The Heart & Heart Disease

Question 1

What is the HR for an average male?

Answer 1

60 - 80 bpm

Question 2

How does the heart contract?

Answer 2

SAN > electrical impulse > AVN > Bundle of His > contraction

Question 3

What are atheromas and how may they affect the heart?

Answer 3

Fatty deposits that narrow/block coronary arteries, restricts blood flow to heart (ischaemia). Initially more of a problem during exercise

Question 4

What is angina?

Answer 4

Heart pain because heart needs more blood for O2 demand during exertion. Pain goes after rest unless complete blockage/clot. If affected muscle completely deprived of O2 = MI

Question 5

How does the outcome of heart disease depend on blockage location?

Answer 5

• End of one of tiny branches of coronary artery = feeling of indigestion (silent MI), may only be detected on ECG
• Further up coronary artery = affect larger area of heart muscle and may cause cardiac arrest (heart stops)

Question 6

Where might the pain of angina be felt?

Answer 6

Chest, jaw, L arm or R because of the way nerves are distributed in chest wall

Question 7

Other angina symptoms?

Answer 7

Pressure in chest, indigestion, nausea, vomiting, sweating, shortness of breath, feeling dizzy/faint

Question 8

What is atrial fibrillation (AF)?

Answer 8

Sinus node fires erratic impulses causing atria to fibriallate > churns up blood as it goes through heart valves to ventricles. Major cause of complications/death due to clot formation.

Question 9

What is AF associated with?

Answer 9

Valvular and ischaemic heart disease, hypertension, heart failure, thyrotoxicosis, alcohol excess, acute infections

Question 10

What would you see on an ECG recording of a patient with AF?

Answer 10

Atria not beating properly so P wave doesn’t show up clearly - may appear as a fibrillatory line (series of small bumps)

Question 11

What is heart failure?

Answer 11

Heart can’t pump full amount of blood with each beat so can’t meet body’s needs. Common cause is heart disease (e.g. after MI or as a result of uncontrolled hypertension/complication of AF/valve disease)

Question 12

What can heart failure only definitely be diagnosed with?

Answer 12

ECG

Question 13

Symptoms of heart failure?

Answer 13

• Shortness of breath
• Foot and leg swelling
• Difficulty sleeping
• Swollen/tender abdomen
• Appetite loss
• Cough with frothy sputum
• Increase in urination at night
• Confusion/impaired memory