Cardiovascular Disorders Flashcards
What are the 3 types of cardiovascular disorders?
- Cardiac muscle disorders
- heart failure
- Electrical transmission disorders
- atrial arrhythmias
- conduction blocks
- Vasculature disorders
- hypertension
- acute coronary syndromes
What is heart failure?
Heart function doesn’t meet body’s metabolic needs
Types:
1. HFpEF —> preserved ejection fraction (EF ≥ 50%)
- dec blood to ventricles
- dec diastolic function —> stiffer muscle
2. HFrEF —> reduced ejection fraction (EF ≥ 40%)
- dec blood out ventricles
- dec systolic function —> weaker muscle
Pathophysiology:
- cardiac damage —> ischaemia
—> myopathy
- hypertension
- valve disease
Diagnosis:
- Symptoms - exertional dyspnoea (breathlessness)
- ECG —> enlarged QRS complex
- Tests - bloods —> elevated BNP (brain natriuretic
peptide)
- chest X-ray —> cardiomegaly
Treatment:
- Drugs —> dec exertional pressure
What is atrial fibrillation?
Disorganised electrical activity and contraction of atria
Pathophysiology:
- Atrial cells spontaneously active
Diagnosis:
- Symptoms - palpitations
- chest pain
- ECG —> no p-wave
—> irregularly irregular rhythm
Treatment:
- Maintain sinus rhythm —> cardioversion
—> anti-arrhythmics
—> catheter ablation
What is Wolff-Parkinson-White syndrome?
Abnormal cardiac electrical conductance to ventricles
Pathophysiology:
- additional accessory conduction pathway between
atria and ventricles (bundle of Kent) —> usually left
Diagnosis:
- Symptoms - tachycardis
- palpitations
- chest pain
- ECG —> pre-excitation in QRS (elevates)
- early depolarisation of ventricles
—> biphasic T-wave
- not stopped at AV node —> overlap
Treatment:
- Not needed
What are conduction blocks?
Issue with cardiac conduction system
Types:
1. First-degree —> slow conduction through AV node
2. Second-degree —> dec AV transmission
3. Third degree —> no AV transmission
Pathophysiology:
- fibrosis
- calcification
- necrosis
… of AV node or purkinje fibres
Diagnosis:
- ECG - First degree —> inc P-R interval
- Second degree —> missing QRS complexes
- Third degree —> no QRS complexes
Treatment:
- Discontinue AV-blocking drugs (beta-blockers,
calcium channel blockers)
- Pacemaker implantation
What is hypertension?
Blood pressure ≥ 140/90 (ambulatory BP ≥ 135/85)
Pathophysiology:
- Primary —> unknown
- Secondary —> other medical condition
Diagnosis:
- Blood pressure ≥ 135/85
Treatment:
- Lifestyle changes
- Anti-hypersensitivity
What are acute coronary syndromes?
Sudden, reduced blood flow to the heart
Types:
1. NSTEMI = Non-ST-Elevated Myocardial Infarction
- coronary artery narrowed (partial
occlusion)
2. STEMI = ST-Elevated Myocardial Infarction
- coronary artery blocked
Pathophysiology:
- Atherosclerosis of coronary artery (full occlusion)
Diagnosis:
- Symptoms - angina - stable —> pain with exertion
- unstable —> pain at rest
- NSTEMI —> radiates
- sweating
- nausea and vomiting
- ECG - NSTEMI —> may have ST-depression
- STEMI —> ST-elevation
- Tests - bloods —> high troponin
Treatment:
- vasodilators —> treat angina
- coronary stents
- antiplatelets
- anti-emetics
- oxygen
- pain relief
What does an enlarged QRS complex on an ECG indicate?
Heart failure
What does no p-wave on an ECG indicate?
Atrial fibrillation
+ irregularly irregular rhythm
What does pre-excitation of the QRS complex on an ECG indicate?
Wolff-Parkinson-White syndrome
+ biphasic T-wave
What does a biphasic T-wave on an ECG indicate?
Wolff-Parkinson-White syndrome
+ pre-excitation of QRS complex
What does an increased P-R interval on an ECG indicate?
First degree conduction block
What do missing QRS complexes on an ECG indicate?
Second degree conduction block
What does no QRS complexes on an ECG indicate?
Third degree conduction block
What do ST-depressions on an ECG indicate?
NSTEMI
