardiomyopathy?
1) Atrial Fibrillation
2) Palpitations
3) Shortness of breath
4) Chest pain
5) Syncope (temp loss of consciousness)
6) Sudden death
What are the 2 classifications of hypertension and which is most common?
Primary = don't know the cause (most common) Secondary = there's an underlying cause
Malignant hypertension
Rapid increase in blood pressure and its medical emergency because it prediposes to stroke
What are the 5 risk factors for Primary Hypertension?
1) Genetic
2) Smoking
3) Alcohol
4) Stress
5) Obesity
What are the causes for Secondary Hypertension?
1) Renal artery stenosis
2) Renal parenchymal disease
3) Physical obstruction to the blood flow
4) Endocrine cause
5) Neurogenic cause
What are the complications of hypertension and the 5 organs affected?
1) BV - micro/macro angiopathy
2) Kidney - granular appearance due to scars
3) Heart - MI and heart failure
4) Eyes - Retinopathy
5) Brain - cerebral haemorrhage (damage)/ cerebral infarction (blockage) and depending on the area of the brain –> will depend on which limb is affected
What are the 2 treatments for hypertension?
1) Lifestyle modifications
2) Anti-hypertensive drugs
Definition of an Aneurysm?
An abnormal dilation of the blood vessels
What is the main cause of an Aneurysm and how?
Caused by a weakening in the blood vessel wall due to:
1) Congenital
2) Atheroma
3) Pressure
4) Infection
What are the 3 treatments for aneurysms?
1) Stents
2) Surgery
3) Using Anti-Hypertensives to lower BP
Describe 5 different examples of aneurysms?
1) Berry Aneurysm - Dilation of the circle of Willis in the brain
2) Aortic Aneurysm - mainly in thoracic and abdominal aorta
3) Atherosclerostic Aneurysm - low abdominal aorta and iliac arteries
4) Micro-Aneurysm - the capillaries of the brain
5) Syphilitic Aneurysm - ascending and arch of the aorta
What is diabetic vascular disease a consequence of?
Atheroscleosis (damage to the BV’s)
What are the 3 complications of atherosclerosis and what are the signs?
1) Retinopathy - blindness
2) Peripheral neuropathy - gangrene
3) Nepropathy - kidney damage
How do you reduce the likelihood of Diabetes Vascular disease?
By controlling the diabetes
What are the 3 examples of Venous diseases?
1) DVT
2) Pulmonary embolism
3) Varicose veins
What is DVT a consequence of ?
Venous return being impeded on or a change in blood components
What are the 5 different causes for DVT?
Venous return being impeded on: 1) Immobility 2) Pregnancy A change in blood components: 1) Heamatological disease 2) Malignancies 3) Oestrogens
Name 1 complication of DVT?
Pulmonary embolism
What are the 5 symptoms of pulmonary embolism?
1) SOB
2) Chest pain
3) Calf swelling
4) Syncope
5) Sudden death
How to treat pulmonary embolism?
Anti-coagulant medication
Define varicose veins
Twisted superficial veins
What causes varicose veins?
1) Impeded venous return
2) Valves in the legs are incompetant
What are the 2 complications of varicose vein?
1) Ulceration
2) Skin irritations
How common is congenital heart disease?
Rare
Define congenital heart disease?
Septal deficit - hole in between the left and the right side of the heart
What are the symptoms of congenital heart disease?
Can be asymptomatic
What are the 4 complications of congenital heart disease?
1) Hypertension
2) Hypoxia
3) Embolism
4) Eisenmenger’s Syndrome: Blue face, drumstick-like fingers and curved nails
