Cardiovascular System Flashcards
1
Q
What are the three types of Acute Coronary Syndrome?
A
- Unstable angina
- NSTEMI
- STEMI
2
Q
What is Angina?
A
- Angina is chest pain that occurs when the blood supply to the muscles of the heart is restricted
3
Q
What causes Angina?
A
- Narrowing or hardening of the main arteries going to the heart
- Atherosclerosis usually
4
Q
What are the types of Angina?
A
- Stable- angina attacks are brought on by obvious trigger such as exercise and improves with medication and rest
- Unstable- Attacks are more unpredictable occurring with no obvious trigger and continuing despite rest
5
Q
What are the symptoms of Angina?
A
- Dull, heavy or tight pain in the chest that can sometimes spread to the left arm, neck, jaw or back
- Usually only lasts a few minutes- angina attack
6
Q
What is the treatment for Angina?
A
- Relieves symptoms, reduce number of attacks and reduce the risk of heart attack or stroke
- Glyceryl trinitrate (nitrate) relaxes and widens blood vessels so increases blood supply to the heart – can be a spray
- Beta blockers, calcium channel blockers to prevent attacks Statins, low dose aspirin and ACE inhibitors reduce the risk or heart attack
- Surgery- CABG where section of blood vessel is taken from another part of the body and used to re-route the flow if blood past a blocked or narrowed artery
- PCI- narrowed section of artery is widened using a stent
7
Q
What is Atherosclerosis?
A
- Hardening, thickening and less elastic artery due to plaque or atheroma
8
Q
What causes Atherosclerosis?
A
- Increased age, smoking, high fat diet, lack of exercise, alcohol, high blood pressure, history
9
Q
What are the symptoms of Atherosclerosis?
A
- May not show until a blockage occurs Chest pain, shortness of breath, fatigue
- Can cause angina, heart attack and stroke
10
Q
What is the treatment for Atherosclerosis?
A
- Healthy diet may stop it getting worse
- Statins for high cholesterol
- Low dose aspirin for blood clot risk CABG, coronary angioplasty or carotid endarterectomy
11
Q
What is Atrial Fibrillation?
A
- Heart condition that causes irregular and often abnormally fast heart rate
12
Q
What causes Atrial Fibrillation?
A
- Atria contracts randomly and so fast that the heart cant relax properly between contractions so reduces hearts efficiency and performance
- Abnormal electrical impulses suddenly start firing in the atria so have irregular pulse rate
- High blood pressure, coronary artery disease, heart failure and valve problems
- Excessive alcohol or smoking may increase risk
13
Q
What are the symptoms of Atrial Fibrillation?
A
- Asymptomatic
- Tiredness and lethargic
- Heart palpitations and chest pain
- Uneven pulse
- ECG-Irregularly irregular rhythm, no P wave, wavy baseline
14
Q
What is the treatment for Atrial Fibrillation?
A
- Medications e.g. beta blockers, warfarin (Stroke risk)
- Cardio version which gives electric shock to try to restore normal rhythm
- Pace maker
15
Q
What is an Atrial Septal Defect?
A
- A hole in the wall that separates the top two chambers of the heart
16
Q
What are the types of Atrial Septal Defect?
A
- Ostium secundum- Septum secundum doesn’t fuse with the septum primum and so foramen ovale doesn’t close properly
- Prnum- lower part of septum
- Sinus venosus- upper part of septum
17
Q
What are the causes of an Atrial Septal Defect?
A
- Occurs during fetal development
- May be genetic
- No clear cause for many children
18
Q
What are the symptoms of an Atrial Septal Defect?
A
- Poor appetite and growth
- Fatigue Shortness of breath and lungs problems
- Increased pulmonary blood flow, Right ventricle volume overload, right sided heart failure
19
Q
What is the treatment for an Atrial Septal Defect?
A
- May be closed in a cardiac catheterization lab or open heart surgery
- May close by itself
20
Q
What is Coarctation of the Aorta?
A
- Narrowing of the Aorta
21
Q
What are the types of Coarctation of the Aorta?
A
- Infant- 70%- occurs after the aortic arch and before Ductus arteriosus (usually closes after birth), narrowing of the aorta means high pressure above the narrow but low pressure below so: Deoxygenated Blood moves into the oxygenated blood stream through Ductus arteriosus and to lower extremities
- Adult- 30%- No Ductus arteriosus, no mixing of blood but pressure is high in the aorta before the narrowing and low below
22
Q
What are the causes of Coarctation of the Aorta?
A
- In infants during fatal development e.g. turners syndrome
23
Q
What are the symptoms of Coarctation of the Aorta?
A
- Infants- Cyanosis- blue or purple discoloration of lower limb which may cause death if not caught
- Adults- Increased pressure in upper extremities and head so increased risk of berry aneurysm Decreased blood pressure in lower extremities so claudication- pain and cramping and RAAS so causes hypertension, posterior and anterior intercostal arteries have reversed flow so pulsate and rib notching occurs
24
Q
What is the treatment for Coarctation of the Aorta?
A
- Balloon dilation to widen aorta or surgically remove coarctation
25
What is Heart block?
* Arrhythmia where a signal is delayed so the heart beats too slowly
26
What are the types of Heart block?
* First degree- delayed but still makes it to the ventricles PR interval greater than 200ms Symptoms- none Treatment- Identify electrolyte imbalances or causes from mediations, usually no further treatment
* Second degree- two types Type 1- Wenkebach PR interval progressively longer with each beat until eventually one is blocked completely (dropped beat) Eventually ventricles contract Symptoms- usually none but may have light headedness, dizziness and syncope Type 2- Mobitz II intermittent dropped beats but fairly random- no progressive lengthening Ratio of conducted to not conducted e.g. 2:1 Symptoms- fatigue dyspnea, chest pain, syncope
* Third degree or complete Signal is completely blocked so none go to ventricles More like 30 beats per minute Symptoms- syncope, confusion, dyspnea, severe chest pain, risk of dying Causes?
27
What are the causes of Heart block?
* Damage or fibrosis to conduction system E.g. LEVs disease- progressive over time, fibrosis develops
* Ischemic heart disease- not enough oxygen so heart cells due- e.g. heart attack
* Heart diseases like cardiomyopathies and myocarditis
28
What is the treatment for Heart block?
* Atropine- to increase heart rate
* Transcutaneous pacing
* Must treat underlying cause
* May need a permanent pacemaker
29
What is Heart failure?
* Heart is unable to pump blood around the body properly as it is too weak or stiff
30
What causes Heart failure?
* Coronary heart disease, high blood pressure, cardiomyopathy, heart rhythm problems, congenital heart disease, damage to valves
31
What causes Heart failure?
* Breathlessness
* Feeling tired most of the time and finding exercise exhausting
* Swollen ankles or legs (oedema)
32
What is the treatment for Heart failure?
* Healthy lifestyle changes
* Medications- ACE inhibitors, Beta-blockers, ARBs, nitrates, diuretics, aldosterone antagonists, Pacemakers, cardiac resynchronization therapy, ICDs
* Surgery e.g. valve surgery or heart transplant
33
What is Hyperkalemia?
* High than normal potassium levels in the blood
* Over 5.5mmol/L
34
What are the causes of Hyperkalemia?
* M- Medications- ACE Inhibitors, NSAIDS
* A- Acidosis- metabolic and respiratory
* C- Cellular destruction- burns and trauma
* H- Hypoaldosteronism and hemolysis
* I- Intake- excessive
* N- Nephrons renal failure Excretion- impaired
35
What are the symptoms of Hyperkalemia?
* Tiredness or weakness
* Numb or tingling
* Nausea and vomiting
* Trouble breathing
* Chest pain
* Irregular heartbeats- palpitations
36
What is the treatment for Hyperkalemia?
* Calcium reduces risk of ventricle fibrillation
* Insulin and glucose- intracellular shift of potassium
* Remove potassium intake
37
What is Hypokalaemia?
* Lower than normal potassium levels in the blood
* Less than 3.5mmoll/l
38
What causes Hypokalaemia?
* Vomiting and Diarrhea
* Medications
* Not enough intake Alkalosis
39
What are the symptoms of Hypokalaemia?
* Weakness, tiredness, cramping, tingling, nausea, vomiting, palpitations, fainting
40
What is the treatment for Hypokalaemia?
* Potassium replacement by mouth or IV (Slowly)
41
What is Hypertension?
* High blood pressure
* Systolic- arterial pressure when the hearts contracting 120-139 is prehypertension 140 and above is hypertension
* Diastolic- arterial pressure when the hearts relaxing 80-89 is prehypertension 90 and above
42
What are the causes of Hypertension?
* No clear cause- primary or essential hypertension- happens over time- old age, obesity, salt heavy diets, don’t move much 10% can have underlying cause
* secondary hypertension e.g. low renal blood flow due to atherosclerosis, vascularize or aortic dissection
* This causes more renin release so water is retained, more fluid volume and hypertension
* More aldosterone due to tumour does the same thing
43
What are the symptoms of Hypertension?
* Primary- usually none- silent killer
* Secondary- underlying cause symptoms
* Wear and tear of endothelial cells in arteries
* Can lead to MI, aneurysm and stroke
* Hypertensive crisis- 180/110mmhg or more
* Urgency- No damage to end organs
* Emergency- damage to end organs- Confusion, drowsiness, chest pain, breathlessness
44
What is the treatment for Hypertension?
* Life style changes
* Antihypertensive medications- ACE inhibitors, ARBs, calcium channel blockers, Diuretics, Beta blockers
45
What is a Myocardial Infarction?
* Heart attack- blood supply to the heart is suddenly blocked e.g. by a blood clot
* Heart muscle death from lack of blood flow
46
What causes an MI?
* Coronary heart disease- major blood vessels that supply the heart get clogged up with deposits of cholesterol (plaques)
* One of these plaques bursts causing a blood clot to develop which blocks the supply of blood to the heart causing a heart attack
47
What are the symptoms of an MI?
* Chest pain- like being pressed or squeezed by a heavy object which may radiate to the jaw, neck, arms and back
* Sometimes may be mistaken for indigestion
* Shortness of breath
* Weak or lightheaded Anxious
48
What is the treatment for an MI?
* Aspirin as helps to thin the blood and reduce the risk of a heart attack
* Chew and then swallow
* May use medications to dissolve the blood clot
* Surgery- Coronary artery bypass graft
* PCI- primary percutaneous coronary intervention
49
What is an NSTEMI?
* Non-ST-Segment elevation myocardial infarction
* Myocardial infarction with partial subendocardial infarct of the wall
* ST segment depression
50
What is a STEMI?
* ST-Segment elevation myocardial infraction
* Transmural infarct
* ST Segment elevation
51
What is Pericarditis?
* Inflammation around the heart
* Layers around the heart become thicker
* May then cause effusion
52
What are the causes of Pericarditis?
* Idiopathic
* Can be Viral Can be Dressler syndrome which is after a heart attack
* Uremic pericarditis- due to high urea levels
* Autoimmune diseases Cancer, radiation, medications
53
What are the symptoms of Pericarditis?
* Fever and chest pain that gets worse when heavy breathing but better when sitting up and leaning forward
* Diminished heart sounds and cardiac output
* Friction rub on auscultation- two pieces of leather rubbing together
54
What is the treatment for Pericarditis?
* Relieve pain and treat underlying cause
* If pericardial effusion can do a Pericardiocentesis
55
What is Shock?
* The heat suddenly cannot pump enough blood to meet your bodies needs
56
What causes Shock?
* Heart attack
* Myocarditis
* Endocarditis
* Weakened heart
* Drug overdose
57
What are the symptoms of Shock?
* Rapid breathing and shortness of breath
* Tachycardia
* Loss of consciousness
* Weak pulse
* Sweating, pale, cold hands and feet
* Heart attack symptoms if caused by this
58
What is the treatment of Shock?
* Improve blood flow and oxygen to the bodies organs
59
What is Tetralogy of Fallot?
* Ventricular septal defect
* Pulmonary stenosis
* Right ventricular hypertrophy
* Displaces aorta
* Oxygenated blood mixes with non-oxygenated blood
* Form of congenital heart disease
60
What causes Tetralogy of Fallot?
* Maternal malnutrition, viral illness, genetic disorder overall unknown
61
What are the symptoms of Tetralogy of Fallot?
* Cyanosis
* Shortness of breath
* Loss of consciousness
* Clubbing, poor weight, tired, irritable, prolonged crying
62
What is the treatment for Tetralogy of Fallot?
* Shunt Balloon dilations
* Open heart surgery
63
What is Transposition of the great arteries?
* Pulmonary artery and aorta are swapped over and connected to the wrong chamber
64
What causes Transposition of the great arteries?
* Viruses, maternal age over 40, maternal diabetes increase risks
* Overall unknown
65
What are the symptoms of Transposition of the great arteries?
* Cyanosis
* Shortness of breath
* Lack of appetite and poor weight gain
66
What is the treatment for Transposition of the great arteries?
* Surgery
* Medication and atrial septostomy
67
What is Tricuspid atresia?
* Tricuspid heart valve has not formed properly
68
What are the causes of Tricuspid atresia?
* Genetic factors such as downs syndrome, viruses, older parents, alcohol Overall Unknown
69
What are the symptoms of Tricuspid atresia?
* Cyanosis
* Difficulty breathing
* Tiring easily and slow growth and poor weight gain
* Symptoms of heart failure like fatigue and swelling
70
What is the treatment for Tricuspid atresia?
* Surgery
71
What is a Transient Ischemic Attack?
* Mini stroke
* Temporary disruption in the blood supply to part of the brain
72
What causes a TIA?
* One of the blood vessels that supply your brain becomes blocked
* Blood clot, fatty material or air bubbles
* Smoking, high blood pressure, obesity etc can increase risk
73
What are the symptoms of a TIA?
* Face- drooped on one side
* Arms- cannot lift both arms
* Speech- slurred or garbled
* Time- has to be treated fast
74
What is the treatment for a TIA?
* Although symptoms resolve in a few minutes or hours will need to prevent further TIAs
* Advice about lifestyle changes
* May need medications
75
What is Aortic Valve stenosis?
* Caused by degeneration, congenital or rhematic fever
* Causes LV hypertrophy and left sided heart failure
76
What is Aortic valve regurgitation?
* Caused by Dilation and Vlavular damage
* Causes bounding pulse and LV hypertrophy
77
What is Mitral valve stenosis?
* Caused by rhematic fever
* Causes RV hypertrophy, thrombus formation and dysphagia
78
What is Mitral valve regurgitation?
* Caused by Mysomatous degeneration, prolapse and rhematic fever
* Causes LV hypertrophy
79
What is a Ventricular ectopic beat?
* Ventricular contractions before the underlying rhythm would normally depolarise
80
What causes a Ventricular ectopic beat?
* Heart disease
* Stimulation e.g. stress, alcohol, caffeine, medication, cocaine
81
What are the symptoms of Ventricular ectopic beats?
* Heart is fluttering, pounding, skipping
* Aware of heart beat
* Feel faint or dizzy
82
What is the treatment for Ventricular ectopic beats?
* Usually not necessary
* Treat underlying cause
83
What is Ventricular fibrillation?
* Rhythm problem that occurs when the heart beats with rapid, erratic electrical impulses
84
What causes Ventricular fibrillation?
* Can be unknown
* Heart problems such as from a heart attack like scars and damage
85
What are the symptoms of Ventricular fibrillation?
* Chest pain, rapid heartbeat
* Dizziness and loss of consciousness
* Nausea
* Shortness of breath
86
What is the treatment for Ventricular fibrillation?
* Cardiopulmonary resuscitation
* Defibrillation
87
What is a Ventricular septal defect?
* Hole between the left and right ventricles
* Form of Congenital heart disease
88
What causes a Ventricular septal defect?
* Congenital heart defect- unknown cause, may be infection, mother nutrition etc
* Severe blunt trauma to the chest
89
What are the symptoms of Ventricular septal defects?
* Shortness of breath
* Paleness
* Failure to gain rate
* Fast heart rate
* Sweating while feeding
* Respiratory infections
90
What is the treatment for Ventricular septal defects?
* Surgical repair
* Catheter procedure
