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Flashcards in cardiovascular 2 Deck (90):
1

what are the two subsets of structural heart disease?

- heart failure because heart muscle weakness
- valvular disease

2

what are the two subsets of structural heart disease?

- heart failure because heart muscle weakness
- valvular disease

3

what are rhythm disturbances

cardia arrhythmias

4

what are investigations for heart disease?

ECG's, echocardiogram, xrays

5

what are some causes of heart failure?

ischaemic heart disease, hypertension, valvular heart disease, alcohol excess

6

symptoms of heart failure?

fluid accumulation

7

where does fluid accumulate in heart disease?

lungs - felt on exertion or laying flat
peripheries - dependent areas

8

what is the onset of heart failure like?

slow onset then present acutely to hospital with SOB

9

treatment of heart failure? meds?

beta blockers, ACE inhibitors, diuretics, digoxin

10

treatment of heart failure? surgical?

PTCA, CABG, transplant, pacemaker

11

dentally when to treat pt at risk of heart failure?

if pt condition unstable, polypharmacy, caution laying pt flat, avoid NSAIDS

12

what side of the heart is most commonly affected in valvular heart disease?

left side of heart - aortic and mitral valves

13

what is the aetiology of valvular heart disease?

congenital, infective endocarditis, rheumatic fever - complication of strep infection, age related

14

what is regurgitation?

loss of valve integrity = leaking

15

what is stenosis?

narrowing of valve, obstruction of flow

16

treatment of valvular heart disease?

meds, surgery - valve replacement

17

what medications should be put in place when giving a pt a metallic heart valve?

metallic valves can thrombose if not adequately warfarinised

18

what is dentally relevant when treating a patient with valvular heart disease?

risk of infective endocarditis
= risk in procedures, gingivitis, caries etc

19

where is infective endocarditis usually found?

usually found on diseased/prosthetic valves

20

what is infective endocarditis caused by?

strep viridans - oral commensal
strep faecilis - bowel commensal
staph aureus - inc. MRSA

21

what are the clinical features of infective endo?

prolonged febrile illness, valve degeneration/failure, embolic disease, immune complex failure = kidney failure

22

what investigations can be done for infective endo?

Echocardiogram, lots of blood cultures

23

what is tx of IE?

prolonged course of IV antibiotics, surgery

24

dentally how to treat IE pt?

keep standards of OH high, avoid surgery/spont. bactereamia

25

patients at risk of IE should be encouraged to do what?

keep OH good, preventitive dentistry

26

what is normal cardiac rhythm?

sinus rhythm

27

abnormal arrythmias what is the beat conduction like?

abnormal beat condition

28

how many beats in a fast irregular heartbeat?
slow irregular heart beat?

>100/min

29

symptoms of arrhythmias?

palpitations, syncope, heart failure, chest pain

30

what is atrial fibrilation associated with?
what is there an increased risk of with it?

cardiovascular disease
risk of stroke increased = need anticoagulants

31

what drugs are used for atrial fibrillation?

digoxin, amiodarone, beta blockers, calcium antagonists

32

what are tachyarrhytmias?

too fast

33

what is SVT?
what is it precipitated by?
what are the symptoms?

supraventricular tachycardia
precipitated by caffiene, anxiety
palpitations, breathless, chest pain

34

in what condition is SVT not benign?

wolf parkinson white syndrome

35

what is the tx of SVT, at time of?

valsalva manouvre
carotid sinus massage
adenosine

36

prevention of SVT?

surgery, drugs

37

what is a bradyarryhtmia?

too slow

38

at what rate/min of heart beat causes dizziness and blackouts?

39

what are causes of bradyarrythmias?

age, ischaemia, drugs

40

what is the tx of bradyarrythmias?

remove underlying cause - could be a drug
may require a pacemaker

41

what are ventricular arryhtmias?

always an emergency!!!

42

what causes ventricular arrythmias?

ischaemic heart disease, drugs, congenital, electrolyte disturbance

43

what is ventricular tachycardia?

beat pattern remains the same - increased speed
breathless, dizzy, chest pain, palpitations
cardiorespiratory arrest

44

what is ventricular fibrillation?

always leads to cardiorespiratory arrest
beat does not follow normal pattern

45

VT tx?

hospital for defib/drugs
long term - drugs, ICD

46

VF tx?

defib
drugs, ICD

47

what are rhythm disturbances

cardia arrhythmias

48

what are investigations for heart disease?

ECG's, echocardiogram, xrays

49

what are some causes of heart failure?

ischaemic heart disease, hypertension, valvular heart disease, alcohol excess

50

symptoms of heart failure?

fluid accumulation

51

where does fluid accumulate in heart disease?

lungs - felt on exertion or laying flat
peripheries - dependent areas

52

what is the onset of heart failure like?

slow onset then present acutely to hospital with SOB

53

treatment of heart failure? meds?

beta blockers, ACE inhibitors, diuretics, digoxin

54

treatment of heart failure? surgical?

PTCA, CABG, transplant, pacemaker

55

dentally when to treat pt at risk of heart failure?

if pt condition unstable, polypharmacy, caution laying pt flat, avoid NSAIDS

56

what side of the heart is most commonly affected in valvular heart disease?

left side of heart - aortic and mitral valves

57

what is the aetiology of valvular heart disease?

congenital, infective endocarditis, rheumatic fever - complication of strep infection, age related

58

what is regurgitation?

loss of valve integrity = leaking

59

what is stenosis?

narrowing of valve, obstruction of flow

60

treatment of valvular heart disease?

meds, surgery - valve replacement

61

what medications should be put in place when giving a pt a metallic heart valve?

metallic valves can thrombose if not adequately warfarinised

62

what is dentally relevant when treating a patient with valvular heart disease?

risk of infective endocarditis
= risk in procedures, gingivitis, caries etc

63

where is infective endocarditis usually found?

usually found on diseased/prosthetic valves

64

what is infective endocarditis caused by?

strep viridans - oral commensal
strep faecilis - bowel commensal
staph aureus - inc. MRSA

65

what are the clinical features of infective endo?

prolonged febrile illness, valve degeneration/failure, embolic disease, immune complex failure = kidney failure

66

what investigations can be done for infective endo?

Echocardiogram, lots of blood cultures

67

what is tx of IE?

prolonged course of IV antibiotics, surgery

68

dentally how to treat IE pt?

keep standards of OH high, avoid surgery/spont. bactereamia

69

patients at risk of IE should be encouraged to do what?

keep OH good, preventitive dentistry

70

what is normal cardiac rhythm?

sinus rhythm

71

abnormal arrythmias what is the beat conduction like?

abnormal beat condition

72

how many beats in a fast irregular heartbeat?
slow irregular heart beat?

>100/min

73

symptoms of arrhythmias?

palpitations, syncope, heart failure, chest pain

74

what is atrial fibrilation associated with?
what is there an increased risk of with it?

cardiovascular disease
risk of stroke increased = need anticoagulants

75

what drugs are used for atrial fibrillation?

digoxin, amiodarone, beta blockers, calcium antagonists

76

what are tachyarrhytmias?

too fast

77

what is SVT?
what is it precipitated by?
what are the symptoms?

supraventricular tachycardia
precipitated by caffiene, anxiety
palpitations, breathless, chest pain

78

in what condition is SVT not benign?

wolf parkinson white syndrome

79

what is the tx of SVT, at time of?

valsalva manouvre
carotid sinus massage
adenosine

80

prevention of SVT?

surgery, drugs

81

what is a bradyarryhtmia?

too slow

82

at what rate/min of heart beat causes dizziness and blackouts?

83

what are causes of bradyarrythmias?

age, ischaemia, drugs

84

what is the tx of bradyarrythmias?

remove underlying cause - could be a drug
may require a pacemaker

85

what are ventricular arryhtmias?

always an emergency!!!

86

what causes ventricular arrythmias?

ischaemic heart disease, drugs, congenital, electrolyte disturbance

87

what is ventricular tachycardia?

beat pattern remains the same - increased speed
breathless, dizzy, chest pain, palpitations
cardiorespiratory arrest

88

what is ventricular fibrillation?

always leads to cardiorespiratory arrest
beat does not follow normal pattern

89

VT tx?

hospital for defib/drugs
long term - drugs, ICD

90

VF tx?

defib
drugs, ICD