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cardiovascular system > Valvular and Ischaemic Heart Disease > Flashcards

Valvular and Ischaemic Heart Disease Flashcards

1
Q

Causes of Cardiac Ischaemia (6)

A
  • Atherosclerosis
  • Embolism
  • Coronary thrombosis
  • Aortic dissection
  • Arteritides- rheumatic arteritis generalized inflammation of arterioles and arterial capillaries occurring in rheumatic fever
  • Congenital
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2
Q

Manifestations of IHDx (5)

A
  • Angina
  • MI
  • Arrythmias
  • Chronic heart failure
  • Sudden death
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3
Q

Dangerous patterns of coronary artery disease (2)

A
  • Left main stem stenosis

* 3-vessel coronary artery disease

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4
Q

Indications for coronary artery bypass grafting (2)

A
  • Symptomatic (any CAD pattern)

* Prognostic (LMSS, 3VDx) Left main stem

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5
Q

Selection of patients for CABG (6)

A
  • Adequate lung function
  • Adequate mental function
  • Adequate hepatic function
  • Ascending aorta OK
  • Distal coronary targets OK
  • LV EF >20%
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6
Q

Conduits for CABG

A
  • Reversed saphenous vein (lower leg)
  • Internal mammary arteries (thorax)
  • Radial arteries (arm)
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7
Q

What is a sternotomy

A

vertical inline incision is made along the sternum after which the sternum itself is
divided or cracked

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8
Q

Problems related to sternotomy (4)

A
  • Wire infection
  • Painful wires
  • Sternal dehiscence
  • Sternal malunion
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9
Q

Post-op problems in cardiac surgery (3)

A

Cardiac tamponade
Death
Stroke

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10
Q

Primary features of tamponade (3)

A

Raised CVP
Raised HR
Low BP

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11
Q

Secondary features of tamponade (3)

A

Oliguria
Increased oxygen requirements
Metabolic acidosis

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12
Q

Treatment for tamponade

A

Re-opening chest

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13
Q

Valvular heart disease in adults is mainly

A

Aortic and mitral valve surgery

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14
Q

Valvular disease in children is

A

All four valves operated with equal frequency

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15
Q

Causes of Valvular Heart Disease in Adults (8)

A
  • Degenerative
  • Congenital
  • Infective
  • Inflammatory
  • LV or RV dilatation
  • Trauma
  • Neoplastic
  • Paraneoplastic
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16
Q

Rheumatic fever is related to what organism

A

Streptococcal infection

17
Q

What is the hallmark pathology of rheumatic fever

A

Pancarditis

18
Q

Signs of rheumatic fever (3)

A

ASO titre- blood test to measure antibodies against streptolysin O, a substance produced by group A streptococcus bacteria
Skin and joint manifestations
Sydenham’s chorea/ St Vitus’ dance

19
Q

What is rheumatic fever treated with

A

Aspirin and bed rest

20
Q

What is the commonest cause of IE

A

Strep viridans

21
Q

What is the second commonest cause of IE

A

Staph aureua

22
Q

What is more easier to treat with antibiotics NVE or PVE

A

NVE

23
Q

Which infection has a higher chance of being cure Staph. viridans or Staph. aureus

A

Staph viridans

24
Q

Indications for surgery in endocarditis (4)

A 
•	Severe valvular regurgitation
•	Large vegetations
•	Persistent pyrexia
•	Progressive renal failure
•
25
Q

What is the treatment for endocarditis post-operatively

A

Antibiotics given IV for 6 weeks post-operatively

26
Q

Aortic stenosis typically presents as (4)

A

Heart failure
Angina
Syncopal episodes
Incidental

27
Q

Murmur in aortic stenosis

A

Usually heard

28
Q

What differentiates aortic stenosis from aortic sclerosis

A

Loss of aortic S2 sound

29
Q

Aortic regurgitation typically presents with (4)

A

Heart failure
Angina
Syncopal episodes
Incidental

30
Q

Murmur in aortic regurgitation is

A

difficult to hear

31
Q

What is severe MR associated with

A

LV and LA dilatation
Onset AF
Pulmonary hypertension

32
Q

What can be seen in the ECHO during mR

A

Systolic blood flow reversal in the pulmonary veins

33
Q

Features of a Cardiopulmonary Bypass

A

Blood drained from RA and returned to ascending aorta

34
Q

Max time for CPB

A

12 hours

35
Q

Maximum cardiac ischaemic time

A

6 hours

36
Q

Common problems with CPB machines

A

Coagulopathy

Air embolism

37
Q

Biological valve

A

no warfarin requires but the valve wears out after 15 years

38
Q

Mechanical

A

warfarin required for life. Valve lasts for >40 years

39
Q

What is better replacement or repair of valve for mitral valve

A

Repair

cardiovascular system (42 decks)

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