Cardiovascular Flashcards
(29 cards)
Aneurysm
- Bulge in a blood vessel caused by a weak spot in the blood vessel wall.
- Can occur anywhere in the body but are most common in the brain and the aorta.
- Fatal if they rupture causing life-threatening bleeding, the larger an aneurysm becomes, the greater risk of rupture.
- Most brain aneurysms can only cause noticeable symptoms if they burst (rupture).
- Can be asymptomatic or symptomatic.
Brain aneurysm symptoms
- Sudden agonising headache “thunderclap” similar to a sudden hit on the head.
- Stiff neck
- Sickness and vomiting
- Pain on looking at light
Abdominal aortic aneurysm (AAA) symptoms
- swelling in the aorta
- Tummy or back pain
- Pulsing feeling in stomach
- Commonly asymptomatic.
- Pulsating mass.
Congestive cardiac/heart failure
- Occurs when the heart can still circulate blood but not efficiently.
- Causes blood to back up into the vessels, leading to fluid accumulation in the lungs and other parts of the body.
- Results from any disorder that impairs ventricular filling or ejection of blood to the systemic circulation.
- Left sided, right sided and biventricular (both)
Congestive cardiac/heart failure symptoms
- SOB
- Fatigue
- Swelling in the ankles, legs and abdomen
- Weight gain
- Polyuria - especially at night
- Chest pain
- Heart palpitations
- Dry cough
- Dizziness or confusion
- Weakness
Acute coronary syndrome (ACS)
- Occurs where there is an abrupt reduction in blood supply to the myocardium leading to myocardial ischemia.
- Ischemia is usually caused by disruption to the internal artery wall, at site of an atheroma plaque causing a blood clot to from and occluding the coronary artery.
What’s ACS an umbrella term for
- unstable angina
- NSTEMI
- STEMI
Myocardial infarction (MI)
- Caused by occlusion of cardiac artery causing damage to the myocardium - e.g. atherosclerosis, emboli
- Interruption of normal coronary blood flow resulting in a portion of cardiac muscle being deprived of oxygenated blood resulting in cardiac muscle becoming necrotic (dying) and replaced by non-contractile scar tissue.
- Signs may vary depending upon which coronary artery is affected, the portion and extent of the infarction and whether to electrical conduction system Is affected.
MI symptoms
- Severe CCP, may radiate to one or both sides of the chest, into neck, jaw, arms and back, often described as crushing in nature that persists >15 mins.
- Pallor, diaphoresis, faintness, giddiness
- Sense of impending doom
- Hypertensive - unless go into shock
- Shallow breathing grey with cyanosed extremities (limbs furthest from the heart).
- SOB
- Nausea / vomiting
- Sometimes an irregular pulse, ECG irregularities.
Types of MI
STEMI - when a coronary artery is completely blocked causing extensive damage to the heart, diagnosed using an ECG and requires urgent treatment to unblock the artery.
NSTEMI - some loss of blood supply to the heart, doesn’t show on an ECG but will show on a blood test. Can progress to a STEMI without treatment.
ACS management/treatment
ACS Management / Treatment
- Administer GTN (vasodilator) which widens blood vessels increasing blood supply to the heart and reducing angina.
- Administer Aspirin (Anti platelet) - relieves pain, prevents blood clots from forming.
- 2 pain scores recorded before and after GTN and aspirin.
- Oxygen for low sats
- Anglesia to relieve pain: Morphine (vasodilator) - reduce BP, heart rate, resps and depresses CNS.
- IV paracetamol
- Ondansetron for sickness
- Attach defibrillator pads in suspected MI
Angina
- Attacks of chest pain caused by reduction in blood flow through the coronary artery causing ischemia.
- May act as a warning of MI (pre-infarction), can precede to an acute MI by a few hours where pain may now be apparent without exertion. Usually lasts longer than 15 mins and is less promptly relived by rest and GTN.
Types of angina
Unstable and stable
Unstable angina
Unstable
- More serious, indicating increasing obstruction.
- Noticeable changes in intensity and duration of pain.
- May occur at rest, sleep, walking.
Clinical presentation
- Retrosternal pain (in the chest behind the breast bone) frequently described as a heaviness in the arms or chest.
- Pain may be referred to the throat, jaw and teeth, also armpits and often into the arm.
- Nausea/vomiting
- Pallor/diaphoresis
Stable angina
Stable
- Attacks have a trigger such as stress or exercise and stop within a few minutes of resting.
Clinical Presentation
- Pain related to exertion. Stenosis (narrowing) of one or more coronary arteries means demands for increased blood supply can’t be met.
- Pain normally subsides on resting within a few minutes and therefore would not be categorised as ACS.
- If pain persists for >15 mins treatment then could be ACS.
Heart failure and causes
- Not a specific disease, occurs as a consequence of the inability of the heart to provide adequate cardiac output for the bodies needs.
- Acute heart failure is new or worsening symptoms consistent with an understanding deterioration in ventricular function.
- Left and right sides of the heart can fail separately or simultaneously.
- Serious condition that occurs when the heart is unable to pump enough blood to meet the body’s needs.
Causes:
- MI
- Myocarditis - inflammation of the myocardium reducing the hearts ability to pump.
- Hypertension
- Valvular heart disease - one or more of the hearts valves do not open and close properly
Left ventricular failure (LVF)
- Failure of the left ventricle to function effectively enough to act as an efficient pump causing an excessive volume of fluid to accumulate in the pulmonary circulation - can be caused by heart becoming too weak or stiff.
- Unable to pump out all blood being returned from the lungs.
- Blood backs up causing a rise in pressure in the left atrium and pulmonary veins.
- Pulmonary veins become engorged forcing plasma serum out of the capillaries into the alveolar space.
- Air mixes with plasma serum, producing white frothy foam - pulmonary oedema.
- Gaseous exchange impaired
- Can often be acute
- May accompany a MI
LVF symptoms
- Pulmonary oedema
- Respiratory distress - rapid reps
- orhopnea / reluctance to lie down
- Cough frothy pink/white sputum
- Abnormal lung sounds such as wheezing and crqckling
- Pallor or cyanosis
- Diaphoresis
- Distended neck veins
- Agitation and confusion
- Tachycardia
- Hypertension
- Chest pain in presence of an MI
Right ventricular failure (RVF)
- Failure of the right ventricle to function effectively enough to act as an efficient pump, causing an excessive volume of fluid to accumulate in the systemic circulation. can be caused by heart becoming too weak or stiff.
- Blood backs up, causing a rise in pressure in the right atrium and systemic veins (e.g superior and inferior vena cava).
- Systemic veins become engorged, pressure in the systemic veins increases, forcing serum out of the veins into the surrounding tissue causes peripheral oedema (Abdomen/extremities - limbs e.g. legs, arms, feet)
RVF symptoms
- Peripheral oedema
- Weakness and or fatigue
- Tachycardia
- Hypertension
- Distended neck veins
- Weight gain
- Congestion of GI tract may compromise digestion and lead to anorexia, nausea, bloating and vomiting.
- Arrhythmias
Heart failure treatments
- Furoseomide if chest sounds bubbly and if oedema isn’t normal for them
- GTN - avoid if patient has hypotension
Coronary/ischemic heart disease
- Condition in which the heart muscle is damaged, or prevented from achieving its full potential, because of diminished or inadequate blood supply due to obstruction.
- Broad term that includes many types of heart conditions including HF.
- Can’t be cured or reversed but can be managed.
Coronary heart disease symptoms
- Chest Pain
- SOB
- Pain in your neck, shoulders, Jaw or arms
- Feeling faint
- Nausea
What’s depolarization
Contraction of the heart
