Week 2 Flashcards
Rheumatic fever in childhood is important because of its association with _______________ disease
diabetes and dyslipidaemias because of their association with ____________ disease.
Smoking is a major risk factor for _________ disease.
Alcohol abuse predisposes to _________ and ________.
valvular heart ; coronary artery
coronary artery; cardiac arrhyth- mias and cardiomyopathy
____________,___________,___________, and ____________ are the most common causes of acute, severe chest pain.
Chronic, recurrent chest pain is usually caused by __________,_________,________,___________.
Myocardial ischaemia, pericarditis, aortic dissection and pulmonary embolism
angina, oesophageal reflux or musculoskeletal pain
Risk factors for cardiovascular disease
■
____________
_____________
_____________
________________
___________________
Smoking
hypertension
hypercholesterolaemia
diabetes
family history of premature vascular disease
Xanthomas are _______________________.
Xanthelasma are __________________________
lesions on the skin containing cholesterol and fats
a type of xanthoma appearing on the eyelids.
Causes of angina
Impaired myocardial oxygen supply
■ Coronary artery disease:
–_____________
– ________ in connective tissue disorders –_________________
■ Coronary artery ———-
■ Congenital coronary artery disease:
– _____________
– anomalous origin from pulmonary artery
■ Severe _________ or _________
atherosclerosis; arteritis; diabetes mellitus
spasm; arteriovenousfistula
anaemia or hypoxia
Causes of angina
Increased myocardial oxygen demand
■ __________________________ : caused by ______________,________,_____________
■ _______________________
Left ventricular hypertrophy
hypertension, aortic valve disease, hypertrophic cardiomyopathy
Tachyarrhythmias
Occasionally angina is provoked only by the first significant activity of the day, a phenomenon known as the ‘_______________’ due to myocardial _____________.
warm-up effect
preconditioning
Pericarditis causes _______ chest pain, which is _______ in character and aggravated by _________,____________ or postural changes.
central
Sharp
deep inspiration
cough
What differentiates STEMI from NSTEMI?
Presence of cardiac bio markers in STEMI
Aortic dissection produces severe _______ pain in either the ___________ of the chest.
tearing
front or the back
Aortic dissection
Typical patient
■ Middle-aged or elderly patient with a history of _________ or ___________
■ Occasionally younger patient with _________ disease (e.g. _________ )
hypertension or arteriosclerotic disease
aortic root
Marfan syndrome
Peripheral pulmonary embolism causes _______-onset sharp, ____________pain, ______________ and __________.
sudden
pleuritic chest
breathlessness
haemoptysis
Major, central pulmonary embolism presents with ________ and _______ pain that can be indistinguishable from ______________ pains and syncope
breathlessness
chest
ischaemic chest
Dyspnoea is an ___________________ occurring either at ___________ or __________________ .
abnormal awareness of breathing
rest or at an unexpectedly low level of exertion
Acute left ventricular failure
Major symptoms
■ Severe _________, _________, ___________, _________,_________
Major symptoms
■ Severe dyspnoea, orthopnoea, frothy sputum, cough, PND
NYHA classification
I
II
III
IV
Asymptomatic
Symptoms on normal exertion, e.g. walking up a flight of stairs
Symptoms on minimal exertion, e.g. getting dressed
Symptoms at rest
Exertional fatigue is an important symptom of heart failure and is particularly troublesome towards the __________
end of the day
Cardiovascular disorders produce dizziness and syncope by _____________, resulting in abrupt _____________.
transient hypotension
cerebral hypoperfusion
Recovery from cardiovascular syncope is usually ______, unlike with other common causes of syncope (e.g. stroke, epilepsy, overdose)
rapid
In _______________ heart disease, clubbing is not present at birth but develops during infancy and may become very marked. ______________ is the only other cardiac cause of clubbing
congenital cyanotic
Infective endocarditis
Cardiac causes of cyanosis ?
Heart failure
Pulmonary edema
Congenital heart disease
Subcutaneous oedema that pits on digital pressure is a cardinal feature of _______________, a cardiac condition .
congestive heart failure
pericardial effusion (_______________)
thickened pericardium ( _______________ )
cardiac tamponade
pericardial constriction
A reduced or absent pulse indicates an obstruction more _________ally in the arterial tree, usually caused by _________________ or ______________ and less commonly by ______________ .
proxim
atherosclerosis or thromboembolism
aortic dissection
_________________ causes symmetrical reduction and delay of the femoral pulses compared with the radial pulses (‘radiofemoral delay’), a sign that should be looked for in younger patients with hypertension. Bruits from collateral vessels may also be heard over the back of such patients.
Coarctation of the aorta
In _____________, and less commonly in ______________, inspiration produces a paradoxical rise in the JVP (Kussmaul’s sign) because the ____________________________________
constrictive pericarditis
tamponade
increased venous return that occurs during inspiration cannot be accommodated within the constrained right side of the heart
A thrill is a ____________ whereas a heave can be a sign of ___________________.
palpable murmur
right ventricular hypertrophy
A thrill feels like a __________ and a heave feels like an abnormally _________________
vibration
large beating of the heart.
The diaphragm and bell of the stethoscope permit appreciation of _____- and _____-pitched auscultatory events, respectively.
high
low
Auscultation at the mitral valve
diaphragm (mitral ______________) and then bell (mitral _________)
regurgitation
stenosis
