2. Cardiovascular system (2) Flashcards
(28 cards)
Types of arrhythmia (5)
Ectopic beat Atrial fibrillation Atrial flutter Paroxysmal supraventricular tachycardia Ventricular tachycardia
Types of bleeding disorders (2)
Clotting factor disorders
Subarachnoid haemorrhage
Types of blood clots
Clots in catheters and lines
VTE
Stroke
Types of blood pressure conditions
Hypertension Hypertension associated with phaeochromcytoma (adrenal gland tumour) Hypertensive crises Pulmonary hypertension Hypotension and shock
Types of vascular disease
Peripheral vascular disease
Vein malformation
Describe the path of deoxygenated blood from the body to the supply of oxygenated blood to the body
Returns to the right atrium via the superior/ inferior vena cava
From the right atrium to the right ventricle via the tricuspid valve
From the right ventricle to the pulmonary artery via the pulmonary valve
From pulmonary artery to lungs where oxygenated
From the lungs to the left atrium via the pulmonary veins
From the left atrium to the left ventricle via the mitral valve
From left ventricle to aorta via aortic valve
From aorta, oxygenated blood supplied to body (returned via vena cava!)
Conduction system of the heart
Sinoatrial node is the pacemaker
Creates and action potential
Wave of excitation spreads across the atria, causing them to contract
On reaching the AV node, the signal is delayed
Then conducted in the bundle of HIs down the intervetricular septum
Bundle of His and Purkine fibres spread the wave impulses along the vetricles, causing them to contract
Conditions that affect the cardiovascular system
- Arrhythmias
- Clotting disorders
- Blood clots
- Blood pressure conditions
- Cardiovascular disease risk (+prevention)
- Heart failure
- Hyperlipidemia
- Myocardial ischaemia
- Oedema
- Vacular disease
What is an ectopic beat?
An extra or missed beat
What is an arrhythmia?
A condition in which the heart beats with an irregular or abnormal rhythm
What is atrial fibrillation?
Rapid and irregular beating of the atria
What is atrial flutter?
Rapid beating of the atria
What is paroxysmal supraventricular tachycardia (SVT)?
Heart suddenly beats much faster than normal. It can then slow down abruptly. Due to improper electrical activity in the upper part of the heart. Cause not known
Types of supraventricular tachycardias?
AF
Atrial flutter
Paroxysmal supraventricular tachycardia
Wolff-Parkinson White syndrome
Ventricular tachycardia
Regular, fast heart rate that arises from improper electrical activity in the ventricles of the heart
Ventricular fibrillation
Abnormal heart rhythm in which the ventricles of the heart quiver instead of pumping normally
Treatment for ectopic beats
Nothing if heart normal, reassure patient. If particularly troublesome, beta blockers sometimes effective.
Treatment for AF
- Assess for stroke and bleed risk: anticoagulate as appropriate
- Ventricular rate control (first line)
- Sinus rhythm control (2nd line)
- Paroxysmal
- Electrical cardioversion
- Pharmacological cardioversion
- Ablation strategy
- Pacemaker
Anticoagulation for AF patients
CHA2DS2-VASc and HAS-BLED used to assess
Warfarin
DOAC if non-valvular cause
Anticoags also indicated during cardioversion
Aspirin less effective than warfarin at preventing eboli - should not be offered as a monotherapy solely for stroke prevention in atrial fibrillation
Ventricular rate control treatment for AF patients
- Standard beta blocker (NOT sotalol)
- Rate limiting CCB
Only use digoxin if sedentary patient and not paroxysmal, as only works to control ventricular rate at rest
If don’t work as monotherapy, can use two in combination
Sinus rhythm control treatment for AF patients
If ventricular function diminished - beta blocker (licensed for HF) +digoxin
If post-cardioversion: standard beta blocker
If not effective, consider oral antiarrhythmic (sotalol, flecanid,e propafenone, dronedarone)
If necessary, start amiodarone (consider in atients with left ventricular impairmnet/ HF)
Treatment for paroxysmal AF
If symptomatic, control ventircular rate with a beta blocker.
If doesn’t work, an oral anti-arrhythmic drug e.g. dronedarone/ sotalol/ amiodarone can be given.
If infrequent episodes, ‘pill in hte pocket’ approach
Electrical cardioversion treatment for AF
Controlled electric shock to try and restore rhythm
Pharmacological cardioversion treatment for AF
Oral/ IV antiarrhythmic drug e.g. flecainide/ amiodarone
