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YR 3 - Illness and Wellbeing > Heart Disorders 1 > Flashcards

Heart Disorders 1 Flashcards

1
Q

describe the structure of the heart.

A

right atrium
right ventricle
left ventricle
left atrium
aorta

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2
Q

what valve separates the right atrium from the right ventricle?

A

bicuspid

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3
Q

describe the circulation of blood in the heart (11)

A

right atrium
bicuspid valve
right ventricle
pulmonary valve
pulmonary artery
lungs
pulmonary veins
left ventricle
mitral valve - mitra - friends
left atrium
aorta

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4
Q

what 3 vessels provide oxygenated blood to the heart?

A

left anterior descending coronary artery
circumflex coronary artery
right coronary artery

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5
Q

describe the left main coronary artery.

A

arises from the aorta and branches into:
- left anterior descending coronary artery
- circumflex coronary artery

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6
Q

describe diastole?

A

the relaxation of ventricles
fill the ventricles with blood

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7
Q

describe systole

A

contraction of ventricles
blood is ejected from ventricles into pulmonary or systemic circulation

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8
Q

define ischaemic heart disease

A

injury to the heart as a result of hypoxia
- from reduced blood flow
- due to mechanical obstruction to the coronal arteries

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9
Q

give 7 risk factors for ischaemic heart disease

A

smoking
obesity
hypertension
diabetes
age
family history
dyslipidaemia

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10
Q

what is dyslipidaemia? how do you treat it?

A

abnormal lipid levels
due to more LDL

treated with statins - medicine to lower cholesterol in blood

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11
Q

give an aetiology which contributes to 90% of ischaemic heart disease

A

90% come from coronary artery atherosclerosis

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12
Q

give 5 different outcomes for IHD (5)

A
  • myocardial infarction from sustained hypoxia
  • unstable and stable angina - chest pain
  • chronic ischaemic heart disease
  • heart failure
  • sudden cardiac death
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13
Q

what can be the complications of myocardial infarction?

think that heart attack, it has been attacked and electrified

A

impaired contractility of the heart

tissue necrosis

electrical instability

pericardial inflammation

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14
Q

what is the pericardium?

A

a fibrous sac surrounding the heart

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15
Q

with complications of MI, what can be 6 outcomes? 1 within the system, and 5 within the heart

A

stroke
cardiogenic shock
congestive heart failure
cardiac tamponade - heart compressed due to excess fluid in pericardium
arrthymias
pericarditis

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16
Q

what can impaired contractibility of the heart lead to?

A
  • promote thrombus = stroke, embolism

-hypotension - more ischaemia = cardiogenic shock

  • congestive heart failure
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17
Q

what can tissue necrosis of the heart lead to? (3)

A
  • papillary muscle infarction
    = muscles in the ventricles
  • valve collapsing = congestive heart failure
  • ventricular wall ruptures = cardiac tamponade
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18
Q

what is electrical instability called in the heart?

A

arrhythmias

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19
Q

what does pericardial inflammation lead to?

A

pericarditis

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20
Q

what are some treatments for ischaemic heart disease? (5)

A

drugs - statins

angioplasty - insert balloon to blocked artery to allow blood flow

stents - permanent tube to open lumen

arrhythmias - implantable defibrillator

heart failure - ventricular assist device - help the heart pump better

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21
Q

what are the key clinical features of ischaemic heart disease (8) and how may it be triggered

A
  • angina pectoris - strangled chest
    when the myocytes are damaged and release inflammatory mediators
  • retrosternal chest pain - feels like its behind the chest
  • radiation to epigastrium, back, neck, jaw or shoulders
  • pale
  • clammy
  • sweaty
  • nauseous
  • weak pulse/low blood pressure
  • breathlessness
  • triggered by physical exertion, eating, exposure to cold or stress
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22
Q

define ‘stable angina’, how it presents, how long it lasts and how it is relieved

A

a significant, progressive occlusion of the vessel

classic chest pain symptoms
- lasts 1-5 minutes
- relieved by rest or glyceryl trinitrate drug

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23
Q

define ‘unstable angina’, how does it present, how long does it last and how does it come about?

A

when an unstable atherosclerotic plaque ruptures

  • intense
  • lasts a long time
  • can be spontaneous or in periods of less exertion
24
Q

define ‘acute coronary syndromes’

A

the sudden dramatic onset of severe chest pain which isn’t relieved by rest

25
Q

what is a difference between myocardial infarction and unstable angina?

A

unstable angina - there is no detectable cell damage

26
Q

how can you diagnose ischaemic heart diseases? (3)

A

clinical features
changes on ECG
cardiac blood markers

27
Q

how are cardiac blood markers used?

A

marks the proteins within the myocytes

  • if myocytes die, proteins released into the bloodstream
  • can detect them and see if the cells have died
28
Q

what protein is found within the myocytes?

A

troponin

29
Q

define heart failure

A

an inability of the heart to pump enough blood to meet metabolic demands of the body

30
Q

describe the aetiology of heart failure (4)

A
  • work overload - valvular heart disease or hypertension
  • myocardial damage
31
Q

describe the pathogenesis of heart failure (8)

A

the heart tries to compensate

  • increased contractibility
  • cardiac hypertrophy
  • neurohumoural responses
    : renin angiotensin system is activated
    : regulate the volume
    : fluid is retained
    : fluid overload
32
Q

what are the key clinical features of heart failure? (4)

A

fatigue
breathlessness
peripheral oedema
swelling

33
Q

what are the clinical guidelines for patients with stable angina?

A

if there is previous history
- must carry glyceryl trinitrite spray or tablets
- use them if they present pain
- hospital admission only if necessary

34
Q

what are the clinical guideline for patients with unstable angina or myocardial infarction?

A

call 999
- comfortable position
- give oxygen
- give sublingual GTN not intramuscular injection
- if you can, give 300mg Aspirin with confirmation

35
Q

what are the clinical guidelines if a patient has non-symptomatic ischaemic heart disease?

A

a patient is vulnerable 4+ weeks following MI
- check with medical practitioner before treatment
- low dose aspirin (75mg) should not be stopped before or after dental treatment

  • antibiotic prophylaxis after coronary artery bypass surgery is not recommended
36
Q

generically, what are the guidelines for IHD patients?

A

dont stop treatment if there is a low risk of bleeding
- delay treatment if required
- consult a cardiologist for definitive advice

37
Q

describe valvular heart disease

A

dysfunction of the heart valves

38
Q

what are the different forms of valvular heart disease and their underlying aetiologies

A

regurgitation - after heart attack, mitral valve is faulty
stenosis - atherosclerosis of aortic valve
atresia - congenital - valves are fused

39
Q

what is Ejection Fraction? how is the ejection fraction affected with systolic and diastolic dysfunction?

A

the proportion of blood within the ventricle that is actually pumped out
- usually 55-70%

systolic dysfunction = decreased contractibility, EF = <40%

diastolic dysfunction - heart is too stiff and cannot fill properly

40
Q

what are the three types of heart failure?

A

left heart failure
right heart failure
congestive cardiac failure - combo of both sides

41
Q

what is left heart failure?

A
  • damage to the left ventricle or valves
  • blood in the pulmonary circuit has nowhere to go
    = build up and stasis of blood in the left system
    = inadequate perfusion of organs
42
Q

what are the symptoms of left heart failure?

A

pulmonary congestion
breathlessness
oedema
systemic hypofusion (organ failure)

43
Q

what is right sided heart failure?

A

occurs from left sided failure or respiratory disease

  • increased back pressure through pulmonary and venous circulation, affecting the right side
44
Q

what are the 2 symptoms of right sided heart failure?

A

leg swelling
organ congestion

45
Q

what is congestive cardiac failure? 3 symptoms

A

a combination of both sides

breathlessness
pulmonary and peripheral oedema

46
Q

what valve issues can you have?

A

failure to open fully - stenosis
failure to close fully - regurgitation
vegetations - become ineffective
abnormal valve function

47
Q

define stenosis, what are the 2 types and the most 2 common aetiologies?

A

when valves fail to open and there is impaired forward flow

mitral stenosis
aortic stenosis

aetiologies:
- chronic valvular injury
- rheumatic valvular disease

48
Q

what is mitral stenosis? what is it’s aetiology and what does it cause?

A

failure of valve between left atrium and left ventricle to close properly
- caused by rheumatic fever

causes:
obstruction to left atrium
- pulmonary congestion
- right ventricular hypertrophy
- right sided heart failure

49
Q

define regurgitation/incompetence/insufficiency, what are the two types?

A

failure for valves to close fully and there is flow reversal

mitral regurgitation
aortic regurgitation

50
Q

where are the papillary muscles?

A

in the ventricles of the heart

51
Q

how can mitral regurgitation occur (5) ? what does it lead to? how can it be treated?

A
  • calcification of the valve ring
  • fibrous scarring - from IHD
  • papillary muscle rupture
  • endocarditis
  • mitral valve prolapse

leads to pan systolic murmur

treated by valve replacement

52
Q

how does aortic regurgitation occur?

A
  • dilation of the ascending aorta
  • endocarditis
  • syphilis
  • rheumatoid arthiritis
53
Q

what are effects of abnormal valve function, what is the overall name for it?

A

valvular heart disease

abnormal blood flow
clot formation
risk of infection

54
Q

what happens if the valve injury is acute?

A

can lead to sudden death

55
Q

what happens if the valve injury is chronic and progressive?

A

leads to heart failure

YR 3 - Illness and Wellbeing (31 decks)

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