Week 6: Cardiovascular Conditions Flashcards

1
Q

What does the cardiovascular system consist of?

A

Heart, blood vessels and blood

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2
Q

What are the three main functions of the heart?

A

Transport, Protection, Regulation

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3
Q

Define myocardium

A

Muscle of the heart

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4
Q

Define ishaemia

A

Insufficent blood supply

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5
Q

Define infarction

A

Cell death due to ischaemia

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6
Q

Define atheroma

A

Fatty, calcified deposits

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7
Q

Define arteriosclerosis

A

Hardening of the arteries

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8
Q

Define atherosclerosis

A

Scaring and fatty, calcified deposits reduced blood flow and hardened arteries

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9
Q

What does ischaemia cause?

A

Angina

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9
Q

Define myocardial infarction

A

Damage

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10
Q

What is a STEMI?

A

An MI that shows elevation of the S-T segment on a heart trace

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11
Q

Define congestive heart disease

A

Due to disease the heart doesn’t pump properly, leads to mal-distribution of bodily fluids

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12
Q

Defie cardiac arrest

A

Heart stopped

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13
Q

What are some non cardiac causes of chest pain

A
  • musculoskeletal
  • oesophageal reflux
  • PE
  • pneumothorax
  • hiatus hernia
  • referred pain
  • pleurisy and other infections
  • hyperventilation syndrome
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14
Q

What are common causes of left side chest pain that are linked to the heart and vascular issues?

A
  • heart attacks
  • coronary artery disease
  • coronary artery dissection
  • pericarditis
  • hypertrophic cardiomyopathy
  • aortic dissection
  • aortic aneurysm
  • mitral valve prolapse
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15
Q

What are the 4 types of atherosclerosis?

A
  • atherosclerosis
  • sclerosis
  • atheroma
  • ischeamia
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16
Q

What are the predisposing factors of atherosclerosis?

A
  • increasing age
  • gender
  • hypertension
  • diabetes mellitus
  • obesity
  • excessive alcohol
  • stress
  • smoking
  • diet
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17
Q

What are acute coronary syndromes?

A

Sudden ischaemia disorders of the heart, represents a continuum of a similar disease process

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18
Q

What does active coronary syndromes include?

A
  • unstable angina
  • INSTEMI
  • STEMI
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19
Q

What does unstable angina, STEMI and INSTEMI, all have?

A

A sudden ischamia, cannot be differentiated in the first hours as all have the same initiating events

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20
Q

What are the initiating events of unstable angina, INSTEMI and STEMI?

A
  • plaque rupture
  • thrombus formation
  • vasoconstriction
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21
Q

Define ischaemia

A

A lack of oxygen with ST depression or T inversion

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22
Q

Define infarct

A

Death of tissue which may or may not show in the Q wave

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23
Q

Define injury

A

Prolonged ischaemia with ST elevation

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24
Q

What is angina pectoris

A

Insufficent blood flow to the heart muscle from narrowing of coronary artery may cause angina = ischaemia chest pain due to a build up of waste products (lactic acid and CO2) causing cramp

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25
Q

What is angina pectoris (chest pain) the most common symptom of?

A

Coronary artery disease

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26
Q

What are the three types of angina?

A
  • stable angina
  • unstable angina
  • variant angina
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27
Q

What is stable angina?

A

Angina that occurs in a regular pattern that is provoked by exertion or emotional stress

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28
Q

What is the maximum duration of stable angina?

A

15 minutes

29
Q

What causes stable angina?

A

A stable lesion in one of the coronary arteries

30
Q

What is unstable angina?

A

A significant acute coronary syndrome that indicated an obstruction that is less stable and that a thrombus may e beginning to form

31
Q

What may unstable angina proceed to?

A

Myocardial infarction

32
Q

What are the symptoms of angina?

A
  • pain behind the sternum, spreading across the chest
  • pale and sweaty
  • pain in neck, throat, jaw, armpit, down arms
  • heaviness on chest or arms
  • indigestion
33
Q

What is the basic structure for management of cardiovascular conditions?

A
  • full history
  • obs
  • cardio assessment
  • O2 if required
  • pain relief
  • 12 lead ECG
  • appropriate medicines
  • IV access
  • rapid transport
  • JRCALC
34
Q

What medication would you supply for angina?

A
  • GTN (systole above 90mmHg) every 5-10 mins
  • Morphine or IV paracetamol or entonox
  • oxygen
  • aspirin 300mg
35
Q

What is a myocardial infarction?

A

“heart attack”, the process of causing death or damage to an area of the myocardium as a result coronary artery occlusion, generally due to a thrombus

36
Q

What is a STEMI?

A

When in an MI the full thickness of the myocardium is involved and ST elevation will occur

37
Q

What is a INSTEMI?

A

When in an MI only a partial thickness of the myocardium us involved, ST elevation will not generally occur

38
Q

What is the cause of a MI?

A

The coronary artery becomes completely blocked either by a thrombus or coronary artery spasm, with increasing ischaemia leading to infarction (tissue can no longer conduct electricity or pump)

39
Q

What are symptoms of a silent MI?

A
  • pulmonary oedema
  • confusion
  • hypotension
  • dyspnoea
  • palpitations
  • syncope or pre-syncope
  • general weakness
  • diabetic keto- acidosis
40
Q

What are the symptoms of an atypical MI?

A
  • musculoskeletal, positional or pleuritic features
  • often unilateral
  • may be described as sharp or stabbing
  • included epigastric discomfort
41
Q

Who is more likely to experience a atypical MI?

A

Females, diabetics, elderly

42
Q

What are the main symptoms for an MI?

A
  • severe central chest pain which can radiate to other body parts
  • crushing/heavy pain across chest
  • cool, grey, clammy to touch
  • coughing, wheezing, SoB
  • sense of impending doom
  • Levines sign
  • nausea/vomiting
43
Q

What is the medication for an MI?

A
  • aspirin 300mg
  • GTN 400mcg (systolic above 90mmHg) 5-10 mins
  • morphine, IV paracetamol or entonox
  • oxygen
44
Q

What is heart failure?

A

A condition resulting from the heart becoming an incompetent pump

45
Q

Why may a heart have an incompetent pump?

A
  • MI
  • myocardial disease
  • chronic hypertension
  • cardiac valvular disease
  • cardiomyopathy
46
Q

What is congestive heart failure?

A

The inability of the heart to supply adequate blood flow and oxygen to peripheral tissues and organs

47
Q

When does CHF occur?

A

When cardiac output decreases or/and the fluid backs up behind the failing ventricle

48
Q

What are the two components of CHF?

A
  • primary problem
  • compensatory mechanisms
49
Q

What are the primary causes of CHF?

A

Heart muscle damage, valve disease, abnormal rhythm

50
Q

What does heart failure result in?

A
  • heart ineffectively pumps blood through the circulatory system
  • excessive fluid accumulation in tissues and peripheries
51
Q

What occurs in heart failure LVF:

A

LV cannot pump out enough blood, pressure builds behind the left side of the heart, vessels are engorged with blood. serum is forced into alveolar spaces, fluid collects in lungs

52
Q

What is the cause of heart failure RHF?

A
  • primary disease of the right heart?
  • secondary to left heart failure
  • blood backs up behind RV, RA and systemic veins
  • cor pulmonale
53
Q

What are symptoms of LVF?

A
  • dyspnoea
  • tachypnoea
  • tachycardia
  • possible cyanosis
  • foamy blood-tinged sputum
  • noisy laboured breathing
  • rated or wheezes
54
Q

What are heart failure symptoms RHF?

A
  • listened neck veins
  • tachycardia
  • systemic oedema
  • swollen abdomen
  • liver discomfort
  • fatigue
  • weight gain
55
Q

What is shock?

A

Defined as inadequate tissue perfusion due to a real or apparent lack or lowering of circulatory bodily fluids

56
Q

What is the progression of shock?

A
  • compensated shock
  • decompensated shock
  • irreversible shock
57
Q

What are the causes of shock?

A
  • pump failure
  • no nervous control
  • fluid loss
  • no sympathetic tone
  • leaky blood vessels
58
Q

What are the 4 types of shock?

A
  • hypovolaemic
  • obstructive
  • disruptive
  • cardiogenic
59
Q

Define hypovolaemic

A

No enough blood in vessels to distribute O2

60
Q

Define obstructive

A

Blood physically cannot reach target area

61
Q

Define disruptive

A

Tone of vessels affected and become floppy or leaky

61
Q

Dfine cardiogenic

A

SV X BPM = CO

62
Q

What is the physiological response to shock?

A

Release of chemical and vascular reaction:
- local vasoconstriction
- formation of a platelet plug
- coagulation
- growth of fibrous tissue into the blood clot that permanently closes and seals the vessel

63
Q

How would you calculate cardiac output?

A

Stroke vol x beats per min = cardiac output

64
Q

What is an aortic aneurysm?

A

The weakening of the artery wall

65
Q

What are some signs of an aortic aneurysm?

A
  • stomach/back pain
  • pulsating in the stomach
  • taring chest pain
  • cold/clammy/sweating/faint
  • unequal BP in arms
  • loss of consciousness
  • features of dissection
66
Q

Why are some causes/risks of aneurysms?

A
  • male and above 65
  • smoke
  • high blood pressure
  • high cholesterol
  • close relative who’s had aneurysm
  • atherosclerosis
  • COPD
  • marfan syndrome
67
Q

What is pericarditis?

A

The inflammation of the lining around your heart causing chest pain

68
Q

What are the symptoms of pericarditis?

A
  • sharp/stabbing chest pain
  • rub on auscultation
  • global elevation on ECG with PR segment depression
  • increased pain with coughing, inspiration, swallowing
  • worse when lying supine
  • relived by sitting forward
  • long duration
69
Q

What are common causes of pericarditis?

A
  • trauma
  • uraemia
  • myocardial infarction
  • other infections
  • rheumatoid, autoimmune etc
70
Q

What is the most common cause of pericarditis?

A

A viral infection such as the cold or flu