ischaemic heart disease

Question 1

describe postural hypotension e.g. syncope upon getting up

Answer 1

1. decreases VR due to gravity
2. decreased preload
3. decreased CO
4. decreased MAP
5. decreased cerebral perfusion

Question 2

describe nocturnal chest discomfort

Answer 2

• increased parasympathetic drive therefore ACh release, causing vasospasm when endothelium is damaged
• when lying down increased VR, increased work of breathing due to pulmonary congestion

Question 3

ECG changes associated with the consequences of vasospasm

Answer 3

• vasospasm gives ischaemic regions, where re-entry circuits may occur (triggered by DAD from SR Ca overload)
• ST elevation due to current of injury from ischemic tissue having abnormal RMP or AP

Question 4

what are some key cardiovascular risk factors

Answer 4

hypertension, obesity, smoker, family history, dislipidaemia, stress

Question 5

what can an echocardiogram test

Answer 5

• wall motion abnormalities
• myocardial scarring
• valve abnormalities

Question 6

side-effects of beta blockers

Answer 6

• fatigue
• reduced exercise tolerance (CO limited so can’t meet needs of exercising muscle)
• nightmares (cross BBB)

Question 7

correlation between anaemia and CO

Answer 7

elevated CO (&HR) at rest, to compensate for decreased O2 supply in anaemia 
  - by autonomic nervous tone

vO2 = Q * 1.33 * Hb (SaO2 - SvO2)