Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DEN303 - IHD > Cardiovascular Disease > Flashcards

Cardiovascular Disease Flashcards

Why know anything about cardiovascular disease? Questions you should ask when faced with cardiovascular disease What are the cardiovascular diseases you might encounter? What are the symptoms and signs of cardiovascular disease? (will expand on this in clinical session) How are these conditions investigated and treated? What are the specific considerations for dentists?

1
Q

Chest pain

A

Angina/MI
GTN spray
Makes veins dilate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Tachycardia

A

Palpitations/breathlessness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Heart failure

A

Breathlessness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Bradycardia

A

Dizziness/fatigue/N

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Endocarditis

A

Usually treated outside of surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Questions to ask

A

Tolerant of Tx?
Will Tx complicate the condition? - very rarely - bleeding risk
Tell anyone about cardiac symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Myocardial issue

A

Heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Valve malfunction

A

Heart failure/endocarditis if infected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Conduction malfunction

- consequences

A

Arrhythmia (tachycardia, bradycardia, sudden death)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Coronary blood supply failure

A

Angina, myocardial infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Heart failure caused by

Common causes

A

Any conditions affecting efficiency of pump –> reduced cardiac output
Previous MI, hypertension, genetic causes, drugs and idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Assessment of pump fx

A 
Transthoracic echocardiography (ultrasound) 
Allows for viewing of valves and ventricles and pick up on heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Symptoms of heart failure

A

Breathlessness after little exercise
Swelling
Dizziness, tiredness and weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Heart failure mechanism

A

Reduced cardiac output increases fluid pressure in lungs (L heart failure)
Venous returns to heart via VC its reduced (R heart failure)
Fluid retention and vasoconstriction results

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clinical signs of heart failure

A 
Low BP
High pulse
Crepitations in lungs 
Raised jugular venous pressure
Pitting ankle oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Valves can become

and causes of it

A 
Regurgitant or stenosed
Same symptoms as heart failure  
Degeneration (ie it just happens)
Rheumatic fever
Congenitally abnormal valve
Endocarditis
Papillary muscle rupture after MI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Vascular stenosis

A

Valve becomes thicker and stiffer and doesn’t open sufficiently

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Infective endocarditis
Most likely in?
Range of possible organisms

A

Systemic infection (night sweats, fever, rigors, weight loss)
Infection lumps moving through blood stream –> VEGETATIONS –> embolic complications
Valves eaten away - regurgitation and heart failure
Artificial valves, abnormal valves, elderly, IV drug abusers and previous endocarditis
Streptococcal or staphlococcal

19
Q

Infective endocarditis causes

A

Cerebral abscesses
Digital emboli
Retinal emboli
Aortic and mitral vegetation

20
Q

Arrhythmia

A

Rhythm examined by ECG <60 >100

21
Q

P waves

A

Atria depolarise

22
Q

QRS

A

Ventricles depolarising

Further apart = slower heart rate

23
Q

T

A

Ventricles repolarising

24
Q

Coronary artery disease
Two types
Left coronary artery divides into 2
Driven by?

A

Angina
Myocardial infarction
Lifestyle and genetic factors
Plaque build up in major arteries

25
Q

Risk factors for CAD

A 
Smoking
High cholesterol 
Hypertension 
Diabetes 
Obesity 
Poor diet
Lack of physical activity 
Other conditions 
Family history 
Genetics
Male sex 
Age
26
Q

Angina
Cause
Feeling

A

CAD becomes obstructive
Plaques are stable
Chest pressure/heaviness/pain/indigestion sometimes radiating to arm, neck and back
Almost always precipitated by stress/exertion when more blood supply is needed

27
Q

Unstable angina

A

Increased frequency, duration or onset at rest

Sign of risk of impending heart attack

28
Q

MI

A

Atherosclerotic plaque in a CA ruptures –> thrombus formation
Inflammatory cells in plaque which weaken it?
Permanent death of some myocardium

29
Q

When does MI occur?

A

Any time, rest, on exertion whilst asleep
Chest discomfort similar to angina
Rarely lasts more than 10 mins
MI can be fatal or lead to lifelong heart failure

30
Q

How to identify CAD?

A

Exercise ECG - easy but inaccurate by inducing ischaemia
Myocardial perfusion scan
Angiography either CT or invasion angio by injecting X ray dye

31
Q

CAD treatment

A 
Lifestyle modifications 
Statins
Anti platelet lowers MI risk 
other risk factors 
All improve prognosis not angina problems
32
Q

Cad treatment if causing angina

A 
Previous
Medicine to reduce attacks
NItrates/long acting tablets 
Beta blockers/Ca channel blockers 
Stenting or CA bypass if medication ineffective
33
Q

Investigations

A

ECG and serum troponin measurement
Death of cardiomyocytes results in raised troponin
ST elevation/non ST elevation - peak in ST segment

34
Q

Management of STEMI/NON STEMI

A 
Anti platelet therapy 
Anticoag for 24-72hr 
Both should have angiography and stenting if poss 
STEMI immed.
NSTEMI within 72 hrs 
MONA previously but no longer useful 
Secondary prevention 
Cardiac rehab
35
Q

Investigation of HF

A

TT echocardiography to detect ventricular impairment
Newer test for elevated serum B-type Natriuretic peptide (BNP)
Cardiac MR

36
Q

Treatment of Heart failure

A

Treatment is predominantly medical (drugs)
ACE inhibitors, Betablockers, Aldosterone Antagonists (Spironolactone or Eplerenone), Diuretics, Ivabradine.
Correction of other causes (anaemia, thyroid dysfunction)
Management of complications (arrhythmia)
Some Heart Failure patients benefit from Cardiac Resynchronisation Therapy (CRT – special form of pacemaker)

37
Q

Investigation of valve disease

A

Transoesophageal echocardiography gives better images

38
Q

Treatment of valves disease
Metal valves
Aortic stenosis

A 
Form of heart failure 
Symptomatic --> valve surgery 
Metallic prosthesis or biological 
Metallic requires lifelong warfarin 
TAVI (transcatheter aortic valve implantation)
39
Q

Arrhythmia investigation

A

Diagnosis made by ECG at time of symptoms
Other investigations look for causes
Treatment varies according to specific type of arrhythmia

40
Q

Treatment of bradyarrhythmia

A

Pacemaker insertion

41
Q

Subcutaneous devices

A

Dual chamber pacemaker
Treats bradyarrhythmia

Implantable cardioverter/defibrillator
Ventricular tachycardia or VF
Can pace bradycardia

Cardiac resynchronisation therapy
Treats heart failure and bradycardia

42
Q

When /when not to defer treatment

A 
Increasing pain at rest 
Increasing breathlessness and/or oedema 
Recent MI (within last 6 weeks( 
Frequent attacks of disabling tachycardia 
Stable awaiting surgery 
Stable angina 
Stable heart failure
43
Q

Adrenaline?

A

Vasoconstriction?

More likely to get angina, high BP,

DEN303 - IHD (58 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions