Cardiovascular disease Flashcards Preview

AH extra cards > Cardiovascular disease > Flashcards

Flashcards in Cardiovascular disease Deck (27):
1

2 things that cause inadequate supply to the myocardium

Reduced coronary blood flow
Myocardial hypertrophy

2

4 IHD syndromes

Anigna pectoris
Acute coronary syndrome
Sudden cardiac death
Chronic ischaemic heart disease

3

3 types angina

Stable- predictable relationship with exertion, due to fixed obstruction
Unstable- plaque disruption, red flag
Varient/prinzmetal- coronary artery spasm

4

2 ways a subendocardial MI might occur without any acute coronary occlusion?

1. Stable athromatous occlusion
2. acute hypotensive episode

5

Main blood marker of cardiac myocyte damage?

Troponins T and I

6

When is troponin peaked?

12hrs post MI

7

What else is troponin raised in?

PE, HF, myocarditis

8

4 other blood markers of cardiac myocyte damage?

Creatinine kinase MB
Myoglobin
Lactate dehydrogenase
Aspartate transaminase

9

What is Dressler's syndrome?

Complication of MI- autoimmune pericarditis.

10

Appearance of heart tissue following MI:
Less than 24 hours
1-2 days
3-4 days
1-3 weeks
More than 3 weeks

Less than 24 hours normal/dark
1-2 days pale, oedema
3-4 days yellow with haemorrhagic edges (macrophages)
1-3 weeks red/grey, pale, thin, granulation tissue then fibrosis
More than 3 weeks dense fibrous scar

11

What is chronic ischaemic heart disease?

Atheroma = relative ischaemia and angina. Risk of sudden death, MI, unstable/variant angina

12

2 most common mutations in familial hypercholesterolaemia

Low density lipoprotein receptor gene
Apolipoprotein B

13

How do heterozygotes with familial hypercholesterolaemia present?

Xanthomas
Early atherosclerosis

14

What BP is definted as HTN

140/90

15

What do all primary/essential HTN causes have in common?

Positive sodium balance

16

How does sodium increase BP?

Increases stroke vol as more water in blood, cardiac output is therefore increased, so vasoconstriction occurs to reduce the blood flow as is above metabolic demand, however this increases SVR so BP (SVRxCO) increases.

17

4 systems that if diseased might cause secondary HTN?

Renal
Endocrine
Cardio
Neuro

18

4 effects of hypertension

Renal failure
Hypertensive crisis
Acute hypertensive encephalopathy
Pulmonary HTN

19

What BP is a HTNve crisis?

180/120

20

Symptoms of acute hypertensive encephalopathy

Confusion, vomiting, convulsions, coma, death

21

Framingham study was on what?

Risk factors for heart disease

22

Describe RAAS?

angiotensin produced in afferent arterioles of kidney
Renin converts angiotensin to angiotensin I
Angiotensin I to angiotensin II
Ang 2 = vasoconstriction and stimulates adrenals to produce aldosterone
Aldosterone inhibits sodium and water loss to increase blood volume.

23

What is Conn's syndrome

Excess aldosterone secretion usually due to adrenocortical adenoma
HTN
elevated aldosterone, low renin
Potassium loss- muscle weaknessm arrhythmias, parasthaesia, metabolic alkalosis

24

What is phaeochromocytoma

Tumour of adrenal medulla, secretes vasoconstrictive catecholamines (adrenaline and noradrenaline)
Presents with pallor, headache, sweating, nervousness, HTN

25

Difference between Cushing's disease and syndrome

Disease= pituitary lesion or neoplasm in adrenals that results in overproduction of glucocorticoids
Syndrome = excess glucocorticoids from any source

26

What is the action of cortisol?

Sympathetic NS activation
Acts on the kidneys to = HTN

27

3 causes of Cushing's

Adrenocortical adenoma (or other neoplasm)
Pituitary adenoma
Paraneoplastic effect of other neoplasms (particularly small cell lung carcinoma) producing adrenocorticotrophic hormone that stimulates adrenals to produce cortisol