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Year 3 - MedEd Lectures > Cardio 1 > Flashcards

Cardio 1 Flashcards

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1
Q

What is the difference between low and high output Heart Failure?

A

Low Output:

  • Reduced Cardiac Output
  • Fails to increase with exertion

High Output:

  • Increased needs (Pregnancy, hyperthyroidism)
  • Normal Cardiac Output
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2
Q

What are the main causes of Chronic Left-Sided Heart Failure?

A

Valvular

Heart Muscle

Systemic

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3
Q

What are the valvular causes of Chronic Left-Sided Heart Failure?

A

Aortic Stenosis (Increased Afterload)

Aortic Regurgitation (Increased pressure in the LV)

Mitral Regurgitation (Increases Preload)

*All these lead to remodelling and hypertrophy of the LV

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4
Q

What are the muscular causes of Chronic Left-Sided Heart Failure?

A

Ischaemic Heart Disease

Cardiomyopathy

Myocarditis

Arrhythmias

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5
Q

What are the systemic causes of Chronic Left-Sided Heart Failure?

A

Hypertension

Amyloidosis

Drugs:

  • Alcohol
  • Cocaine
  • Chemotherapeutics (eg. doxorubicin)
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6
Q

What are the causes of Chronic Right-Sided Heart Failure?

A

Left Heart Failure (Congestive)

Pulmonary Hypertension

Pulmonary Embolism

Chronic Lung Disease (Interstitial, fibrosis, CF)

Tricuspid Regurgitation

Pulmonary Valve Disease

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7
Q

What are the main causes of High-Output Heart Failure?

A

NAP MEALS

Nutritional Deficiency (Thiamine)

Anaemia

Pregnancy

Malignancy

Endocrine (Hyperthyroidism)

AV Malformations

Liver Cirrhosis

Sepsis

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8
Q

What are the main presenting symptoms of Left Heart Failure?

A

Exertional Dyspnoea

Orthopnoea

Nocturnal Dyspnoea

Fatigue

Nocturnal Cough (Pink, frothy sputum)

Wheeze

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9
Q

Which signs would you observe on a patient with Left Heart Failure?

A

Pulsus Alternans

AF (Co-existent with Mitral Regurgitation)

Displaced Apex Beat

S3 Gallop Rhythm

S4 in severe HF

Murmur (due to underlying cause)

Fine end-insiratory crackles at lung bases

Wheeze

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10
Q

What are the main presenting symptoms of Right Heart Failure?

A

Swelling (Pitting Ankle Oedema, ascites etc)

Weight Gain

Fatigue

Reduced exercise tolerance

Anorexia

Nausea

Nocturia

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11
Q

What are the main signs you may observe on a patient with Right Heart Failure?

A

Face Swelling

Raised JVP

Tricuspid Regurgitation murmur

Ascites

Hepatomegaly

Pitting Oedema in ankles and sacrum

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12
Q

What is Cor Pulmonale?

A

RHF due to increased Pulmonary Pressure

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13
Q

How would you investigate suspected Heart Failure?

A

ECG

FBC, U&Es, LFTs, TFTs, BNP (used to exclude HF)

CXR

Transthoracic Echo with Doppler - Diagnostic

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14
Q

How would you manage a case of Heart Failure?

A

Treat the Cause

Lifestyle advice

Ace Inhibitors

Beta Blockers

Diuretics

Digoxin

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15
Q

How does Acute HF differ from Chronic HF?

A

Rapid onset/worsening of symptoms of Heart Failure.

Either due to:

Acute worsening of existing Heart failure Symptoms

or

New-onset symptoms, often due to ACS

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16
Q

How would you manage a case of Acute Heart Failure?

A

ABC

Sit patient up

High flow O2

Furosemide IV

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17
Q

What are the main complications of Heart Failure?

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A

Pleural Effusion

Renal Failure

Acute Exacerbations

Death

18
Q

What is the prognosis for Heart Failure?

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A

50% of severe cases die within 2 years.

2-20% mortality in acute cases

19
Q

How is Cardiomyopathy defined?

Study These Flashcards
A

A group of disease in which the myocardium becomes structurally and fucntionally abnormal.

20
Q

How does Cardiomyopathy typically present?

Study These Flashcards
A

Symptoms of HF may occur (Dizziness, SOB on exertion)

Collapse

Sudden Death

FHx

21
Q

Which signs on examination could point towards a diagnosis of Cardiomyopathy?

Study These Flashcards
A

Signs of HF (resp. crackels, increased JVP)

Murmurs

S3

S4

22
Q

How would you investigate suspected Cardiomyopathy?

Study These Flashcards
A

Bloods

BNP
CXR

ECG

Stress testing

Echo

Cardiac Catheterisation

23
Q

What is Dilated Cardiomyopathy?

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A

Enlarged Ventricles become dilated and weaken, preventing effective contraction.

24
Q

What may cause Dilated Cardiomyopathy?

Study These Flashcards
A

Alcohol

Viral Illness

Autoimmune conditions

Haemochromatosis

Hereditary

25
How would you investigate suspected Dilated Cardiomyopathy?
CXR - Globular Heart Echo - Dilated Ventricle Signs/Symptoms of Tricuspid and Mitral Regurgitation
26
What is Hypertrophic Cardiomyopathy (HOCM)?
The heart muscle thickens inwards, eventually blocking blood flow out of the ventricle. In _SBAs_ - Tends to be **Young Athletes** having **Syncopal Episodes** with **FHx of Sudden Cardiac Death**
27
Describe the inheritance pattern of HOCM.
Autosomal Dominant 50% of cases are Familial
28
How would you investigate suspected Hypertrophic Cardiomyopathy?
**_ECG_** Q waves LAD LVH signs **_Echo_** Ventricular Hypertrophy
29
How would Left Ventricular Hypertrophy appear on an ECG?
Deep S in V1/V2 Tall R in V5/6 S in V1 + R in V5 or V6
30
What is Restrictive Cardiomyopathy
Ventricles become abnormally Rigid. This means they progressively lack the flexibility to expand as the ventricles fill with blood.
31
What is Kussmaul's Sign?
Paradoxical rise in JVP in inspiration. Due to restricted filling of the Ventricles. Seen in restrictive Cardiomyopathy.
32
What is Arrhythmogenic Right Ventricular Cardiomyopathy?
Progressive fatty and fibrous replacement of the Ventricular Myocardium.
33
What is Constrictive Pericarditis?
Chronic Inflammation of the Pericardium, leading to thickening and scarring.
34
What may cause Constrictive Pericarditis?
Idiopathic Infectious (TB, Bacterial, Viral) May be acute Cardiac Surgery and Radiation
35
How does Constrictive Pericarditis present?
Resembles Restrictive Cardiomyopathy Kussmaul's Sign
36
How would you investigate a suspected case of Constrictive Pericarditis?
CXR - Pericardial Calcification Echo - Increased Pericardial Thickness Cardiac CT/MRI (Usually before surgical management)
37
What is Myocarditis and what causes it?
Inflamation of the Myocardium in the **absence** of ischaemia Causes include: Infection Drugs (Cocaine, penicillins, cephalosporins, digoxin, anticonvulsants) Radiation
38
How does Myocarditis typically present?
**_Symptoms_** Flu-like symptoms Positional Chest Pain (Worse when lying) SOB Palpitations **_Signs_** Pericardial Rub Arrhythmias
39
How would you investigate a suspected case of Myocarditis?
ECG (Non-specific ST changes, T-Wave abnormalities) CK & Troponin (Mild rise, not seen in pericarditis) Endomyocardial Biopsy (Diagnostic, not routinely performed)
40
Which murmur would likely be heard in a patient with HOCM?
Ejection Systolic HOCM leads to Aortic Stenosis

Year 3 - MedEd Lectures (29 decks)

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