SP3: Heart Diseases Flashcards
What is Ischaemic heart disease (IHD)?
Spectrum of disorders resulting from an imbalance between myocardial need for oxygen and adequacy of supply
What causes 95% of IHD?
95% of IHD caused by atheroma of the coronary arteries
Plaque
Name some risk factors of IHD
- Hypertension
- Hyperlipidaemia
- Smoking
- Diabetes mellitus
- Age
- Gender
- Familial predisposition
- Obesity
- Insufficient exercise
What are some complications of IHD? (6)
- Calcification
- Rupture of plaque
- Ulceration
- Haemorrhage
- Thrombosis
- Aneurysm
What are some clinical syndromes linked with IHD?
- Sudden death
- Myocardial infarction
- Angina
- Chronic IHD
What is the cause of sudden cardiac death?
Due to artheroma with complicated plaque. Death is usually due to arrhythmias (irregular heart beat)
When do symptoms of stable angina occur?
Occurs after exercise
What could unstable angina potentially progress to?
May progress to MI or sudden death
How can central chest pain due to stable angina be relieved?
By rest or vasodilators
What are the two types of acute myocardial infarction?
- Transmural
- Subendocardial
What causes a transmural infarction?
Arterial occlusion
Where does a transmural infarction take place?
Across the whole thickness of myocardium
Where does a subendocardial infarction take place?
Confined to the inner third of the ventricle and well defined area
What causes a subendocardial infarction?
Caused by rapid lysis of occlusive thrombus
What is the site of infarct for;
Massive anterolateral MI
Left Main coronary artery
What is the site of infarct for;
Anteroseptal MI
Left anterior descending coronary artery
What is the site of infarct for;
Lateral MI
Left circumflex coronary artery
What is the site of infarct for;
Posterior/inferior MI
Right coronary artery
What are some short term complications of IHD? (6)
- Sudden death
- Cardiac rupture
- Septal rupture
- Papillary muscle failure
- Pericarditis
- DVT
What are some long term complications of IHD? (5)
- LV failure
- Aneurysm
- Dressler’s syndrome
- Recurrent infarction
- Sudden death
What is stenosis?
Failure of valve to open fully preventing forward flow
What is valve regurgitation?
Failure of valve to close allowing backward flow
What is infective endocarditis?
Colonisation of heart valves by infectious agent
What are some diseases that increase your chances of developing IE?
- Congenital heart disease
- Rheumatic heart disease
- Artificial valves
- Floppy mitral valve/calcified aortic valve
- Immunodeficiency
- Immunosuppression
- Intravenous drug abuse
What type of IE is someone with previous heart disease likely to develop?
Acute or subacute?
Subacute
Which IE has a higher mortality?
Acute or subacute?
Acute
IE in which side of the heart will affect the lungs?
Right side of the heart
What are some symptoms of Acute rheumatic fever? (6)
- Fever
- Migratory polyarthritis
- Pancarditis
- Subcutaneous nodules
- Erythema marginatum
- Sydenhams chorea
