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B2. Cardiovascular System > Valvular and Ischemic Heart Disease - Therapy > Flashcards

Valvular and Ischemic Heart Disease - Therapy Flashcards

1
Q

What are some causes of cardiac ischaemia?

A

Atherosclerosis

Embolism

Coronary thrombosis

Airtuc dussection

Arteritides

Congenital

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2
Q

What is aortic dissection?

A

Tear in the wall of the aorta

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3
Q

What is a tear in the wall of the aorta called?

A

Aortic dissection

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4
Q

What are some manifestations of ischaemic heart disease?

A

Angina

Myocardial infarction

Arrythmias

Chronic heart failure

Death

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5
Q

What is arrythmias?

A

Irregular heart beat

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6
Q

What is irregular heart beat called?

A

Arrythmias

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7
Q

What are indications for coronary artery bypass grafting (CABG)?

A

Symptomatic

Prognostic

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8
Q

What does CABG stand for?

A

Coronary artery bypass grafting

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9
Q

What is coronary artery bypass grafting (CABG)?

A

Surgical procedure used to treat coronary heart disease by diverting blood around a narrowed or clogged part of arteries to improve blood flow to the heart

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10
Q

What is a surgical procedure used to treat coronary heart disease by diverting blood around a narrowed or clogged part of arteries to improve blood flow to the heart called?

A

Coronary artery bypass grafting (CABG)

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11
Q

What is used for the seleciton of patients for CABG?

A

Adequate lung function

Adequate mental function

Adequate hepatic function

Descending aorta okay

Distal coronary targets okay

Left ventricle ejection fraction (LV EF) > 20%

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12
Q

What does LV EF stand for?

A

Left ventricle ejection fraction

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13
Q

What are contraindications for CABG?

A

Reversed suphenous vein

Internal mammary arteries

Radial arteries

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14
Q

What is sternotomy?

A

Surgical procedure in which a verticle incision is made along the sternum, after the sternum itself is divided

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15
Q

What is the surgical procedure in which a verticle incision is made along the sternum, after the sternum itself is divided called?

A

Sternotomy

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16
Q

What are sternotomy related problems?

A

Wire infections

Painful wires

Sternal dehiscence

Sternal malunion

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17
Q

What is sternal dehiscence?

A

Process of seperation of the body sternum

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18
Q

What is the process of seperation of the body sternum called?

A

Sternal dehiscence

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19
Q

What is sternal malunion?

A

Sternal pain with clicking and/or instability for more than 6 months in the absence of infection

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20
Q

What is sternal pain with clicking and/or instability for more than 6 months in the absence of infection called?

A

Sternal malunion

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21
Q

What are some possible post-operative problems in cardiac surgery?

A

Cardiac tamponade

Death

Stroke

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22
Q

What is cardiac tamponade?

A

Clinical syndrome caused by the accumulation of fluid in the pericardial space resulting in reduced ventricular filling

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23
Q

What is a clinical syndrome caused by the accumulation of fluid in the pericardial space resulting in reduced ventricular filling?

A

Cardiac tamponade

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24
Q

What are the primary features of cardiac tamponade?

A

Raised central venous pressure

Raised heart rate

Low blood pressure

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25
Q

What are the secondary features of cardiac tamponade?

A

Oliguria

Increased oxygen requirements

Metabolic acidosis

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26
Q

What is oliguria?

A

Urine output less than:

1mL/kg/hr in infants
0.5mL/kg/hr in children
400 or 500ml/24 hours in adults

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27
Q

What is the treatment of tamponade?

A

Chest re-opening

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28
Q

What are the long term outcomes post CABG?

A

50% have no further cardiac problems 10 years later

5% may require a repeat CABG

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29
Q

What is the most common valve surgery in adults?

A

Mitral and aortic

30
Q

What is the most common valve surgery in children?

A

All 4

31
Q

What are some causes of valvular heart disease in adults?

A

Degenerative

Congenital

Infective

Inflammatory

Left ventricle or right ventricle dilation

Trauma

Neoplastic

Paraneoplastic

32
Q

What are 3 common valve problems requiring surgery?

A

Senile tricuspid aortic stenosis

Bicuspid aortic stenosis

Degenerative mitral regurgitation

33
Q

What is rheumatic fever related to?

A

Steptococcal infection

34
Q

What does rheumatic fever lead to?

A

Pancarditis

35
Q

What is the treatment of rheumatic fever?

A

Aspirin and bed rest

36
Q

What is the most common heart problem worldwide?

A

Rheumatic heart disease

37
Q

What is endocarditis?

A

Infection of the endocardium

38
Q

What is infection of the endocardium called?

A

Endocarditis

39
Q

What are the 2 most common organisms to cause endocarditis?

A

1) Strep virdans
2) Staph aureus

40
Q

What gives rise to subacute bacterial endocarditis?

A

Strep virdans

41
Q

What gives rise to acute bacterial endocarditis?

A

Staph aureus

42
Q

Is the chances of curing endocarditis higher with antibiotics when it is caused by strep virdans or staph aureus?

A

Strep virdans

43
Q

What are indications for surgery in endocarditis?

A

Severe vavular regurgitation

Large vegetations

Persistance pyrexia

Progressive renal failure

44
Q

What is to be given after surgery for endocarditis?

A

Antibiotics by IV for 6 weeks post-operatively

45
Q

What is aortic stenosis?

A

Narrowing of the aortic valve opening

46
Q

What does aortic stenosis typically present in?

A

Heart failure

Angina

Syncope epidoses

Asymptomatic incidental finding

47
Q

What is the murmur like in aortic stenosis?

A

Easily heard

48
Q

What investigations are done for aortic stenosis?

A

ECG

ECHO

49
Q

What treatment is done for severe aortic stenosis?

A

Aortic valve replacement

50
Q

What is aortic regurgitation?

A

Leaky aortic valve causing backflow of blood

51
Q

What does aortic regurgiation present as?

A

Heart failure

Angina

Asymptomatic incidental finding

52
Q

What is the murmur due to aortic regurgitation like?

A

Hard to hear

53
Q

What is the relationship between the severity of aortic regurgitation and the loudness of the murmur?

A

The louder the mumur the more severe the aortic regurgitation

54
Q

What is the treatment for severe aortic valve regurgitation?

A

Aortic valve replacement

55
Q

What is mitral stenosis?

A

Narrowing of the mitral valve

56
Q

What is the murmur due to mitral stenosis like?

A

Hard to hear

57
Q

What may the patient have to do to hear the murmur due to mitral steonsis?

A

Exercise

58
Q

When is surgery used to treat mitral stenosis?

A

When mitral valve area is less than 1.5cm2 on ECHO

59
Q

What is mitral regurgitation?

A

Leaking of the mitral valve causing backflow of blood

60
Q

What is severe mitral regurgitation associated with?

A

Left ventricular and left atrial dilation

Onset of atrial fibrillation

Pulmonary hypertension

61
Q

What is the treatment for severe mitral regurgitation?

A

Mitral valve replacement

62
Q

What is severe mitral regurgitation on ECHO characterised by?

A

Blood flow reversal in pulmonary veins

63
Q

What is a cardiopulmonary bypass?

A

Technique in which a machine takes over the function of the heart and lungs during surgery

64
Q

What is a technique in which a machine takes over the function of the heart and lungs during surgery?

A

Cardiopulmonary bypass

65
Q

What happens during a caridopulmonary bypass?

A

Blood drained from right atrium and returned to the ascending aorta

66
Q

What is the maximum time of cardiopulmonary bypass?

A

12 hours

67
Q

What is a common problem with cardiopulmonary bypass?

A

Coagulopathy

68
Q

What are different choices of heart valve replacements?

A

Biological valve

Mechanical valve

69
Q

What is the advantage and disadvantage of a biological valve replacement?

A

No warfarin required but the valve wears out after 15 years

70
Q

What is the advantage and disadvantage of mechanical valve replacement?

A

Warfarin required for life but valve lasts for more than 40 years

71
Q

When is repair of the valve better than replacement?

A

For the mitral valve

B2. Cardiovascular System (41 decks)

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