Lung And Heart Flashcards
What are the three main types of lower respiratory infections, and what causes them?
Bronchitis, pertussis, and pneumonia are the main types of lower respiratory infections. They can be caused by viral, bacterial, or fungal pathogens that multiply on the epithelium. This causes inflammation and increased mucus secretion which may obstruct the airway.
What are some common symptoms of lower respiratory infections? How are they diagnosed?
Common symptoms include:
* Cough
* Shortness of breath
* Fever
* Generalized malaise
* Chest pain
Diagnosis is typically done through:
* Auscultation of the lungs
* X-ray
* CRP blood test
* Microbiological tests (e.g., sputum culture, PCR)
What is bronchitis and how is it treated?
Bronchitis is an inflammation of the bronchial tubes. Treatment typically involves rest, fluids, and cough suppressants
When can an athlete with bronchitis return to sport?
A physician should clear an athlete to return to sport after bronchitis. There is a lack of reliable studies to guide return to sport decisions for lower respiratory infections.
What is pertussis, and how is it spread?
Pertussis, also known as whooping cough, is a highly contagious, acute respiratory illness characterized by severe coughing episodes. It is a bacterial infection caused by Bordetella pertussis, and it is spread through droplets.
What are the complications of pertussis?
Pneumonia is a common complication of pertussis.
How is pertussis treated and prevented?
Pertussis is treated with antibiotics and supportive care such as rest and fluids. Cough mixtures and suppressants are not effective treatments. The best way to prevent pertussis is through vaccination. However, immunity from childhood vaccination wanes after 5-10 years.
Describe the three stages of pertussis.
Stage 1 (1-2 weeks): This stage is similar to a common cold with symptoms like a runny nose, low-grade fever, and a mild cough.
Stage 2 (1-10 weeks): This stage is characterized by intense coughing fits followed by a “whoop” sound during inhalation. Vomiting and exhaustion after coughing fits are common.
Stage 3 (2-3 weeks): This is the recovery phase where coughing fits gradually become less severe and less frequent.
What is pneumonia?
Pneumonia is an infection that inflames the air sacs in one or both lungs, which may fill with fluid.
What is a pneumothorax?
A pneumothorax occurs when air leaks into the space between the lung and chest wall, causing the lung to collapse.
What are the causes of a pneumothorax?
There are several causes of pneumothorax:
Spontaneous: Happens without an obvious cause, often in tall, young males.
Trauma: Caused by a chest injury or broken rib.
Damage from underlying disease: Certain lung diseases can increase the risk of pneumothorax.
What are the symptoms of a pneumothorax?
The primary symptoms are sudden chest pain and shortness of breath.
How is a pneumothorax diagnosed and treated?
Diagnosis is done through physical examination, chest x-ray, and CT scan. Treatment depends on the size of the pneumothorax:
* Small pneumothorax (<15%): Conservative treatment with weekly chest x-rays is the standard approach.
* Larger pneumothorax (>15%): A chest tube is inserted into the lung for re-expansion for several days.
When can an athlete with a pneumothorax return to sport?
Athletes should refrain from strenuous training until the pneumothorax is properly treated and resolved. They will need a repeat x-ray and physical examination before returning to sport, and the timeline for return will vary depending on the individual case.
What are the symptoms and signs of asthma?
** Asthma is characterized by:
* Wheezing (primarily during exhalation)
* Coughing, wheezing, and chest tightness during exercise
* Inflammation, increased mucus production, and airway narrowing
* Expiratory resistance and air trapping
How is asthma diagnosed?
- Medical history review
- Physical examination
- Allergy tests
- Pulmonary function tests
What are the different types of pulmonary function tests (PFTs) used to diagnose asthma?
Various PFTs help diagnose asthma:
* Spirometry: Measures airflow and how well air moves in and out of the lungs.
* Diffusing Capacity: Assesses how effectively oxygen and carbon dioxide are exchanged between the lungs and bloodstream.
* Bronchodilator Reversibility: Checks if lung function improves after inhaling a bronchodilator like albuterol.
* Exercise Testing: Used to diagnose exercise-induced asthma (EIA) or bronchospasm (EIB).
What are the two main categories of asthma treatment medications?
- Long-term control medications: These are taken daily to keep asthma under control. Examples include inhaled corticosteroids (e.g., fluticasone, budesonide), leukotriene modifiers (e.g., montelukast, zafirlukast), long-acting beta-agonists (e.g., salmeterol, formoterol), and combination inhalers.
- Quick-relief medications: These are used as needed to provide rapid, short-term symptom relief during an asthma attack. Examples include short-acting beta-agonists (e.g., albuterol, levalbuterol), ipratropium, and oral or intravenous corticosteroids.
What is the difference between exercise-induced asthma (EIA) and exercise-induced bronchospasm (EIB)?
- EIA occurs in people with underlying asthma, and exercise triggers or worsens their symptoms.
- EIB affects individuals without a history of asthma who experience bronchospasm specifically during exercise.
How is exercise-induced bronchospasm (EIB) treated?
- Short-acting beta-agonists are the primary treatment for EIB, taken 15-20 minutes before exercise.
- Long-acting beta-agonists have also shown effectiveness in treating EIB.
- Note: All β-agonists are prohibited by WADA except for salbutamol (albuterol) and salmeterol, which require a declaration of use. Other β-agonists need a Therapeutic Use Exemption (TUE).
- Warming up and humidifying the air using masks can also help, although this is not always feasible.
- Avoiding exposure to cold temperatures and pollutants is also recommended.
Describe the warm-up strategy for asthmatic athletes.
- Asthmatic athletes can benefit from inducing a “stress asthma reaction” 1-3 hours before competition to make their airways less responsive during the actual event.
- This can be achieved through high-intensity interval training (3-4 x 20-30 second sprints) or steadily increasing sport-specific activity for 5-30 minutes.
- A bronchodilator medication should be taken 15-60 minutes before competition.
What does the acronym PAC stand for, and what are its characteristics?
PAC stands for Premature Atrial Contraction. It is an early heartbeat where the P wave on an EKG changes, but the QRS complex usually remains normal. PACs can cause palpitations and are often caused by stress, caffeine, alcohol, fatigue, or underlying heart conditions. They are diagnosed through an EKG and treated with lifestyle modifications. Medications like beta-blockers may be prescribed if PACs are frequent and cause symptoms.
What is an echocardiogram, and what is it used for?
An echocardiogram, or “Echo,” is a non-invasive test that uses sound waves to create images of the heart. It provides information about the heart’s structure and function, helping diagnose and monitor various heart conditions.
What is athlete’s heart, and what are its signs?
Athlete’s heart refers to the normal structural and functional changes that occur in the heart due to regular athletic training. It involves an increase in left ventricle (LV) muscle mass, wall thickness, and chamber size to accommodate increased volume and pressure loads.
Signs of athlete’s heart include:
* Bradycardia (heart rate less than 60 bpm)
* Systolic murmur
* Extra heart sounds
* ECG/EKG abnormalities, such as ST changes
* Enlarged heart visible on an echocardiogram
Is treatment necessary for athlete’s heart?
No treatment is necessary for athlete’s heart as it is a benign condition resulting from physiological adaptation to exercise.
What is sudden cardiac death (SCD), and what are its key characteristics in athletes?
SCD is a rare event in which the heart suddenly and unexpectedly stops beating, leading to death. In athletes, it often occurs as the first indication of an underlying heart problem. Other characteristics of SCD in athletes:
* Male to female ratio of 2:1
* More common in high school age and slightly older athletes
* Occurs in approximately 0.75 per 100,000 athletes per year (three times higher than non-athletes)
What are the common causes of SCD in athletes of different age groups?
- Athletes under 35 years old: Genetic and acquired cardiovascular abnormalities are the usual culprits, including hypertrophic cardiomyopathy, commotio cordis, and myocarditis.
- Athletes 35 years and older: The majority of SCD cases are due to atherosclerotic coronary artery disease.
What is hypertrophic cardiomyopathy (HCM), and what are its characteristics?
** HCM is a genetic condition that causes thickening of the left ventricle (LV) wall. This thickening can obstruct blood flow and lead to ventricular tachycardia/fibrillation, increasing the risk of sudden cardiac death (SCD). Key characteristics of HCM:
* Estimated prevalence of up to 1 in 200
* Commonly affects competitive athletes between 13 and 30 years old who experience sudden death
* Not preventable due to its inherited nature, but early identification is crucial for treatment and preventing complications
What are the treatment options for hypertrophic cardiomyopathy (HCM)?
** HCM treatment aims to manage symptoms and reduce the risk of complications. Options include:
* Medications: Beta-blockers (e.g., propranolol, metoprolol) to slow the heart rate and reduce symptoms; blood thinners (e.g., warfarin, rivaroxaban) to prevent blood clots
* Surgery: Septal myectomy, an open-heart procedure to remove excess heart muscle, may be performed
* Implantable cardioverter-defibrillator (ICD): This device monitors the heart rhythm and delivers an electric shock if a life-threatening arrhythmia occurs
What is commotio cordis?
Commotio cordis is a rare and often fatal condition that occurs when a blunt impact to the chest during a specific point in the heart’s electrical cycle triggers a life-threatening arrhythmia .
What is myocarditis, and what are its common causes and symptoms?
** Myocarditis is inflammation of the heart muscle (myocardium), often caused by a viral infection (65% of cases).
* Viruses: Common culprits include Coxsackievirus (a type of enterovirus), adenovirus, and COVID-19. Around 5-19% of individuals with a viral infection may develop mild myocardial inflammation.
Symptoms of myocarditis can include:
* Chest pain
* Fatigue
* Shortness of breath
Myocarditis can disrupt the heart’s electrical system, impairing its pumping ability and potentially leading to arrhythmias. It also increases the risk of blood clots.
How is myocarditis diagnosed and treated?
Myocarditis is diagnosed using a combination of tests, including:
* Electrocardiogram (EKG)
* Echocardiogram (Echo)
* Blood tests
* Cardiac MRI
Treatment typically involves:
* Prolonged rest (around six months) to allow the heart to heal
* Medications to manage arrhythmias
What are the key screening methods for identifying athletes at risk of cardiac events?
A thorough screening process is essential for identifying athletes who may be at risk of cardiac events. This includes:
* Detailed history and physical examination
* Involvement of a multidisciplinary team to assess and flag potential concerns
Any abnormal findings during the history and physical exam, such as:
* Syncope (fainting)
* Exercise-related chest pain
* Heart rate irregularities
* Family history of cardiovascular diseases should prompt further investigation.
What is Marfan syndrome, and what are its common signs?
Marfan syndrome is a genetic disorder that affects the body’s connective tissues, leading to a wide range of potential signs and symptoms. Common signs include:
* Tall and slender build
* Long arms, legs, and fingers
* Long, narrow face
* High, arched palate and crowded teeth
* Sternum that either protrudes outward (pectus carinatum) or caves inward (pectus excavatum)
* Flexible joints
* Curved spine (scoliosis)
* High pressure in the eye (ocular hypertension or glaucoma)
* Cystic changes in the lungs
* Abnormal heart sounds
What are the cardiac and pulmonary risks associated with Marfan Syndrome?
Individuals with Marfan syndrome are at increased risk of:
* Cardiac problems: Cardiomyopathy, heart murmurs, mitral valve prolapse, aortic root dilation, and heart failure are potential concerns
* Pulmonary conditions: Recurrent spontaneous pneumothorax, asthma, pneumonia, bronchitis, and cystic lung disease are more common in people with Marfan syndrome
When can athletes with Marfan syndrome participate in sports?
Athletes with Marfan syndrome can participate in low-to-moderate static and low-dynamic competitive sports if they meet certain criteria:
* No aortic root dilation
* No moderate-to-severe mitral valve regurgitation
* No family history of sudden death in a relative with Marfan syndrome
It’s crucial for individuals with Marfan syndrome to be carefully
evaluated by a cardiologist to determine their eligibility for sports participation based on their individual cardiac health.
