Lecture 16 - Lung and heart Flashcards
Bronchitis
Pathology
- inflammation of the lining of bronchial tubes
- 90% are viral, sometimes bacterial
Bronchitis
Symptoms
- nasal congestion, runny nose, sore throat,mild cough
- increased coughing for more than 10 days, fever, fatigue, shortness of breath, tightness/pain in chest (burning)
Bronchitis
Diagnosis
- auscultation (rhonchi, wheezing)
- slight fever or may be afebrile
Bronchitis
Treatment
- suspension of training
- adequate hydration
- cough supressant
- asthma inhalers
- NSAIDS, nasal decongestants
if cough > 3 weeks alternative diagnosis should be considered
Bronchitis
RTS
- acute usually lasts 3-10 days, dry cough may last longer
- once symptoms resolve, return to low levels of activity gradually
Pertussis (whooping cough)
Pathology
- highly contagious accute respiratory illness
- severe spasmodic caughing episodes
- bacterial
- transmission by droplets
- incubation 5-10 days
- stage 1 - 1-2 weeks
- stage 2 - 1-10 weeks
- stage 3 - 2-3 week
Pertussis (whooping cough)
Complications
pneumonia
Pertussis (whooping cough)
treatment
- antibitotics
- rest
- fluids
Pertussis (whooping cough)
Prevention
vaccine
Pneumonia
Pathology
- viral, bacterial or fungal invection that inflames the air sacs in one or both lungs (they fill with fluid or puss)
Pneumonia
Symptoms
- persistent cough
- fever, chills, night sweats
- shortness of breath, chets pain, cyanosis
- headaches, muscle ache
- fatigue
- confusion
Pneumonia
Diagnosis
- physical examination
- x-ray
- lab test (PCR sputum culture)
Pneumonia
Treatment
- antibiotics/antivirals/antifungals
- rest
- fluids
- pain managemnet
- cough supressant
- oxygen therapy
Pneumothorax
Pathology
- air leaks into the space between the lung and the chest wall causing lung to collapse
Pneumothorax
Causes
- spontaneous (tall, male athletes)
- trauma
- damage from underlying disease
Pneumothorax
symptoms
sudden chest pain and shorntess of breath
Pneumothorax
diagnosis
- physical examination
- chest-x-ray
- CT scan
Pneumothorax
treatment
- small (less than 15%) –> conservative treatment with weekly x-rays
- large (>15% of lung space) –> chest tube in lung for reexpansion for several days
What is asthma?
reversible airway diseas charcterized by airway narrowing and inflammation
Asthma
pathology
- inflammation, increases mucous production, airway narrowing
- expiratory resistance and air trapping
Asthma
Diagnosis
- medical history
- physical axamination
- allergy tests
- pulmonary function tests
What are the 4 pulmonary function tests?
- spirometry
- diffusing capacity
- bronchodilator reversibility
- exercise testing
Asthma
Treatment
long term (day to day)
- inhaled corticosteroids
- leukotrien modifiers
- long-acting beta agonist
- comibination inhalers
short term (asthma attacks)
- short acting beta agonists
- ipratropium
- oral and IV corticosteroids
What is exeercise induced asthma (EIA)?
patients who have underlying asthma where exercise exacerbates it
What is exercise induced bronchospasm (EIB)?
bronchospasma associated with exercises, no history of asthma)
What is the difference in diagnosis between EIA and EIB?
EIA:
- pulmonary tests
- history of asthma
- bronchodilator response
EIB:
- exercises challenge tests
- spirometry
- cold air test
What is the P wave?
atrial contraction
What is the QRS wave?
ventricular contraction
What is the T wave?
recovery of ventricles
What is tachycardia?
> 100bpm
What is bradycardia?
<60bpm
What is premature atrial contraction (PAC)?
early beat, P wave changes, QRS is normal
PAC
symptom
palpitations
PAC
Causes
- stress
- caffeine
- alcohol
- fatigue
- underlying heart conditions
How do we diagnosis PAC?
EKG
PAC tratement:
- lifestyle modifications
- medication (if needed)
What is athletes heart?
Normal structure and function changes that occur with routine athletic training
VOlume and pressure laods in the LV increase –> increase LV muscle mass, wall thickness, chamber size
What does athletes heart cause?
- maximal SV and CO output
- lower resting HR and longer diastolic filling time
- systolic and dyastolic function remain normal
What might physical examination of someone with athletes heart reveal?
- bradycardia
- systolic murmur
- extra heart sounds
Are males or females more likely to die from sudden cardia death?
males (male to female 2:1)
Is risk SCD higher in athletes?
yes, 3x more
What are some causes of SCD?
- hypertrophic cardiomyopathy, commotio cordic, myocarditis
What does screening entail for SCD?
- multidisiplinary team to flag at-risk athletes
- abnormal findingds on history and physical exams require furtehr investigation (syncope sysmptoms, exercise related chest pain, HR irregularity, family history of CVD)
What is hypertrophic cardiomyopathy?
- genetic condition (inherited and can’t be preventedz)
- LV hypertophy which casn lead to ventricular tachycardia/fibrillation and SDC
Hypertrophic cardiomyopathy treatment
- indentify early
- beta blockers
- blood thinners
- surgery
- implantable cardioverter-defribrillator
What is commotio cordis?
blunt chest trauma over heart that causes SDC
- hit in chest just before T wave
- electrical incident with ventricular febrillation
tretament: chest protectors
Myocarditis
pathology
- inflammation of heart muscle
- viral (65%) or other causes such as covid
Myocarditis
Symptoms
- chets pain, fatigue, shortness of breath
- cna affect hearts electrical system reduciong hearts ability to pump causing arrhythmias
- increased risk of blood clot
Myocarditis
Diagnosis
- EKG
- chest echo
- blood tests
- cardiac MRI
Myocarditis
Treatment
- prolonged period of rest
- medication for arrythmias
What is marfan syndrome?
genetic disorder that effects connective tissues
Signs of marfan syndrome:
- tall, slender build
- long leges, arms and fingers
- long narrow face
- high arches, crowded teeth
- sternum caves in or out
- flexible joints
- curved spine
- high pressure in eyes
- cystice change sin lungs
- abnormal heart sounds
What is the stimated prevalence of marfan?
1:5000
What doe marfan increase the risk of?
cardiac problems:
- cardiomyopathy
- heart murmur
- mitral valve prolapse
- aortic root dilation
pulmonary conditions
- recurent sponatneous pneumothorx
- asthma
- pneumonia
- bronchitis
- cystic lung changes
How can we detect an infection?
CRP test ( <3mg/L is normal, more means infection)
