CV Disorders

Question 1

What is Atrial fibrillation (AF)?

Answer 1

Disorganised electric activity and contraction

Question 2

What is Wolff-Parkinson-White (WPW)?

Answer 2

Syndrome causing tachycardia & abnormal cardiac electrical conductance

Question 3

What are 2 forms of atrial arrhythmias?

Answer 3

Atrial fibrillation

Wolff-Parkinson-White

Question 4

What is an underlying cause of AF?

Answer 4

Spontaneously active cells throughout the atria

Question 5

What is an underlying cause of WPW?

Answer 5

additional accessory conduction pathway (the bundle of Kent) between the atria and ventricles

Question 6

What are signs + symptoms of AF + WPW?

Answer 6

Palpitations & chest pain

Question 7

What are ECG findings for AF?

Answer 7

Absent p-waves & ‘irregularly irregular’ rhythm.

Question 8

What are ECG findings for WPW?

Answer 8

QRS pre-excitation & biphasic/ inverted T-wave of ECG

Question 9

What are treatment options for AF?

Answer 9

strategies to maintain sinus (e.g. cardioversion, anti-arrhythmics, catheter ablation)

Question 10

What are treatment options for WPW?

Answer 10

benign, no treatment required

Question 11

What is conduction block?

Answer 11

b

Question 12

What are underlying causes of conduction block?

Answer 12

Damage (fibrosis, calcification, necrosis) to the conduction system (
AV node or His Purkinje system)

Question 13

How are conduction blocks graded?

Answer 13

First-degree block
Second-degree block
Third-degree block

Question 14

What is first-degree block?

Answer 14

slowing down of conduction through AV node

Question 15

What is second-degree block?

Answer 15

reduced transmission of signal from atria to ventricles

Question 16

What is third-degree block?

Answer 16

complete block of current from atria to ventricles

Question 17

What are the ECG finding for a first-degree block?

Answer 17

increased P-R interval

Question 18

What are the ECG finding for a second-degree block?

Answer 18

increased P-R interval or ‘missing’ QRS complexes, depending on type of block

Question 19

What are the ECG finding for a third-degree block?

Answer 19

p-waves not followed by QRS complexes

Question 20

What are the treatment options for conduction block?

Answer 20

Discontinuation of AV-blocking drugs (e.g. beta-blockers, calcium channel blockers)
pacemaker implantation in severe cases

Question 21

What is heart failure?

Answer 21

Heart unable to maintain adequate circulation for metabolic requirements of body

Question 22

What is preserved ejection fraction (HFpEF)?

Answer 22

EF ≥ 50%, ↓ diastolic function, stiff heart muscle

Question 23

What is reduced ejection fraction (HFrEF)?

Answer 23

EF ≥ 40%, ↓ systolic function, weakened heart muscle

Question 24

What is an underlying cause of heart failure?

Answer 24

secondary to cardiac damage (ischaemia, myopathy)
hypertension
valve disease

Question 25

What are signs + symptoms of heart failure?

Answer 25

exertional dyspnoea (shortness of breath during exertion)

Question 26

What are tests that can be done to identify heart failure?

Answer 26

Blood test: elevated brain natriuretic peptide (BNP) | Chest X-ray: cardiomegaly

Question 27

What are the treatment options for heart failure?

Answer 27

Drugs that reduce the exertional pressure on the heart

Question 28

What is hypertension?

Answer 28

high blood pressure

Question 29

How is hypertension defined clinically?

Answer 29

Clinical BP ≥ 140/90 mmHg & ambulatory BP daytime average ≥ 135/85 mmHg

Question 30

What are the causes of primary hypertension?

Answer 30

unknown

Question 31

What are the causes of secondary hypertension?

Answer 31

resulting from another medical condition (e.g. kidney disease, adrenal disease)

Question 32

How can hypertension be identified?

Answer 32

Blood pressure measurement: readings ≥ 135/85 mmHg

Question 33

What are treatment options for hypertension?

Answer 33

Lifestyle changes followed by anti-hypertensive medication

Question 34

What is angina?

Answer 34

chest pain (due to myocardial ischaemia caused by atherosclerosis)

Question 35

What is NSTEMI?

Answer 35

non-ST-elevated myocardial infarction : myocardial tissue damage due to prolonged ischaemia

Question 36

What is STEMI?

Answer 36

ST-elevated myocardial infarction : serious myocardial tissue damage due to prolonged ischaemia

Question 37

What is the underlying cause of angina in acute coronary syndromes?

Answer 37

Atherosclerotic lesions of the coronary artery

Question 38

What is the underlying cause of NSTEMI?

Answer 38

atherosclerosis + artery blockage

Question 39

What is the underlying cause of STEMI?

Answer 39

severe atherosclerosis + complete artery blockage

Question 40

What are signs + symptoms of angina?

Answer 40

chest pain on exertion (stable) or at rest (unstable)

Question 41

What are signs + symptoms of NSTEMI?

Answer 41

chest pain, sweating, nausea + vomiting

Question 42

What are signs + symptoms of STEMI?

Answer 42

radiating chest pain, sweating, nausea & vomiting

Question 43

What would be the ECG findings for NSTEMI?

Answer 43

ST-depression/no changes

Question 44

What would be the ECG findings for STEMI?

Answer 44

ST-elevation w/ reciprocal ST-depression

Question 45

What would the blood test findings for NSTEMI + STEMI?

Answer 45

high troponin levels

Question 46

What are the treatment options for angina?

Answer 46

vasodilators

Question 47

What are the treatment options for NSTEMI + STEMI?

Answer 47

``` coronary stents antiplatelets vasodilators anti-emetics oxygen & pain-relief ```

Question 48

What does WPW result in pre-excitation before QRS complex?

Answer 48

additional ventricular pathway = ventricular depolarisation before ventricular depolarisation starts in the AV node

Question 49

Why does WPW result in a biphasic T-wave?

Answer 49

due to current not being stopped at AVN, another repolarisation is starting before the depolarisation ends