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Cardiovascular > SOB > Flashcards

SOB Flashcards

1
Q

What is an ETT

A

exercise tolerance test

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2
Q

what does thalium show

A

metabolically active areas taking up more of it, perfusion defects, infarction (fixed defect), ischaemia (reversible defect)

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3
Q

what is the first treatement for a NSTEMI

A

thrombolysis

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4
Q

why is PO2 normal in anaemia

A

oxygen still in blood just not enough haemoglobin to carry it

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5
Q

what is haemodynamic instability

A

perfusion failure represented by clinical features of circulatory shock and advanced heart failure

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6
Q

what does a narrow QRS mean

A

SVT

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7
Q

what does a wide QRS mean

A

ventricular tachycardia

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8
Q

what are the factors contributing to production of shortness of breath

A

increased;

  • work of breathing
  • ventilatory drive

impaired resp muscle function

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9
Q

what can cause increased work on breathing

A

airflow obstruction (asthma, chronic bronchitis, tracheal obstruction)

decrease pulmonary compliance (pulmonary oedema, fibrosis)

restricted chest expansion (resp muscle paralysis)

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10
Q

what can cause increased resp drive

A

physiological dead space (ventilation-perfusion miss match e.g. infection, PE)

stimulation of resp centre

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11
Q

what are the chemical and neural stimulation of respiration

A

increased:

  • aterial hydrogen ion conc (metabolic acidosis)
  • arterial PacO2 (resp acidosis)
  • central arousal (anxiety, thyrotoxicosis)

decreased:
-aterial PaO2 via aortic, carotid and brain stem chemoreceptors (pneumonia, anaemia)

pulmonary j receptor (in lungs) discharge (pulmonary oedema)

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12
Q

what is after load

A

force against which left ventricle contracts to eject blood into systemic circulation

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13
Q

what can increase afterload

A

increased peripheral resistance- which can be raised by high blood pressure

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14
Q

what happens when the left side of the heart fails

A

the left atrial and left ventricular pressures rise. The increased left-sided
pressures (called preload) produce back pressure on the lungs and cause a rise
in pulmonary capillary hydrostatic pressure resulting in accumulation of fluid
in the interstitial and intraalveolar lung spaces: - a condition known as
pulmonary oedema

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15
Q

how is pulmonary oedema manifested clinically

A

varying degrees of shortness of breath

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16
Q

what causes orthopnoea

A

increased venous return caused by lying down

17
Q

what are the cardiac causes of SOB

A
  • MI (most common)
  • hypertension (leads to heart failure)
  • arrhythmia
  • valvular disease
  • cardiomyopathies: dilated, hypertrophic, restrictive
  • diabetes
18
Q

what are the main diagnostic investigations in heart failure

A

ECG (hypertrophy, MI), CXR, echo

19
Q

what investigations should be carried out for chest pain and in what order

A

ECG, bloods, CXR, ETT, (Thallium)

20
Q

list non cardiac causes of SOB

A
  • COPD
  • Pneumothorax
  • asthma
  • musculoskeletal
21
Q

what investigations should be carried out for breathlessness and in what order

A

ECG, CXR, bloods, Echo

22
Q

what investigations should be carried out for palpitations and in what order

A

ECG, 24 hour ECG, Echo

23
Q

what investigations should be carried out for murmurs and in what order

A

ECG, Echo

24
Q

what investigations should be carried out for IE and in what order

A

blood cultures, (serology if negative) echo

25
Q

what is the method of thallium perfusion scintigraphy

A
  • Radiolabelled isotope taken up by normally perfused
    myocardial cells.
  • Gamma camera counts radioactivity over the myocardium
  • Images taken at rest and after stress
  • Stress can be exercise or pharmacological
26
Q

what is a cardiac CT angiogram

A

special type of x-ray examination of the
heart that helps determine if fatty or Calcium deposits
have narrowed the patient’ coronary arteries.

27
Q

what are the pros and cons of CT angiography

A 
p- 
• Excellent cardiac anatomy depiction
• Non-invasive coronary arteries assessment
• Functional assessment
• Chamber assessment
• Looks at vessels and lungs
c-
• Significant radiation
• Resolution less than angiograms
• Contrast allergy/nephropathy
• Need special equipment/expertise
28
Q

what can be seen with echocardiography

A
  • chambers
  • valves
  • muscle walls
  • great vessels
  • blood flow
  • function of heart
29
Q

What X-Ray technique is used to visualise the coronary arteries and how is it carried out?

A

Coronary angiography

Catheter in radial/femoral arteries, inject dye and then x ray

Cardiovascular (34 decks)

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