Cardiovascular: Session 8 Flashcards Preview

ESA 2: Cardiovascular > Cardiovascular: Session 8 > Flashcards

Flashcards in Cardiovascular: Session 8 Deck (20)
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1
Q

What some causes of chest pain?

A
  • Cardiac pathology
    • Ischaemic
    • Pericarditis
  • Respiratory pathology
    • Pulmonary embolism
    • Pneumonia
  • Musculoskeletal pathology
    • Rib fracture
    • Costochondritis
  • Upper Gastrointestinal Reflux
2
Q

What some symptoms of pneumonia? (respiratory associated chest pain)

A
  • Pain in the sides of the patient
  • Temperature
  • Cough
  • Breathlessness
3
Q

What are some symptoms of pulmonary embolism?

A
  • Breathlessness
  • Chest pain is sharp
  • Well localised
  • Worse with inspiration
  • Cough
4
Q

What are some symptoms of constochondritis?

A
  • Sharp well localised pain
  • Tender to palpate
  • Worse with movement of chest walls
  • Coughing with inspiration
5
Q

What are some symptoms of pericarditis?

A
  • Retrosternal chest pain
  • Sharp pain, localised to front of the chest
  • Aggravated with inspiration, cough, lying flat
  • Eased with sitting up and leaning forward
  • Pericardial rub may be heard on auscultation
6
Q

What are some symptoms of ischaemic heart pain?

A
  • Dull retrosternal chest pain
  • Heaviness
  • Central pain radiating to the jaw, neck and shoulder
7
Q

What are some symptoms of upper gastrointestinal related chest pain?

A
  • Burning pain
  • Can be felt centrally or going upwards
  • Certain food or lying flat can make it worse
8
Q

What is pericarditis?

A

Inflammation of the pericardium often secondary to a viral illness.

9
Q

What are the modifiable risk factors of atherosclerosis?

A
  • Smoking
  • Hypertension
  • Hypercholesterolaemia
  • Diabetes
  • Obesity
  • Sedentary lifestyle
10
Q

What some non-modifiable risk factors of atherosclerosis?

A
  • Advanced age
  • Family history
  • Male
11
Q

When does heart tissue ischaemia occur in stable angina?

A

Heart tissue ischaemia occurs only when metabolic demands of cardiac muscle are greater than what can be delivered via coronary arteries.

12
Q

What conditions are included in acute coronary syndrome?

A
  • Unstable angina
  • Myocardial infarction
  • Non-ST elevation myocardial infarction (NSTEMI)
  • ST elevation myocardial infarction (STEMI)
13
Q

What are the sequence of events that lead to an acute coronary syndrome?

A
  • Atherosclerotic plaque ruptures
  • Platelet aggregation and formation of thrombus
  • Formation of completely occlusive thrombus from partially occlusive thrombus
14
Q

What is the difference between heart tissue death and heart tissue ischaemia?

A

Cardiac enzymes leak from necroses cardiac muscle cells after death. (Troponin I)

15
Q

What is the history of a patient with stable angina?

A
  • Dull, retrosternal chest pain triggered by exertion
  • Chest pain is relieved by rest. No chest pain at rest
  • GTN spray can relieve the pain
16
Q

What the typical history of a patient with unstable angina?

A
  • Dull retrosternal chest pain occurs at rest

- The pain may be more intense and last longer than in stable angina

17
Q

What are the diagnostic tests in suspected acute coronary syndrome?

A

ECG

  • Changes suggestive of current ischaemia or infarct
  • Look at ST segments, T waves +/- pathological Q waves

Blood tests
-Troponin - presence indicates cardiac myocyte death

Other investigations

  • To exclude other potential diagnosiss
  • To identify potential complications
18
Q

What are the ECG changes to STEMI?

A

Patterns of infarct

  • ST segment elevation
  • Hyperacute T waves

The localisation of the changes helps to determine anatomical site

19
Q

What are the ECG changes in unstable angina and NSTEMI?

A
  • ST segment depression

- T wave flattening or inversion

20
Q

How would you differentiate between the NSTEMI and unstable angina?

A

Test the troponin I which will be present in an NSTEMI.