Valvular and IHD Therapy Flashcards
What are 5 different causes of cardiac ischaemia?
Atheroscelrosis Embolism Coronary thrombosis Aortic dissection Arteritides Congenital
What is arteritides?
Inflammation of an artery
What are commissures?
The places where the cusps of the valves meet
What is aortic dissection?
The intima and media of the aorta are ripped apart and blood enters the space
What are the manifestations of ischaemic heart diseases?
Angina MI Arrythmias Chronic heart failure Sudden death
What are two dangerous patterns of coronary artery disease?
L main stem stenosis
3 vessel coronary artery disease (LAD, L circumflex, RCA)
What are indications for coronary artery bypass grafting (CABG)?
Symptomatic (any CAD pattern)
Prognostic (left main stem stenosis, 3 vessel coronary artery disease)
What are requirements for CABG?
Adequate:
Lung function
Hepatic function
Mental function
Ascending aorta OK
Distal coronary arteries OK
LV EF>20%
What are the potential conduits used for CABG?
Reversed saphenous vein
Internal mammary arteries
Radial arteries
Name 3 post-op problems in cardiac surgery
Cardiac tamponade
Death
Stroke
What is a cardiac tamponade?
Build up of fluid or blood in the pericardial space
What are the primary features of cardiac tamponade (following cardiac surgery)?
Raised CVP
Raised heart rate
Low BP
What are the secondary features of cardiac tamponade following cardiac surgery?
Oliguria (low urine output)
Increased O2 demand
Metabolic acidosis
What can cardiac tamponade lead to if it becomes too severe?
Cardiac arrest
Which valves are most commonly operated on in adults?
Aortic and mitral
Which valves are most commonly operated on in children?
All four valves
List the causes of valvular heart disease in adults
Degenerative valves Congenital Infective Inflammatory LV or RV dilatation Trauma Neoplastic Paraneoplastic
What is rheumatic fever?
Cardiac inflammation and scarring triggered by streptococcal infections
It manifests into pancarditis, involving inflammation of the myocardium, endocardium, and epicardium
What is the clinical presentation of pancarditis?
Friction rub
Skin rash
Acute renal failure
St Vitus’ Dance
How is pancarditis treated?
Aspirin and bed rest
Which organism give rise to subacute bacterial endocarditis?
Strep viridians
Which organism give rise to acute bacterial endocarditis?
Staph aureus
Is endocarditis caused by staph. aureas or strep. viridans more likely to be cured?
Higher chance with strep viridian’s
What is the chance of survival of natural valve endocarditis with antibiotics alone?
90%
