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Cardiovascular > Investigations of heart disease > Flashcards

Investigations of heart disease Flashcards

1
Q

What is the S1 heart sound?

A

Mitral and tricuspid valve closure

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2
Q

What is the S2 heart sound?

A

Aortic and pulmonary valve closure

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3
Q

What is the S3 heart sound?

A

In early diastole during rapid ventricular filling, normal in children and pregnant women, associated with mitral regurgitation and heart failure

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4
Q

What is the S4 heart sound?

A

‘Gallop’, in late diastole, produced by blood being forced into a stiff hypertrophic ventricle, associated with LV hypertrophy

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5
Q

Where can the apex beat be palpated?

A

5th left intercostal space and mid-clavicular line

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6
Q

What is responsible for the apex beat?

A

The left ventricle

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7
Q

What is the definition of stroke volume?

A

The volume of blood ejected from each ventricle during systole

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8
Q

What is the definition of cardiac output?

A

The volume of blood each ventricle pumps per minute (L/min)

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9
Q

What is the definition of total peripheral resistance?

A

The total resistance to flow in systemic blood vessels from beginning of aorta to vena cava

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10
Q

What is the definition of preload?

A

How much blood is in the ventricles before it pumps (end-diastolic volume)

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11
Q

What is the definition of afterload?

A

The pressure the left ventricle must overcome to eject blood during contraction

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12
Q

What is the definition of contractility?

A

The force of contraction and the change in fibre length

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13
Q

What is the definition of elasticity?

A

The myocardial ability to recover normal shape after systolic stress

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14
Q

Name 4 types of P wave abnormalities

A
  • Low amplitude
  • High amplitude
  • Broad notched ‘bifid’
  • Alternative pacemaker foci
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15
Q

Name 4 types of P wave abnormalities

A
  • Low amplitude
  • High amplitude
  • Broad notched ‘bifid’
  • Alternative pacemaker foci
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16
Q

What might cause low amplitude P wave abnormalities?

A
  • Atrial fibrosis
  • Obesity
  • Hyperkalaemia
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17
Q

What might cause high amplitude P wave abnormalities?

A

• Right atrial enlargement

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18
Q

What might cause broad notched ‘bifid’ P wave abnormalities?

A

• Left atrial enlargement

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19
Q

What might cause alternative pacemaker foci P wave abnormalities?

A
  • Focal atrial tachycardias

* ‘Wondering pacemaker’

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20
Q

Name 2 types of PR interval abnormalities

A
  • Prolonged

* Shorter

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21
Q

What might cause prolonged PR interval abnormalities?

A

Disorders if the AV node and specialised conducting tissue

22
Q

What might cause shorter PR interval abnormalities?

A
  • Often in younger patients

* In pre-excitation (Wolff-Parkinson-White)

23
Q

Name 3 types of QRS complex abnormalities

A
  • Broad QRS complexes
  • Small QRS complexes
  • Tall QRS complexes
24
Q

What might cause broad QRS complex abnormalities?

A

Ventricular conduction delay, bundle branch block (BBB)

25
What might cause small QRS complex abnormalities?
* Obese patient * Pericardial effusion * Infiltrative cardiac disease
26
What might cause tall QRS complex abnormalities?
* L ventricular hypertrophy (S wave in V1 and R wave in V5/6 >35mm) * Thin patients
27
Name 2 types of QT interval abnormalities
* Long QT | * Short QT
28
What might cause elevated ST segment abnormalities?
* Early repolarisation * MI * Pericarditis/myocarditis
29
What happens to the T wave defelection in bundle branch block?
Deflection is in the opposite direction to the QRS complex
30
What is the range of the normal heart rate?
60-100 BPM
31
What controls the normal heart rate?
The dominant pacemaker = the sinoatrial node
32
Name 6 common tachycardias
1. Atrial fibrillation (AF) 2. Atrial flutter (AFl) 3. Supraventricular tachycardia 4. Focal atrial tachycardia 5. Ventricular tachycardia (VT) 6. Ventricular fibrillation (VF)
33
Give 4 causes of bradycardia
1. Conduction tissue fibrosis 2. Ischaemia 3. Inflammation/infiltrative disease 4. Drugs
34
What is 1st degree AV heart block?
A simple prolongation of the PR interval which doesn't usually cause symptom or need treatment
35
Give 4 potential causes of 1st degree AV heart block
* Hypokalaemia * Myocarditis * Inferior MI * AVN blocking drugs e.g. β-blockers, CCB
36
What is 2nd degree AV heart block?
Electrical impulses sometimes fail to reach the lower heart chamber which can cause skipped beats
37
What are the 2 types of 2nd degree AV heart block?
Mobitz types 1 and 2
38
Outline characteristics of Mobitz type 1 heart block
* Beats skipped in a regular pattern * PR interval gradually increases until AV node fails completely and no QRS waves are seen then it starts over again * Symptoms not usually experienced
39
Outline characteristics of Mobitz type 2 heart block
* Beats skipped in an irregular pattern * Sudden, unpredictable loss of AV conduction and loss of QRS * Due to a loss of conduction in Bundle of His and Purkinje fibres * Can cause light headiness, dizziness and syncope
40
What is 3rd degree AV heart block?
* Aka complete heart block * Electrical impulses cannot pass from the atria to the ventricles * P waves are completely independent of QRS complex
41
Give 5 causes of complete heart block
1. Structural heart disease 2. IHD 3. Hypertension 4. Endocarditis 5. Lyme’s disease
42
What treatment can you give for complete heart block?
* Depends on aetiology * Permanent pacemaker * IV atropine
43
What are the characteristic shapes seen in a left bundle branch block ECG?
* ‘w’ shape in V1 | * ‘m’ shape in V6
44
What are the characteristic shapes seen in a right bundle branch block ECG?
* ‘m’ shape in V1 | * ‘w’ shape in V6
45
Describe the depolarisation that occurs in left bundle branch block
Septal depolarisation is reversed as impulse spreads to RV via R bundle branch then to LV via the septum
46
In right bundle branch block, why is the early part of the QRS complex unchanged?
The LV is still activated normally
47
What might be seen on an ECG of infarction or ischaemia?
* T wave flattening inversion * ST segment depression/elevation * Q waves changed in old infarction
48
What might be seen on an ECG in hyperkalaemia?
* Tall T waves * Flattening of P waves * Broadening of QRS * Eventual ‘sine wave pattern’
49
What might be seen on an ECG in hypokalaemia?
* Flattening of T wave | * QT prolongation
50
What might be seen on an ECG in hypercalcaemia?
QT shortening
51
What might be seen on an ECG in hypocalcaemia?
QT prolongation

Cardiovascular (5 decks)

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