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Anatomy and Physiology > Heart Conditions > Flashcards

Heart Conditions Flashcards

1
Q

What is coronary artery disease?

A

Narrowing of the coronary arteries, usually by atheroma

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2
Q

What is atheroma?

A

Degeneration of walls of arteries caused by build up of fat and scar tissue, leading to restricting of the circulation and risk of thrombosis (blood clot)

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3
Q

What is acute coronary syndrome?

A

Damage or death of heart muscle usually following blockage of one or more of the coronary arteries

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4
Q

What is heart failure?

A

Abnormal back pressure due to inability of the heart to maintain normal circulation

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5
Q

What is cardiac arrest?

A

Where the heart stops and here is lack of circulating blood to the brain and vital organs

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6
Q

What is hypercholesterolaemia?

A

Cholesterol is an important substance used in the structure of cell membranes and steroid hormones

Elevated cholesterol as a result of foods high in LDL and HDL

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7
Q

What should normal cholesterol levels for healthy adults be?

A

5mml/l

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8
Q

What is atherosclerosis? And what does it do?

A

Increased deposition of cholesterol into arteries leads to formation of ‘atherosclerotic plaques’.
It is these plaques which narrow lumen of arteries and increase mean arterial pressure (BP)

These atherosclerotic plaques reduce the amount of blood travelling to coronary arteries and thus with significant deposition, chest pain can occur as a result of myocardial ischaemia. If these plaques rupture, arteries can become totally occluded.

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9
Q

What is hypertension?

A

High blood pressure = >140/90

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10
Q

Why does hypertension occur?

A

Damaged vasculature which is closely linked to atherosclerotic processes including lipid deposition and plaque formation caused by smoking etc

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11
Q

What are hypertensive patients at risk of?

A

Myocardial Infarction, angina, cerebrovascular events (strokes and TIAs), subarachnoid haemorrhages and kidney failure

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12
Q

What does TIA stand for?

A

Transient Ischaemic Attack

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13
Q

What increases the probability of a person having a TIA?

A

Temporary blood clots

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14
Q

What is arteriosclerosis?

A

A degenerative process in which the vessels of the circulatory system become damaged over time

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15
Q

What is arteriosclerosis often due to?

A

It is often due to advancing age as collagen and elastin fibres are degraded but it’s onset can be accelerated through smoking and excessive alcohol consumption

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16
Q

Alongside arteriosclerosis, what other conditions can increase the risk of an individual having angina or an MI?

A

Hypertension, hypercholestrolaemia, atherosclerosis

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17
Q

What are some risk factors for cardiac disease?

A

Hypercholestrolemia

Hypertension

Diabetes

Family history of coronary artery disease at an early age

Smoking

Obesity

Alcohol

Physical inactivity

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18
Q

What is angina pectoris?

A

Temporary lack of oxygen in the myocardial tissue and the accumulation of carbon dioxide and lactic acid

Related to exertion

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19
Q

What is stable angina?

A

It follows a recurrent pattern

Exertion or emotion precipitates pain of similar intensity, duration and location

Most attacks are relieved by rest in 2-3 minutes

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20
Q

What are some clinical features of angina?

A

Pain behind breast bone, running the length of the bone and spreading across chest

Pain radiates to throat, jaw and teeth and also into the armpits and arms

Described as heaviness in the arms or chest

Pallor

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21
Q

What are some treatments for angina?

A

Rest

Oxygen if required

Administration aspirin

Administration of Glyceryl Trinitrate (GNT)

Pain relief

Hospital

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22
Q

What is aspirin?

A

Acetylsalicylic Acid

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23
Q

What form is aspirin in and how much does it contain?

A

In tablet form containing 300 mg

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24
Q

When would you give aspirin?

A

Clinical ECG evidence of an MI or ischaemia

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25
Q

What are the three key actions that aspirin takes?

A

Anti-platelet
Anti-pyretic
Anti-inflammatory

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26
Q

What are some contra-indications of aspirin?

A

Known aspirin allergy or sensitivity

Children under 16 years

Severe hepatic disease

Haemophilia

Active GI bleeding (gastrointestinal bleeding from mouth to rectum

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27
Q

What are some cautions that need to be taken before using aspirin?

A 
Asthma
Pregnancy 
Kidney and liver failure
Gastric and duodenal ulcers
Current treatments with anti-coagulants (blood thinners)
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28
Q

What are some side effects of aspirin?

A

Wheezing in asthmatics

Gastric bleeding

29
Q

What is GTN?

A

Glyceryl Trinitrate

Metered dose spray containing 400mcg GTN per dose

Tablets containing GTN 2, 3 or 5mg for buccal administration

30
Q

What are some indications for the use of GTN?

A

Cardiac chest pain due to angina or MI

Acute cardiogenic pulmonary oedema

31
Q

What does GTN do?

A

Vasodilator

Dilation of coronary arteries/relief of coronary spasm

Dilation of systemic veins resulting in lower preload

Reduced BP

32
Q

What are some contra-indication of GTN?

A

Hypotension (systolic >90mmHg)

Hypovolaemia (low blood plasma)

Head trauma

Cerebral haemorrhage

Sildenafil within 24 hours (AKA viagra used to treat erectile dysfunction and pulmonary arterial hypertension)

Unconscious patients

33
Q

What is needed for GTN to be given for it to work?

A

The oral mucosa must be moist for GTN absorption

34
Q

How would you use the Sub-lingual spray of GTN?

A

400-800mcg every 5 mins if required (no Max dose)

35
Q

How would you give buccal tablets of GTN?

A

2,3 or 5mg tablets - 1 tablet

Remove tablet if side effects occur

36
Q

What is Entonox?

A

Also known as gas and air

Combination of 50% nitrous oxide and 50% oxygen

It is a pain relieving gas

It is stored in medical cylinders that have a blue body with white quartered shoulders

37
Q

What are some indications for the use of Entonox?

A

Moderate to severe pain

Labour pains

38
Q

What actions does Entonox have?

A

Inhaled analgesic agent (diminishes sensation to pain without loss of consciousness)

39
Q

What are some contra-indications for the use of Entonox?

A

Severe head injuries with impaired consciousness

Decompression sickness or anyone who has been diving within the last 24 hours

Violently disturbed psychiatric patients

Intraocular injections of gas within the last 4 weeks

Abdominal pain where intestinal obstruction is suspected

40
Q

What are the three main cautions needed to be taken before administering Entonox?

A

Pneumothorax - abnormal collection of air in pleural space between lung and chest wall

Pneumomedastinum - pressure rises in lungs and causes alveoli to rupture

Pneumoperitoneum - abnormal presence of air or other gas in peritoneal cavity, a potential space within the abdominal cavity

41
Q

How is Entonox administered?

A

Self administered via face mask or mouth piece. Takes 3-5 minutes to become effective and 5-10 minutes for maximum effect

Can be used in children who are capable of following administration instructions and can activate the demand valve

42
Q

What is important when using Entonox in colder temps?

A

Must invest several times because gases separate and need to remix

43
Q

What is acute coronary syndromes?

A

More serious and indicates increasing obstructions of coronary arteries

Unpredictable with changes in frequency, intensity or duration of pain

May occur at rest

Unstable angina may precede an Acute Myocardial Infarction (AMI) by a few hours a day

44
Q

What is Acute Myocardial Infarction (AMI)?

A

Process of death or damage to an area of heart muscle

Coronary artery becomes blocked or significantly narrowed

Due to blood clot or embolism

45
Q

What is the problem with an acute myocardial infarction (AMI)?

A

Prevents oxygen from reaching the muscle beyond the blockage

May result in heart failure or death

May cause heart arrhythmias

46
Q

What is the different between a STEMI and a NonSTEMI AMI?

A

STEMI is a full thickness damage of heart muscle

NonSTEMI is a partial thickness damage of heart muscle

47
Q

What is the most common cause heart sudden death form heart disease?

A

AMI

80% arrest into VF

48
Q

What are the clinical features of AMI?

A

Severe central chest pain which may radiate to one or both sides of the chest and into the neck, jaw, arms or back and is often described as crushing in nature

Heavy feeling in arms or paraesthesia

Sweating, fainting, giddiness, nausea and vomiting

Sense of impending doom

Grey or cyanosed

Changes in vital signs

49
Q

What is some treatment options for ATM?

A

Rest - do not allow to walk

Oxygen if SPO2 is less than 94% (88% in COPD)

Aspirin

GTN

Analgesia

Monitor

Place defib pads on

Rapid transport - into a Primary Percutaneous Coronary Intervention (PPCI) centre if STEMI

50
Q

what is heart failure?

A

The inability of the heart to pump adequately

51
Q

What is heart failure caused by?

A

MI
Myocarditis
Hypertension
Valvular heart disease

52
Q

What is left sided heart failure known as?

A

LVF

Usually more acute and may accompany an AMI

53
Q

What is a symptom of heart failure and why does this happen?

A

Present as short of breath by fluids retained in lungs

54
Q

When does right sided heart failure usually occur?

A

It’s usually secondary to LVF (left sided failure) and occurs over time

RVF

55
Q

What is some clinical signs of RVF?

A

Increased to need to urinate at night

Oedema in the body (often pitting)

Swelling of the abdomen

Very rapid weight gain form fluid retention

56
Q

What are some clinical signs of LVF? (Left sided heart failure)

A

Shortness of breath

Reduced ability to exercise

Fatigue and weakness

Rapid or irregular heartbeat

Persistent cough or wheezing with white or pink blood-tinged phlegm

Difficulty concentrating or decreased alertness

Sudden, severe shortness of breath and coughing up pink, foamy mucus

Chest pain if heart failure is caused by heart attack

57
Q

What are some treatment options for LVF?

A

Rest

Oxygen if SPO2 is less than 94% (88% in COPD)

GTN

Furosemide

Salbutamol

Prealert

58
Q

What are furosemide contained in and how much is stored?

A

Ampoules containing furosemide 40mg in 2ml

59
Q

What is an indication for the use of furosemide?

A

Pulmonary oedema secondary to LVF

60
Q

How does furosemide work?

A

Potent diuretic with rapid onset (30 minutes) and short duration

61
Q

What are some contraindications for the use of furosemide?

A

Pre-comatose state secondary to liver cirrhosis

Severe renal failure with anuria (can’t produce urine)

Children under 18 years old

62
Q

What dosage of furosemide appropriate?

A

40mg IV slowly over 2 minutes

63
Q

What are some cautions needed to be taken for use of furosemide?

A

Hypokalaemia (low potassium levels)

Pregnancy

Hypotension

64
Q

What are some possible side effects of furosemide?

A

Hypotension

Gastrointestinal disturbances

65
Q

What does DVT stand for?

A

Deep Vein Thrombosis

66
Q

What is DVT?

A

A blood clot that usually occurs in a deep leg vein, such as the calf or the thigh

67
Q

What are some causes of DVT?

A

Previous history of DVT or pulmonary embolism

Family history of blood clots

Inactivity for long periods

Blood vessel damage

Certain conditions or treatments that cause blood to clot more easily than normal - such as cancer

Being pregnant

Being overweight or obese

The combined contraceptive pill and hormone replacement therapy (HRT) both contain the female hormone oestrogen which causes blood to clot more easily

68
Q

What are some symptoms of DVT?

A

Unilateral - swelling in one or both legs

Pain or aching in affected area

Warm skin

Red skin or discoloured

Sharp chest pain

Shortness of breath

Haemoptysis

Blood clot breaks free becomes a pulmonary embolism in the lungs

Anatomy and Physiology (26 decks)

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