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CVR > Common cardiovascular conditions > Flashcards

Common cardiovascular conditions Flashcards

1
Q

Congenital heart disease

A

General term for range of birth defects that affect the normal way the heart works

Affects 1 in 100 babies born in the UK

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2
Q

Risk factors with congenital heart disease

A
  • Down’s syndrome
  • The mother having infections (rubella) druing pregnancy
  • Mother smoking or drinking alcohol during pregnancy
  • Mother having poorly controlled type 1 or type 2 diabetes
  • Other chromosome defects, where genes may be altered from normal and can be inherited
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3
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5
Q

Types of congenital heart disease-
atrial septal defects

A

People have a hole between the upper heart chambers
Oxygenated blood from systemic circulation enters pulmonary circulation

Usually acyanotic

Large, long term ASD damage the heart and lungs may require surgery

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6
Q

Subtypes of atrial septal defects

A

Secundum
Primum
Sinus venosus
Coronary sinus

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7
Q

Secundum

A

The most common type of ASD (occurs in 1/150 live births, 65-75% affecting females).
Occurs in the middle of the atrial septum.

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8
Q

Primum

A

Affects the lower part of the wall between the upper heart chambers.

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9
Q

Sinus venosus

A

Rare type of ASD (<5%).

Deficiency in myocardial wall separating the right pulmonary veins from the superior vena cava.

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10
Q

Coronary sinus

A

Rare type of ASD.
Deficiency in myocardial wall separating the coronary sinus and the left atrium.

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11
Q

Congenital heart disease - ventricular septal defects

A

People have a hole between the lower heart chambers (ventricular septum).

Oxygenated blood from systemic circulation enters pulmonary circulation.

Large, long-term VSDs can damage the heart and lungs and may require surgery.

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12
Q

Subtypes of ventricular septal disease

A

Conoventricular
Perimembranosus
Inlet
Muscular

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13
Q

Conoventricular VSD

A

Hole occurs where portions of the ventricular septum should meet just below the aortic and pulmonary valves.

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14
Q

Perimembranous VSD:

A

Hole in the upper section of the ventricular septum.

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15
Q

Inlet VSD:

A

Hole in the septum near where blood enters the ventricles via the tricuspid and mitral valves.

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16
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A
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17
Q

Muscular VSD:

A

Hole in the lower muscular part of the ventricular septum.

The most common type of VSD.

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18
Q

Congenital heart disease - patent ductus arteriosus

A

People have a hole between the aorta and pulmonary artery

Oxygenated blood from systemic circulation enters pulmonary circulation.

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19
Q

Congenital valvular heart disease -
Congential valve stenosis

* Aortic valve stenosis

A
  • Aortic valve is narrowed.
  • Reduced blood flow out of the heart.
  • Left ventricular hypertrophy, tachycardia / palpitations.
  • Heart failure.
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20
Q

Pulmonic valve stenosis

A
  • Pulmonary valve is narrowed.
  • Reduced blood flow out of the heart.
  • Right ventricular hypertrophy, dyspnoea, particularly during physical activity, fatigue, syncope.
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21
Q

Acquired heart disease in children and adults -

Dilated cardiomyopathy

A

Left ventricle becomes dilated (enlarged).
Reduced pumping efficiency.
May lead to…
valve problems, tachycardia, arrhythmias, blood clots, lung congestion / heart failure, and/or sudden cardiac death.

22
Q

Risk factors with dilated cardiomyopathy

A

Family history

Autoimmune, viral infection, complications during/after pregnancy, CHD, diabetes, exposure to toxins, MI, hypertension, thyroid disease.

23
Q

Acquired heart disease in children and adults

Inflammatory conditions

A

Endocarditis.
Myocarditis.
Pericarditis.

24
Q

Risk factors with inflammatory conditions

Acquired heart disease in children & adults

A

Viral or bacterial, fungal infection.
Cancer.
Autoimmune disease (e.g., Lupus or rheumatic fever).

25
Q

Acquired heart disease in children and adults-

Endocarditis

A
  • Relatively rare.
  • Infection of the inner lining of the heart – can damage heart valves.
  • Usually bacterial infection.
  • More common in: i) congenital heart disease or valve conditions; ii) adults than children; iii) men than women.
26
Q

Acquired heart disease in children and adults-

Myocarditis

A

Necrosis and inflammation of myocardium

Usually linked to viral infection (also bacterial, fungal, parasitic forms). Sometimes drug reactions or general inflammatory condition.
Decreased myocardial function (efficiency).

Enlargement of heart.

Chest pain, dyspnoea, arrythmias, blood clots, stroke, MI.

27
Q

Acquired heart disease in children and adults

Pericarditis

A

Inflammation of pericardium – fluid accumulation in pericardial space.

Haemodynamic compromise as pressure builds around heart.

Severe limitation to venous return and cardiac output – swelling in stomach, feet and legs.
Cardiac Tamponade - restricted space for heart to operate.

Eventually severe hypotension can result.

Cerebral hypoperfusion – syncope.

Cardiac arrest.

28
Q

Cardiovascular disease (CVD) epidemiology

A

Type of non-communicable disease

Ischaemic heart disease is leading cause of death worldwide

29
Q

Atherosclerosis - epidemiology

A

Contributes to more mortality and serious morbidity than any other disorder in the Western World

Major complications are a number of cardio- and cerebrovascular diseases:

  • Coronary Heart Disease (CHD):

1) Acute Coronary Syndromes
2) Chronic Ischaemic Heart Disease

  • Peripheral Arterial Disease (PAD)
  • Cerebrovascular Disease (Stroke)
30
Q

Atherosclerosis - aetiology

A

Chronic inflammatory condition affecting large- and medium sized vessels (e.g., aorta, coronary arteries, and large vessels supplying the brain).

Characterised by ‘hardening’ of the arteries due to the formation of fibrofatty legions in the** intimal lining.**

Exact cause unknown; several predisposing risk factors.

31
Q

Atherosclerosis - risk factors

A

Age (Men: ≥45 y; Women: ≥55 y or premature menopause without oestrogen replacement therapy)

Family history of premature CHD (MI or sudden death before 55 y in male first-degree relative, or before 65 y in female first-degree relative)

Current cigarette smoking

Hypertension (≥140/90 mmHg [confirmed on several occasions] or on antihypertensive medication)

Hyperlipidaemia

Low HDL cholesterol (<40mg/dL)

Diabetes Mellitus

Obesity

Physical Inactivity / Sedentary behaviour

32
Q

Negative risk factor - atherosclerosis

A

High HDl cholesterol (≥ 60mg/dL)

33
Q

Atherosclerosis- pathophysiology

A

Response to Injury Hypothesis –> incl. later modifications:

Endothelial Dysfunction (Injury) –> Increased permeability & leucocyte adhesion, with monocyte emigration and platelet adhesion.

Lipid accumulation in intima, and macrophage engulfment of lipids –> Foam Cells

Smooth muscle cell migration from media to intima

Smooth muscle proliferation, and deposition of collagen & other extracellular matrix

Development of fibrous plaque with lipid core

34
Q

What casues endothelial dysfunction?

A
  • Insulin resistance
  • Hypertension
  • Hyperlipdaemia
  • Normal wear and tear
  • Fibrinogen
  • Carbon monoxide
  • Turbelent flow
  • Smoking
  • Free radicals
  • Diabetes mellitus
  • Viral attack
  • Ageing
  • Fibrinogen
35
Q

Coronary heart diease

A

Caused by impaired blood flow

Disease of the coronary arteries can cause Angina, myocardial infarction (MI), dysrhythmias, conduction defects, heart failure and sudden death.

36
Q

Two types of atherosclerosis lesions

A

Stable plaque –> obstructs blood flow; associated with chronic ischaemic heart disease (e.g., stable angina)

Unstable plaque –> can rupture causing platelet adhesion and thrombus formation; associated with acute coronary syndromes (unstable angina and MI)

37
Q

Acute coronary syndromes:

A
  • Unstable Angina,
  • Non-ST segment Elevation MI (Non-STEMI)
  • ST segment Elevation MI (STEMI)
38
Q

Unstable angina

A

Characterised by symptoms (usually prolonged: >20 minutes) at rest

No serum markers for myocardial damage; ECG changes

39
Q

Non-ST segment elevation MI:

A

Characterised by symptoms (usually prolonged: >20 minutes) at rest

Serum markers for myocardial damage present – indicating severe ischaemia and damage to the myocardial tissues; ECG changes

40
Q

ST segment elevation MI

A
  • Acute MI (heart attack) characterised by ischaemic death of myocardial tissue.
  • Serum markers detectable
  • Area of infarct = vessel affected:

30-40 % Right Coronary Artery
40-50 % Left Anterior Descending Artery
15-20 % Left Circumflex Artery

  • Sudden death from Acute MI –> death occurs within 1h symptom onset
  • Usually attributed to fatal dysrhythmias (ventricular fibrillation)
  • Early hospitalisation greatly improves chances of survival
41
Q

Chronic iscaemic heart disease

A
  • Inability of the coronary arteries to supply blood to meet the metabolic demands of the heart.
    Caused by impaired blood flow –> atherosclerosis again!

3 classifications:
Chronic stable angina
Variant angina
Silent myocardial ischaemia

42
Q

Chronic stable angina

A

Associated with a fixed atherosclerotic obstruction and pain that is precipitated by increased work demands on the heart but which is relieved by rest.

43
Q

Variant angina

A

Results from spasms of the coronary arteries or other dysfunctions.

44
Q

Silent myocardial ischaemia

A

Occurs without symptoms

45
Q

Peripheral arterial disease

A

Obstruction of the large arteries that supply the bodys periphery

Describes atherosclerotic blockages of the lower extremities

Causes acute or chronic ischamia

46
Q

Risk factors for peripheral arterial disease

A

Age (men aged 60+ y)
Smoking
Diabetes Mellitus

47
Q

Peripheral arterial disease-

Progressive disease state:
Signs and symptoms

A
  • Pain and cramping with walking (particularly calf pain)
  • Tingling / aching / numbness in legs or feet
  • Atrophic changes (thinning skin & subcutaneous fat)
  • Cool foot
  • Popliteal pulse weak or absent
  • Blanched limb colour when leg elevated –> gravitational effects on perfusion pressure
48
Q

Peripheral disease state:
Progressive disease state

Long term damage

A

Ischaemic pain at rest, ulceration and gangrene develop.

49
Q

what is a vagina

A

something i haven’t had in a while

50
Q

Who is the best County Footballer

A

Is goalkeeper a real position

51
Q
A

CVR (11 decks)

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