Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 2a Stuff > Cardiology > Flashcards

Cardiology Flashcards

(108 cards)

Start Studying
1
Q

Define MI and the difference between STEMIs and NSTEMIs

A

MI occurs when cardiac myocytes die due to prolonged myocardial ischaemia. STEMIs show an ST elevation on ECG whereas NSTEMIs do not.

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

Causes of MI

A

ATHEROSCLEROSIS

Emboli, coronary spasm, vasculitis

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

MI risk factors

A

Age, males, FHx, smoking, HTN, obesity

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

Clinical manifestations of MI.

A

Crushing chest pain which may radiate to the arm/jaw.

Raised JVP, increased pulse and blood pressure changes, 4th heart sounds, signs of HF.

Anxiety, nausea, sweating, palpitatiions

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

First line investigations for MI

A

ECG - STEMI will show ST elevation and tall T waves

Troponin blood testing

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

Gold standard for investigating MI (often not needed)

A

Coronary angiography

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

Management of STEMI

A

Initially 300mg aspirin.

Hospital - aspirin +/- ticagrelor. Beta blcokers, CCBs

Other drugs used include GTN, antithrombins, statins, ACEi etc.

PRIMARY PCI IS THE TREATMENT OF CHOICE

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

Treatment of NSTEMI and unstable angina

A

Alleviate pain and secondary prevention (antiplatelets and antithrombotic)

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

Complications of MI

A

Cardiogenic shock, cardiac arrhythmias, pericarditis, emboli, aneurysms, ventricular rupture, papillary muscle rupture.

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

Can ACS occur without chest pain?

A

YES! This is called silent ACS and often occurs with elderly and diabetics.

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

Define angina

A

Chest pain caused by a mismatch between oxygen supply and demand by myocardial cells.

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

Main cause of stable angina

A

Atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Difference between stable and unstable angina.

A

Stable angina is a CCS induced by effort and relieved by rest. Unstable angina is an ACS which is not relieved by rest.

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

Investigations of angina

A

ECG, coronary angiography, perfusion MRI, bloods

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

Management of stable angina

A

Reassurance and lifestyle modifications

Medications

  • Secondary prevention (aspirin, statins, ACEi)
  • Anti-anginal drugs (beta blockers, CCBs)
  • Exacerbations (GTN spray)

Revascularisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Key presentations of stable angina

A
  1. Heavy central chest pain which may radiate to jaw/arms
  2. Pain occurs with exercise
  3. Pain eases with rest or GTN

(classical angina has 3/3, atypical angina has 2/3 and non-anginal chest pain has 1/3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Define heart failure

A

An inability of the heart to deliver blood (and oxygen) at a rate enough to meet with the requirements of the metabolising tissues, despite normal or increased cardiac filling pressures.

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

Causes of heart failure

A

MYOCARDIAL DYSFUNCTION (usually from MI)

HTN, alcohol abuse, cardiomyopathy, valve disease, endocarditis, pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Different types of HF

A

HFREF (EF<40%) - commonly caused by IHD

HFPEF (EF>50%) - increased stiffness and decreased LV compliance leads to impaired diastolic filling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Key presentations of HF

A

Dyspnoea, fatigue, tachycardia, peripheral oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Signs of HF on examination

A

Displaced apex beat, tender hepatomegaly, cardiomegaly, pleural effusion, elevated JVP, 3rd an 4th heart sounds, ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

1st line investigations for HF

A

ECG

NT-pro BNP blood test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Gold standard investigation for HF

A

Cardiac MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

HF management

A

Prevention – lifestyle advice

Drug management – diuretics, ACEi, ARBs, beta blockers, aldosterone antagonists, vasodilators and nitrates

Revascularisation, myocardial stunning, transplantation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
HF complications
AF, VF, kidney failure, anaemia, stroke
26
Define hypertension
An abnormally high blood pressure in the clinic (>140/90)
27
Causes of hypertension
Primary/Essential HTN = idiopathic Secondary causes of HTN include pheochromocytoma, Conn's and Cushing's Contributory lifestyle factors such as stress, smoking and obesity
28
1st line investigations for HTN
Clinical BP | Confirm with ambulatory or home BP
29
Other tests in patients with HTN
Bloods, urine dipstick, ECG, cholesterol, echo
30
HTN drug treatment for patients under 55
1. ACEi (or ARB) 2. ACEi + CCB 3. ACEi + CCB + diuretic 4. add beta blocker, alpha blocker or spironolactone
31
HTN drug treatment for patients over 55 or from an Afro-Caribbean background
1. CCB 2. CCB + ACEi 3. CCB + ACEi + diuretic 4. add beta blocker, alpha blocker or spironolactone
32
Thresholds for treatment of HTN
Low risk = 160/100 | High risk = 140/90
33
BP targets for HTN
Routine = 140/90 Elderly = 150/90 PMH of stroke/CKD/diabetes = 130/80
34
Define atrial fibrillation and flutter
Tachyarrhythmia characterised by an irregularly irregular pulse, rapid HR and ECG changes. (Atrial flutter is chaotic beat but regularly irregular)
35
Causes of atrial fibrillation
IHD, HF, mitral valve disease, HTN, hyperthyroidism, alcohol induced
36
Pathophysiology of atrial fibrillation
Atrial ectopic beats (thought to originate in pulmonary veins) lead to dysfunction of the cardiac electrical signalling pathway. As a result, the atria no longer contract in a coordinated manner. Due to irregular contractions, the atria fail to empty properly. This may result in stagnant blood accumulating within the atrial appendage, increasing the risk of clot formation and embolic stroke.
37
Clinical manifestations of atrial fibrillation
Chest pain, dyspnoea, palpitations, fatigue, irregularly irregular pulse
38
1st line investigation
ECG
39
Tests other than ECG for atrial fibrillation
Blood tests, echo, TFTs, CXR
40
Differential diagnosis of atrial fibrillation
Tachycardias, ventricular atopic beats, Wolff-Parkinson-White
41
Management of atrial fibrillation
Beta blockers, rate-limiting CCBs, digoxin, amiodarone, anticoagulants
42
Complications of atrial fibrillation
STROKE, heart failure, sudden death
43
What is an electrical storm?
3 episodes of VF or VT during a 24-hour period
44
Arrhythmias other than atrial fibrillation
- Supraventricular tachycardia - Ventricular tachycardia - Sinus tachycardia - AV blocks - LBBB - RBBB - Ventricular ectopic - Wolff-Parkinson-White
45
Define acute pericarditis
An inflammatory pericardiac syndrome with or without pericardial effusion
46
Causes of pericarditis
Viral, bacterial, autoimmune, neoplastic, metabolic, traumatic and iatrogenic, amyloidosis, aortic dissection
47
What is a pericardial effusion and what can it lead to?
A collection of fluid within the potential space of the pericardial sac - can lead to cardiac tamponade
48
Key presentations of pericardial effusion
Chest pain, pericardial chest rub, ECG abnormalities, pericardial effusion (2 of these required for diagnosis)
49
1st line diagnosis for pericarditis
Clinical diagnosis based on signs and symptoms
50
Other tests for pericarditis
ECG, CXR, echo, blood tests
51
Management of pericarditis
Sedentary activity, NSAIDs or aspirin, colchicine
52
Treatment of pericardial effusion
Pericardiocentesis
53
Complications of pericarditis
Cardiac tamponade | Constrictive pericarditis
54
Signs of cardiac tamponade
Pulsus paradoxus, muffled heart sounds, hypotension, increased JVP
55
Treatment of cardiac tamponade
Pericardiocentesis, pericardiectomy, thoracotomy
56
Define infective endocarditis
Infection of heart valves or other endocardial-lined structures within the heart.
57
Types of IE
Left-sided native IE Left-sided prosthetic IE Right-sided IE Device related IE
58
Epidemiological changes in IE
Used to be a disease of the young affected by rheumatic heart disease. Now affects the elderly, drug abusers, those with congenital defects and prosthetic heart valves
59
Causes of IE
Bacteraemia arising from poor dental hygiene, IV drug abuse and soft tissue infections.
60
Pathophysiology of IE
Early microbial adherence is crucial. Bacterial adherence to a platelet-fibrin nidus. Hallmark of IE is vegetation.
61
Clinical manifestations of IE
Signs of systemic infection. Heart murmurs, splinter haemorrhages, Osler's nodes, Janeway lesions, Roth spots on fundoscopy, petechiae
62
1st line investigation for IE
Blood cultures - 3 samples from 3 peripheral sites
63
Other investigations for IE
TRANSTHORACIC ECHO, urinalysis, CXR
64
Management of IE
Antimicrobials Treat complications Surgery if antibiotics ineffective, complications occur or have a large vegetation needing removal
65
Complications of IE
HF, arrhythmias, abscess formation in cardiac muscle, emboli formation (stroke, vision loss)
66
Define aortic stenosis
Chronic progressive disease characterised by narrowing of the aortic valve area. Symptoms occur when the valve area is 1/4th of normal
67
Causes of aortic stenosis
Calcific aortic valvular disease - most common Bicuspid aortic valve Rheumatic heart disease
68
Pathophysiology of aortic stenosis
Narrowing of the aortic valve causes a pressure gradient to develop between LV and aorta (increased afterload) LV function initially maintained by compensatory pressure hypertrophy. When these mechanisms are exhausted, LV function declines.
69
Key presentations of aortic stenosis
Exertion dyspnoea, exertion syncope, ejection systolic murmur, slow rising carotid pulse, soft or absent second heart sound
70
1st line investigations for aortic stenosis
Echocardiography | Doppler derived gradient and valve area
71
Other investigations for aortic stenosis
CXR, ECG, cardiac CT
72
Management of aortic stenosis
Surgical aortic valve replacement - definitive treatment TAVI Consider IE prophylaxis in dental procedures
73
Factors that decrease survival rates for aortic stenosis
Angina, syncope, HF
74
Define mitral regurgitation
Backflow of blood from the LV into the LA during systole due to abnormalities of the valves, chordae tendinea or papillary muscles
75
Causes of mitral regurgitation
``` Myxomatous degeneration Ischaemic MR Rheumatic heart disease IE Dilated and hypertrophic cardiomyopathy Collagen diseases ```
76
Pathophysiology of mitral regurgitation
Pure volume overload! Compensatory mechanisms - LA enlargement (leading to pulmonary HTN), LV hypertrophy and dilation, increased contractility
77
Key presentations of mitral regurgitation
Exertion dyspnoea, pansystolic murmur, displaced hyperdynamic apex beat, soft 1st heart sound, prominent 3rd heart sound, right heart failure
78
1st line investigations for mitral regurgitation
Echocardiogram
79
Other tests for mitral regurgitation
ECG, CXR, cardiac catheterisation
80
Management of mitral regurgitation
Vasodilators, rate control for AF, anticoagulants, diuretics Serial echocardiography IE prophylaxis Surgery if symptomatic, EF <60% or new onset AF
81
Define aortic regurgitation
Leakage of blood into the LV from the aorta during diastole due to ineffective coaptation of aortic cusps
82
Causes of aortic regurgitation
Bicuspid aortic valve Rheumatic heart disease IE Aortic dissection
83
Pathophysiology of aortic regurgitation
Combined pressure and volume overload Compensatory mechanisms - LV dilation and hypertension - can lead to HF
84
Key presentations of aortic regurgitation
Hyperdynamic and displaced apical pulse, wide pulse pressure. Systolic ejection murmur, diastolic blowing murmur. Significant symptoms occur late - angina, dyspnoea, LV failure, palpitations
85
How is aortic regurgitation diagnosed?
By physical exam. Then echocardiogram. Can also perform a CXR.
86
Aortic regurgitation management
IE prophylaxis Serial echocardiograms Vasodilators Surgery - definitive treatment
87
Define mitral stenosis
Obstruction of LV inflow that prevents proper filling during diastole. Normal area is 4-6cm2 but symptoms arise at around <2cm2
88
Causes of mitral stenosis
Rheumatic carditis is predominant cause IE Mitral annular calcification
89
Pathophysiology of mitral stenosis
Progressive dyspnoea due to pulmonary congestion. Increased trans-mitral pressure leads to LA dilation and AF RHF due to pulmonary HTN Haemoptysis
90
Key presentations of mitral stenosis
Mitral facies, small-volume pulse, a-wave jugular venous pulse, diastolic murmur, loud opening heart sound
91
1st line test for mitral stenosis
Echocardiogram
92
Other tests for mitral stenosis
CXR, ECG, cardiac catheterisation
93
Mitral stenosis management
IE prophylaxis Serial echocardiogram Diuretics, beta blockers/digoxin/CCBs Percutaneous mitral balloon valvotomy Mitral valve replacement in serious cases
94
Define shock
Acute circulatory failure resulting in inadequate organ perfusion. Systolic BP <90 or MAP <65
95
Types of shock
``` Anaphylactic shock (IgE mediated allergic reactions) Septic shock (uncontrolled infection) Hypovolaemic shock (bleeding, burns, fluid loss) Cardiogenic shock (arrhythmias, MI, PE, cardiac tamponade) ``` Other - tension pneumothorax, spinal cord injury, Addison's, heat exhaustion
96
Investigation and management of shock
ABCDE IV Fluids! Depending on cause may need adrenaline, antibiotics, reperfusion therapy etc.
97
Definition of cardiomyopathy
A group of diseases of the myocardium that affect the mechanical or electrical function of the heart.
98
4 main groups of cardiomyopathy
``` Hypertrophic cardiomyopathy (HCM) Arrhythmogenic cardiomyopathy (ARVC) Dilated cardiomyopathy (DCM) Restrictive cardiomyopathy (RCM) ```
99
Causes of cardiomyopathy
GENETICS!! HCM - sarcomeric protein gene mutations DCM - cytoskeletal gene mutation ARVC - desmosome gene mutations
100
Pathophysiology of HCM
Hyperdynamic contraction of the heart which impairs diastolic relaxion. Causes chaotic myofibrillar disarray with features of ischaemia causing arrhythmias.
101
Pathophysiology of DCM
Characterised by dilation of ventricles.
102
Pathophysiology of ARVC
RV becomes thin and the muscle is replaced by fat and fibrous tissue leading to dilation
103
Key presentation of cardiomyopathies
Arrhythmias! Angina, SOB, palpitations, dizzy spells, syncope
104
Gold standard investigation for cardiomyopathy
Cardiac catheterisation
105
1st line tests for cardiomyopathy
ECG, echo, CMR
106
Important investigation to do for cardiomyopathy
GENETIC ANALYSIS! | And should try to test family members.
107
Management of cardiomyopathy
FAMILY EVALUATION lifestyle modifications Management of symptoms HF management
108
Complications of cardiomyopathies
HF, blood clots, valvular issues, cardiac arrest, sudden death

Phase 2a Stuff (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions