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Kin 187 > CVD - Atrial Fibrillation > Flashcards

CVD - Atrial Fibrillation Flashcards

1
Q

What is CVD

A

Heart and blood vessel disease related to atherosclerosis

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2
Q

What is atherosclerosis

A

Condition that develops due to plaque build up in walls of arteries

Leading cause of death globally

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3
Q

Heart attack is

A

When blood flow to heart is blocked by a blood clot

Causes cardiac muscle to die

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4
Q

What are the two types of stroke

A

Ischemic stroke

Hemorrhagic stroke

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5
Q

What is ischemic stroke

A

Most common

When blood vessel to brain gets blocked

Causes brain cells to die

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6
Q

Hemorrhagic stroke is

A

When blood vessel within brain bursts

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7
Q

Heart failure (congestive) is

A

Heart is not pumping blood as well as it should

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8
Q

Cardiac Disease can be (2)

A

Arrhythmia

Heart valve problems

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9
Q

What is arrhythmia

A

Abnormal rhythm of the heart

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10
Q

Heart valve problems include

A

Stenosis

Regurgitation

Mitral valve prolapse

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11
Q

What are the different types of arrhythmias

A

Atrial fibrillation

Ventricular fibrillation

Bradycardia

Tachycardia

Conduction disorders

Premature contraction

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12
Q

What is atrial fibrillation

A

Upper heart chambers contract irregularly

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13
Q

What is ventricular fibrillation

A

Disorganised contraction of the lower heart chambers

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14
Q

Conduction disorders are

A

When the heart does not beat normally

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15
Q

What is the most common cardiac arrhythmias

A

Atrial fibrillation

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16
Q

Atrial fibrillation causes

A

Quivering or irregular heartbeat

Multiple reentrant circuits in the atria

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17
Q

What does multiple reentrant circuits in the atria lead to

A

Blood clots
Stroke
Heart failure
Other heart related complications

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18
Q

Atrial fibrillation can be seen as

A

Missing P waves

Electrical current does not flow

Av node often cant regulate the chaotic current

Irregular ventricular rate

When the beat is off and the blood supply can be unpredictable

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19
Q

Missing P wave indicates the

A

Absense of atrial depolarisation

SA node may not start the contraction

20
Q

Electrical current not flowing in atrial fibrillation is due to

A

Contractions being rapid and disorganised

21
Q

What happens as a result of AV node not being able to regulate the chaotic current

A

Ventricles beats more often

22
Q

Slow ventricle response is seen as

A

Long gaps

Small R height

23
Q

Moderate ventricular response is seen as

A

Upside down??

24
Q

Rapid ventricular response is seen as

A

Close together

Large R height

25
Q

What are the ways we medically manage atrial fibrillation

A

Conversion back to normal sinus rhythm

Controlling ventricular rate response

Preventing blood clots

26
Q

How do we converse back to normal sinus rhythm

A

Electrical cardioversion

Radiofrequency ablation

Maze procedure

27
Q

What is electrical cardioversion

A

Low voltage electric current to reset heart rhythm back to normal sinus rhythm

28
Q

What is radiofrequency ablation

A

Radio waves to manage arrhythmias, usually before pacemaker implant

29
Q

What is maze procedure

A

Create scar tissue to block abnormal signal, direct electric signal through a controlled path to ventricles

30
Q

How do we control ventricular rate response

A

Reducing overly high heart rate

Pharmacologic:
Digoxin
Beta blockers
Calcium channel blockers
Anti arrhythmic
31
Q

What does digoxin do

A

Slow heart rate at atria to ventricle

Inhibition of sodium potassium ATP

32
Q

What does Beta blockers do

A

Slow HR

Antagonists that block the receptors sites for Epi and NE on adrenergic beta receptors of SNS

33
Q

What do Calcium channel blockers do

A

Slows HR

Reduce strength of cardiac muscle contraction

Prevent or reduce the opening of channels not allowing Ca++ get into cells

34
Q

How do we prevent blood clots

A

Antiplatelets

Anticoagulants

Antithrombotic

35
Q

What is the effect on exercise response

A

Rapid irregular ventricular heart rate

Exercise capacity is reduced by 15-20%

36
Q

Rapid irregular ventricular heart rate is because (during effect on exercise response)

A

HR is high at any workload

Reduced SV due to limited atrial assistance during diastole

HR response can be affected by comorbid conditions and medications - a smaller increase in heart rate and SBP as exercise increases

37
Q

When can exercise testing be useful when certain things are considered (each drug)

A

Digoxin may control ventricular response - diffuse ST effects

Verapamil may mask ischemia and decrease HR response to exercise

Beta blockers may reduce exercise capacity and decrease submaximal and maximal HR and BP

Age predicted HRmax targets are not valid

Irregular ventricular response may make BP determination less precise or more difficult

38
Q

Verapamil is what type of drug

A

Calcium channel blocker

39
Q

When creating an exercise program what should be considered

A

Variability of the ventricular rate - Intensity should be prescribed with work rate or perceived exertion

Comorbidities are needed in population with AF

Oberve for exertional HYPOtension

40
Q

What is really important to do during each session

A

Assess rhythm

41
Q

What are the short benefits of exercise training in AF (<6months)

A

Reduced AF burden

Reduced symptom severity

42
Q

What are the long benefits of exercise training in AF

A

Increased AF freedom

Reduced symptom severity

43
Q

What is the FITT requirement for AF

A

3-5 days per week

<= 95% peak HR

120 to 200 min/wk

Aerobic exercise and/or resistance training

44
Q

What are the overall potential benefits of AF

A

Reversed atrial remodeling

Weight loss

Improved BP control

Improved glycemic control

Reduced inflammation

Improved autonomic tone

45
Q

What is AF burden

A

Duration/numbers of longest AF episode

percentage of time

46
Q

What is AF freedom

A

Absence of AF period

Kin 187 (21 decks)

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