Cardiovascular 2

Question 1

What are structural heart disease investigations?

Answer 1

ECG
chest X-rays
Echocardiogram

Question 2

What are causes of heart failure?

Answer 2

Ischaemic heart disease
Hypertension
Valvular heart disease
Alcohol excess

Question 3

What are symptoms of heart failure?

Answer 3

Fluid accumulation- oedema on lungs and peripheries

Question 4

What is a sign of fluid on lungs?

Answer 4

Breathlessness on exertion and on lying flat

Question 5

How does heart failure present?

Answer 5

Gradual onset
SOB- Often during night when lying flat
Sudden death

Question 6

What medications are used to treat heart failure?

Answer 6

Diuretics
ACE inhibitors / angiotensin ll receptor antagonists
Beta blockers
Digoxin

Question 7

What other treatments are used re. Heart failure?

Answer 7

Treatment of underlying causes
Surgical - cabg
Surgical- PTCA- Percutaneous transluminal coronary angioplasty
Rarely- transplant 
Pacemaker

Question 8

What should dentists be aware of re. Heart failure?

Answer 8

Polypharmacy
Avoid NSAIDS- cause fluid retention
Cautious when lying patient flat

Question 9

Re. Valvular heart disease, what side of the heart is most commonly affected?

Answer 9

Left side- mitral, aortic valve

Question 10

What are causes of heart disease?

Answer 10

Congenital
Infective endocarditis
Rheumatic fever
Age related

Question 11

What Are the two types of valvular heart disease?

Answer 11

Regurgitation

Stenosis

Question 12

What is regurgitation?m

Answer 12

Valve becomes floppy
Loss of valve integrity
Leaks

Question 13

What is stenosis?m

Answer 13

Narrowing of valve, obstructing flow

Question 14

What is the treatment of valvular heart disease?

Answer 14

Medication
Surgery:
Valve replacement - porcine, metallic

Question 15

What is infective endocarditis?

Answer 15

Usually occurs on diseased or prosthetic valves
Due to bacteraemia:
Strep viridans
Strep faecalis
Strep aureus

Question 16

What are clinical features of infective endocarditis?

Answer 16

Prolonged febrile illness
Valve degeneration and failure
Embolic disease
Immune complex formation

Question 17

What investigations can be used re. Infective endocarditis?

Answer 17

Blood cultures

Echocardiogram

Question 18

What is treatment for infective endocarditis?

Answer 18

Prolonged course of intravenous antibiotics

? Surgery

Question 19

What is normal cardiac rhythm?

Answer 19

Sinus rhythm

Question 20

What is arrhythmia?

Answer 20

Abnormal cardiac rhythm
Irregular
Too fast/slow
Abnormal beat conduction

Question 21

What makes a too fast rhythm?

Answer 21

> 100/ minute

Question 22

What makes a rhythm too slow?

Question 23

What can be symptoms of cardiac arrhythmias?

Answer 23

Nil
Palpitations
Chest pain
Heart failure
Syncope

Question 24

What is atrial fibrillation?

Answer 24

Irregular heart beat

Question 25

What does atrial fibrillation increase risk of?

Answer 25

Stroke

Question 26

What is tachyarrythmia?

Answer 26

Too fast heart beat

Question 27

What are symptoms of supraventricular tachycardia?

Answer 27

Palpitations Chest pain Breathlessness

Question 28

What can treatment be at time of SVT?

Answer 28

Vagal manoeuvres Carotid sinus massage Drugs- adenosine

Question 29

What is bradyarrythmia?

Answer 29

Heart beat too slow

Question 30

What are causes of bradyarrythmia?

Answer 30

Age Ischaemia Drugs

Question 31

What treatment may bradyarrythmia require?m

Answer 31

May require pacemaker

Question 32

What are ventricular arrhythmias?

Answer 32

Abnormal heart conduction- peri arrest rhythm

Question 33

What can be the cause of ventricular arrhythmias?

Answer 33

Heart attack Drugs Congenital Electrolyte disturbances

Question 34

What is ventricular tachycardia?

Answer 34

Always symptomatic | Cardio respiratory arrest

Question 35

What is ventricular fibrillation?

Answer 35

Always cardio respirator arrest

Question 36

What are dental aspect relevant re. Pace makers?

Answer 36

Theoretical risk of electrical intereference see BNF | avoid adrenaline containing local anaesthetic in certain situations

Question 37

What are structural heart diseases?

Answer 37

Heart failure- muscle weakness | Valvular heart disease