CV Disorders

Question 1

What is the basic definition of HF?

Answer 1

Heart unable to maintain adequate circulation for metabolic requirements of body.

Question 2

What is HFpEF?

Answer 2

HF with preserved EF.

EF ≥ 50%, ↓ diastolic function

Question 3

What is HFrEF?

Answer 3

HF with reduced EF.

EF ≥ 40%, ↓ systolic function

Question 4

What are the underlying causes of HF?

Answer 4

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

Question 5

Signs and symptoms of HF?

Answer 5

Exertional dyspnoea.

Question 6

What tests can you do for HF?

Answer 6

Blood test: elevated brain natriuretic peptide (BNP)

CXR: cardiomegaly

Question 7

Treatment options for HF?

Answer 7

Drugs that reduce the exertional pressure on the heart.

Question 8

ECG findings for HF?

Answer 8

Not usually many.

Main one is an enlarged QRS complex.

Question 9

Define atrial fibrillation.

Answer 9

Disorganised electric activity and contraction

Question 10

Define Wolff-Parkinson-White.

Answer 10

Syndrome causing tachycardia & abnormal cardiac electrical conductance.

Question 11

Underlying cause of AF?

Answer 11

Spontaneously active cells throughout the atria

Question 12

Underlying cause of WPW?

Answer 12

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

Question 13

Signs and symptoms of WPW and AF?

Answer 13

Palpitations and chest pain

Question 14

What are the ECG findings for AF?

Answer 14

Absent p-waves & ‘irregularly irregular’ rhythm.

Question 15

What are the ECG findings WPW?

Answer 15

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

Question 16

Treatment options for AF?

Answer 16

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

Question 17

Treatment options for WPW?

Answer 17

Benign, no treatment required

Question 18

Define a first-degree block

Answer 18

Slowing down of conduction through AV node

Question 19

Define a second-degree block

Answer 19

Reduced transmission of signal from atria to ventricles

Question 20

Define a third-degree block

Answer 20

Complete block of current from atria to ventricles

Question 21

What is the underlying cause of a conduction block?

Answer 21

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

Question 22

What are the ECG findings for 1s, 2nd and 3rd degree blocks?

Answer 22

1. Increased P-R interval
2. Increased P-R interval or ‘missing’ QRS complexes, depending on type of block
3. P-waves not followed by QRS complexes

Question 23

Treatment options for a conduction block?

Answer 23

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

Question 24

Which type of conduction block is a medical emergency?

Answer 24

3rd Degree Block
No QRS Complex
Need to treat immediately
(quite rare)

Question 25

Define hypertension

Answer 25

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

Question 26

What is the underlying cause of hypertension?

Answer 26

Primary (essential): unknown | Secondary: resulting from another medical condition (e.g. kidney disease, adrenal disease)

Question 27

What investigation can you do to determine if a person has hypertension?

Answer 27

Blood pressure measurement: readings ≥ 135/85 mmHg

Question 28

Treatment options for hypertension?

Answer 28

Lifestyle changes followed by anti-hypertensive medication

Question 29

Define angina.

Answer 29

Chest pain due to myocardial ischaemia caused by atherosclerosis

Question 30

Define non-ST-elevated MI.

Answer 30

Myocardial tissue damage due to prolonged ischaemia caused by atherosclerosis and artery blockage.

Question 31

Define STEMI.

Answer 31

Serious myocardial tissue damage due to prolonged ischaemia caused by severe atherosclerosis and complete artery blockage

Question 32

What is the underlying cause of angina, NSTEMI and STEMI?

Answer 32

Atherosclerotic lesions of the coronary artery causing ischaemia (angina), artery blockage (NSTEMI) and then complete artery blockage (STEMI).

Question 33

What are the signs and symptoms of angina, NSTEMI and STEMI?

Answer 33

Angina: chest pain on exertion (stable) or at rest (unstable) NSTEMI: chest pain, sweating, nausea & vomiting STEMI: radiating chest pain, sweating, nausea & vomiting

Question 34

What are the ECG findings for NSTEMI?

Answer 34

ST-depression/no changes & high troponin levels

Question 35

What are the ECG findings for STEMI?

Answer 35

ST-elevation with reciprocal ST-depression & high troponin levels

Question 36

What is the treatment option for angina?

Answer 36

Vasodilators

Question 37

What are the treatment option for NSTEMI?

Answer 37

Coronary stents, antiplatelets, vasodilators, anti-emetics, oxygen & pain-relief

Question 38

What are the treatment options for STEMI?

Answer 38

Coronary stents, antiplatelets, vasodilators, anti-emetics, oxygen & pain-relief (same as NSTEMI)