Cardiology Flashcards Preview

Hugh's MD2 Foundation > Cardiology > Flashcards

Flashcards in Cardiology Deck (32):
1

What are the three general groups of factors that can cause HTN?

Increased Preload

Cardiac aetiology 

Increased Afterload

2

What are the acute coronary syndromes?

AMI

Unstable angina

2

What are the cardiovascular risk factors?

Hypertension

Increasing age

Diabetes

FHx IHD

Hyperlipidaemia

Smoking

Obesity

Sedentary lifestyle

3

How does hypertension typically lead to heart failure?

Increased afterload > LVH > Stiff LV > Diastolic failure > Often leads to systolic HF

3

What are the possible causes of exacerbation of chronic heart failure?

Mad Hatter

 

MI

Anaemia

Diabetes

HTN

Arrhythmia

Thyrotoxicosis

Temp (Infection)

Embolism

Renal

Regularly taking meds?

4

What is primary hypertension?

Hypertension with no specific aetiology

4

Why are beta-blockers not preferred anti-hypertensives?

Heavy side effects

- Nightmares

- Increased weight

- Insulin resistance 

4

What some adjunct treatments for AMI?

O2

Morphine

Aspirin

IV heparin

IV GTN

Possibly other anti-platelets 

Beta-blockers & ACE inhibitors

5

What are some causes of secondary hypertension?

Renal disease eg damage to nephrons

Renal artery stenosis

Adrenal secreting tumours

Sleep apnoea

6

What are some signs that reperfusion has occurred?

Resolution of pain or ST elevation

Reperfusion Arrhythmia - Idioventricular rhythm 

8

What is the target BP is patients with CV risk factors?

130/80

10

At what point in the CV system does the BP drop most significantly?

Arterioles

11

What is the mechanism of action of calcium channel blockers?

Inhibit the L-type Ca channels. Different types have different binding properties therefre can reducing contractility, SA activity, AV node conduction or vascular tone

 

Can be vascularly selective - dihydropyridine CCBs > arteriolar vasodilation > reduce afterload (Ca is required for SM contraction)

 

Or cardiac and vascular selective with negative inotropic and chronotropic properties > used for HTN, arrhythmias and angina

 

13

The WHO definition of AMI requires 2 out of 3 of the following criteria. Name those 3

Symptoms of myocardial ischaemia

Elevated cardiac enzymes (troponin or CK)

Typical electrocardiographic pattern involving the developent of Q waves, ST segment changes or T wave changes

14

What is the usual ejection fraction?

50% of ventricular volume therefore ~70ml (of 140ml)

15

Why are anterior infarcts the worse?

Because the area they supply contributes most to the ejection fraction

17

In which type of heart failure can ejection fraction be preserved? How?

Diastolic heart failure

Ventricle doesn't fill (eg due to mitral stenosis)

18

Why can heart failure trigger fluid retention?

Reduced CO > Reduced renal blood flow > Activation of RAAS > fluid retention

19

How does cardiac hypertrophy effect EDV?

Hypertrophic myocardium is less conpliance

Diastolic refill is impair

EDV is reduced

20

What is pulse pressure?

The difference between systolic and diastolic BP

21

When is high systolic BP seen in isolation?

Elderly with stiff arteries

22

What is the cut off for EDP over which point oedema/congestion will occur?

20-30mmHg

23

What is can be concluded for a LVHF patient with a normal echo?

Diastolic HF as EF is preversed

24

List the heart murmur in order of commonality?

1. Aortic Stenosis

2. Mitral Regurgitation

3. Aortic Regurgition

4. Mitral stenosis

25

Which is more life threatening, VF or VT?

VF

26

Describe the pathophysiology of Wolff-Parkinson-White syndrome

Abnormal conduction pathways allow impulses to bypass the AV node and can lead to tachyarrhythmias

27

What causes a 3rd heart sound? When is it heart?

Sloshing of blood around the ventricle

Early to mid diastole

28

What causes a 4th heart sound? When is it heart?

Forceful contraction of the atria to overcome a stiff ventricle

29

How is the diagnosis of hypertension made?

BP >140/90 after 5mins seated and 2 readings 2 minutes apart

A follow up reading 1-4 weeks later

30

What are the classes of drugs used for the treatment of HTN? When is each used for first line?

A - ACEI or ARBs - If patient is <55y.o.

B - Beta-blockers - avoided due to side effects

C - Calcium channel inhibitors - If >55 or black

D - Diuretics - If there is a component of fluid retention

31

What are some side effects of beta-blockers?

Postural hypotension

Weight gain

Insulin resistance

Nightmares

Impotence

32

Which anti-hypertensives are avoided in HF?

Non-dihydropyridines