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Cardiovascular system 16/17 > Therapy for valvular heart disease > Flashcards

Therapy for valvular heart disease Flashcards

1
Q

What can cause cardiac ischaemia?

A 
Atherosclerosis
Embolism
Coronary thrombosis
Aortic dissection
Arteritides (inflammed artery)
Congenital
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2
Q

How can cardiac ischaemia manifest?

A 
Angina
MI
Arrhythmias
CHF
Sudden death
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3
Q

Name the two most dangerous forms of CAD

A

Left main stem stenosis

3 vessel coronary artery disease

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4
Q

Name the indications for CABG

A

Symptomatic (any CAD pattern)

Prognostic (left main stem/3 vessel disease)

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5
Q

What is required of patients to undergo CABG?

A 
Adequate lung function
Adequate mental function
Adequate liver function
Ascending aorta is healthy
Distal coronary artery targets are healthy
LV ejection fraction >20%
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6
Q

What can be used to replace damaged vessels in CABG?

A

Reversed saphenous vein
internal mammary arteries
radial arteries

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7
Q

What procedure provides access to the heart and lungs?

A

Median sternotomy

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8
Q

What is a median sternotomy called if it is being reperformed for another surgery?

A

Resternotomy

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9
Q

State some sternotomy related problems

A

Wire infections
Painful wires
Sternal dehiscence (splitting)
Sternal malunion

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10
Q

What are some possible post-op complications in cardiac surgery?

A

Cardiac tamponade
Death
Stroke

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11
Q

What is cardiac tamponade?

A

Fluid build up in pericardium leading to compression of the heart

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12
Q

What are some symptoms of cardiac tamponade?

A 
Cariogenic shock
SOB
Weakness
Lightheadedness
Cough
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13
Q

What can cause cardiac tamponade?

A 
Cancer
Kidney failure
Chest trauma
Pericarditis
Connective tissue disease
Hypothyroidism
Aortic rupture
Following chest surgery
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14
Q

What are some clinical features of cardiac tamponade?

A 
Raised JVP
Increased HR
Low BP
Quiet heart sounds
Oliguria (low urine output)
Increased O2 demand
Metabolic acidosis
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15
Q

How do you treat cardiac tamponade?

A

Open chest and drain via pericardiocentesis

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16
Q

Which valves are more likely to be operated on in children?

A

All 4, as they are likely to be affected by a congenital abnormality

17
Q

Which valves are more likely to be operated on in adults?

A

Mitral or aortic, most affected by ageing and degeneration

18
Q

What can cause valve disease in adults?

A 
Degenerative
Congenital
Infective
Inflammatory
LV or RV dilatation
Trauma
Neoplasm
Paraneoplastic
19
Q

What are the 3 most common valve problems operated on in Aberdeen?

A

Senile tricuspid AS
Bicuspid AS
Degenerative MR

20
Q

What causes Rheumatic fever?

A

Group A Streptococcul infections

21
Q

What test is used for diagnosing rheumatic fever?

A

Anti-streptolysin O (ASO) titre - measures levels of antibodies for streptomycin O in the blood, a substance produced by group A streptococcus

22
Q

What is the hallmark signs of rheumatic fever?

A

Pancarditis (inflammation of the heart)
Skin and joint manifestations as well
Syndehams chorea/St Vitus’ dance

23
Q

What is the most common organism causing infective endocarditis?

A

Strep viridans

24
Q

What is the second most common organism causing infective endocarditis

A

Staph aureus

25
Q

When is surgery indicated in those with IE?

A 
Severe valvular regurgitation
Large vegetations
Persistent pyrexia
Progressive renal failure
Following full 6 week course of Abx
26
Q

What procedure is used to temporarily take over the function of the heart and lungs during surgery?

A 
Cardiopulmonary bypass (CPB) pump,
often called a heart-lung machine. Non-pulsatile flow, anticoagulation used throughout, induced hypothermia
27
Q

Where does a CPB take the blood out of the body?

A

Right atrium

28
Q

Where does a CPB return blood to the body?

A

Ascending aorta

29
Q

What are the pros and cons of a biological valve replacement versus a mechanical valve replacement?

A

Bio - no warfarin but lasts 15 years

Mech - lifetime warfarin but lasts >40 years

Cardiovascular system 16/17 (40 decks)

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