CVS Flashcards
1
Q
S+S
A
- Chest P/discomfort
- Breathlessness
- Palpitations
- Fatigue
- Dizziness and syncope
- Sleep disturbance- can’t lie flat
- Oedema – lower limb, sacrum- reduced circulatory flow
2
Q
Non cardiac causes of chest P- gastroesophageal
A
Perforation may be caused by forceful vomiting and disease. Sudden, severe constant P from neck to oesophagus, neck swelling
Spasm- confused with cardiac condition as its relieved with nitrates, not related to exertion (like cardiac P), swallowing extremely hot or cold substances often causes this which leads to chest P
Reflux- burning sensation, referred to as heartburn, aggravated by lying down or after meals, chronic cough or dysphagia
3
Q
Non cardiac causes of chest P- pulmonary
A
Pleuritic in nature- P varies with respiratory cyvle, exacerbated during inspiration and coughing
Typically sharp and unilateral
Usually caused by lower resp tract infection
Spontaneous pneumothorax- results in sharp chest P, that may radiate to ipsilateral shoulder, can be caused by underlying condition, typical Px is talk, thin, male, smoker
Pulmonary embolism- acute acute of dyspnea, pleuritic chest P, severe hypoxia and risk factors such as recent surgery, underlying malignancy, bedridden/sedentary state
4
Q
Non cardiac causes of chest P- MSK
A
Costochondritis, rib fracture, myalgia
Palpation of chest may reproduce symptoms
5
Q
Non cardiac causes of chest P- herpes zoster
A
Burning sensation, unilateral dermatomal distribution
Physical exam findings may be lacking as P often occurs before onset of vascular lesion |(blister), making diagnosis difficult
6
Q
Angina
A
Reduced blood flow to heart
7
Q
Angina types
A
Stable
Unstable
Variant
Refractory
8
Q
Stable angina
A
Most common, usually occurs during activity, relived by rest or medication, predictable, short term episodes. Occurs due to mismatch between blood supply and metabolic demand, causes regional wall abnormalities
9
Q
Unstable angina
A
Unpredictable, medical emergency, occurs at rest, more severe symptoms, inc duration (20 mins), heart starved of O2= potential heart attack
10
Q
Variant angina
A
Not due to CAD, caused by spasm in coronary arteries that temporarily reduces blood flow, tends to occur in cycles, typically rest, relived by medicine
11
Q
Refractory angina
A
Episodes are frequent despite medication + lifestyle changes
12
Q
Angina causes
A
- Caused by dec blood flow to heart
- Symptom of CAD
- Can be result of aortic stenosis
13
Q
Angina population
A
60+
14
Q
Angina risks
A
Family Hx of heart disease
Aging
15
Q
S+S angina
A
- Often described as squeezing, pressure, heaviness, tightness or P in chest
- May feel like heavy weight on chest
- P may be felt in arms, neck, jaw, shoulders and back
- Dizziness, fatigue, nausea, shortness of breath, sweating
16
Q
Angina prognosis
A
- Angina medication- glycerol tri-nitrate
- Lifestyle changes- lose wight, healthy due
- Rest
17
Q
Myocardial infarction
A
- Heart attack occurs when flow of blood to heart is reduced or blocked
- Myocardial cells don’t have a blood supply, requires lots of O2 as in constant use
18
Q
MI population
A
Male 45+
W 55
19
Q
MI risks
A
- Age- men aged 45, women aged 55
- Tobacco use
- High blood pressure
- Obesity
- Diabetes
- Family Hx
20
Q
S+S MI
A
- Variable
- Chest P- pressure, tightness, P, squeezing or aching
- Cold sweat
- Fatigue
- Heartburn or indigestion
- Dizziness
- Shortness of breath
- Women can have silent infarctions= no symptoms
21
Q
MI prognosis
A
nc risk post first acute infarction
22
Q
Aortic dissection
A
- Serious condition in which tear occurs in layer of aorta
- Blood rushes through tear causing inner and middle layers of aortic to dissect
23
Q
Aortic dissection causes
A
- Uncontrolled high blood pressure
- Atherosclerosis
- Aortic aneurysm
24
Q
Aortic dissection population
A
Men 60-70
25
AD risks
- Turner syndrome
- Marfan syndrome
- Other connective tissue disorder
26
Aortic Dissection S+S
- Feeling of tearing P followed by sudden low back P
- Loss of consciousness
- Shortness of breath
- Weak pulse in one arm or thigh compared with other
- Leg P
- Difficulty walking
27
AD prognosis
- If detected early the chance of survival increases significantly
Synthetic graft to reconstruct aorta
28
Valvular heart disease
- One or more valve doesn’t work properly
- Causes poor blood flow through the heart to the body
29
Valvular disease cause
- Congenital
- Infection
- Degenerative conditions
- Stenosis- thickened valves or calcified obstructs flow
30
Valvular disease population
65+
31
VD risks
- Older age
- Hx of certain infections
- High blood pressure
- Congenital heart disease
32
VD S+S
- Might not have symptoms for many years
- Heart murmur
- Chest P
- Fatigue
- Shortness of breath
- Swelling in ankles and feet
- Dizziness
33
VD prognosis
- Depends on type and severity of disease
- Sometimes requires surgery to repair or replace valve
34
Aneurysm
- Abnormal bulge in wall of blood vessel
- Can rupture, causing internal bleeding (fatal)
- Aortic, abdominal aortic, thoracic aortic, brain, peripheral aneurysm
35
Aneurysm cause
- High blood pressure/hypertension over many years damage/weakening of blood vessels
- Atherosclerosis- weakens blood vessels
36
Aneurysm population
30-60
Women
37
Aneurysm risks
- High blood pressure
- Size, location, growth
- Family Hx
38
Aneurysm S+S
- Dependent on location
- Brain- can lurk without symptoms, can rupture and leak (haemorrhagic stroke- medical emergency), most don’t rupture, severe headache, nausea, blurred/double vision, seizure, photosensitivity. Unruptured- P above/behind eye, dilated pupil, change in vision, numbness of one side of face
- Aortic- back P, cough, weak/scratchy voice, shortness of breath, tenderness in chest
- Abdominal- dizziness, P in lower back, sweaty/pale/clammy skin, fast heartbeat, shortness of breath
- Peripheral- pulsating lump that can be felt, leg P/cramping with exercise, ulcers of toes/fingers, radiating P, gangrene/tissue death
39
Aneurysm prognosis
- Some have below risk of rupture
- Doctor required to identify size/risk of rupture
- Rupture= fatal (especially in brain)
40
Hypertrophic changes
- Heart muscles become thickened
- Makes it harder for blood to be pumped around body
41
Hypertrophic cause
- Genetic mutation that causes muscle thickening
- Typically affects septum, can block blood flow between chambers
42
Hypertrophic changes population
- Can be diagnosed at any age
- Hypertrophy may be present at birth or in childhood, however much more common to appear normal
43
Hypertrophic risks
- Inherited- people with one parent with hypertrophic cardiomyopathy have a 50% chance of developing
- Should be screened
44
Hypertrophic S+S
- Often goes undiagnosed due to lack of symptoms
- Shortness of breath, chest P, changes to hearts electrical system life-threatening irregular heart rhythm/sudden death
- Chest P during exercise
- Fainting post exercise
- Heart murmur
- Sense of palpitations
- Shortness of breath
45
Hypertrophic prognosis
- Multiple complications (e.g., heart failure, syncope, mitral valve disease, blocked blood flow)
- No prevention but important to identify condition early to start treatment ASAP
46
Palpitation causes
- Stress
- Depression
- Strenuous exercise
- Stimulants- e.g., caffeine, nicotine, cocaine
- Hormone changes
47
Palpitation risks
- Stress
- Anxiety disorders or panic attacks
- Pregnancy
- Hyperthyroidism
48
Palpitation S+S
- Feeling of fast-beating, fluttering or pounding
- May be felt in throat or neck as well as chest
- Can occur during rest or activity
49
Palpitation prognosis
- Usually harmless, rarely a symptom of a more serious condition
50
Dysponea
- Left ventricle failure results in dysponea due to oedema in lungs, alveoli and intestinal fluid lungs become stiff more respiratory effort required for proper ventilation
51
Dysponea risks
- Heart disease
- Respiratory infection
- Cancer, especially lung
- Asthma
- Obesity
52
Dysponea S+S
- Shortness of breath, intense tightening of chest
53
Dysponea prognosis
- Bronchodilators can open airways
- Steroids reduce swelling
- P medication
54
Syncope
- Occurs when you faint because your body overreacts to certain triggers, such as sight of blood
- Triggers HR and blood pressure to drop suddenly
- Leads to reduced blood flow to the brain brief loss of consciousness
55
Syncope cause
- Occurs when part of nervous system that regulates HR and blood pressure malfunctions to a trigger
- HR slows and blood vessels in legs dilate
- Allows blood to pool in legs, which lowers blood pressure
- Combined drop in blood pressure and slowed HR quickly reduces blood flow to your brain fainting
- Common triggers- heat exposure, standing for long period of time, seeing blood, having blood drawn, fear of bodily injury
56
Syncope population
Children and young adults
57
Syncope risks
- Over heating
- Dehydration
- Heavy sweating
- Sudden changes of body position- blood pooling in legs
58
Syncope presentation
- Pale skin
- Light-headedness
- Tunnel/blurred vision
- Nausea
- Feeling warm
- Cold, clammy sweat
- During episode- dilated pupils, slow, weak pulse, and jerky movements
59
Syncope prognosis
- Usually harmless and requires no treatment
- Potential to injure yourself during syncope episode
- Doctor may recommend tests to rule out more-serious causes, such as heart disease
- Cant prevent- lie down and lift legs if feeling faint
60
Oedema
- Excess fluid in interstitial space
61
Causes of pitting oedema
Congestive heart failure, venous insufficiency, kidney disease
Blood pressure meds, NSAIDs, steroids, oestrogen (birth control), DVT
62
Causes of non-pitting oedema
Lymphatics
Lymphedema- lymphatic fluid builds up--> swelling. Secondary= breast cancer, etc
Myxedema- usually due to hypothyroidism--> inc accumulation of fluid in legs, feet, mouth, etc
63
Non-pitting oedema treatment
Resolve underlying condition
Exercise inc lymphatic flow
Elevation- inc circulation
64
Pitting oedema grades
Grade 1- 1-2mm, immediate rebound
2- 3-4mm, 15s rebound or less
3- 5-6mm, 60s
4- 8mm, 2-3 mins
65
Pitting oedema treatment
Mild- resolve on own- elevation
Severe- medicine- furosemide
Chronic- long term management of underlying condition (compression socks)
66
Oedema population
Older adults
Pregnant women
67
Oedema risks
- Being pregnant
- Certain medication
- Having long-lasting illness, e.g., congestive heart failure
- Having surgery that involves a lymph node
68
Oedema S+S
- Swollen lower limbs (can affect anywhere in body)
- Pitting- leaves dimple
- Puffiness
- Stretched or shiny skin
- If left too long legs may turn brown, haemosiderin- toxin in blood comes to surface to try and be removed
69
Oedema prognosis
- See a doctor if shortness of breath, irregular heartbeat, chest P
- Mild usually goes away- compression socks, raising affected arm/leg higher than heart
70
DVT
- Occurs when blood clot forms in one or more deep veins in body, usually legs
71
DVT cause
- Anything that prevents blood from flowing or properly clotting
- Damage to vein from surgery or inflammation and damage due to infection or injury
72
DVT population
- Over 40
- People with Hx of DVT/blood clots
73
DVT risks
- Age- 60+
- Lack of movement
- Injury or surgery
- Pregnancy
- Birth control
- Obesity
74
DVT presentation
- Leg swelling
- Leg P, cramping or soreness that often starts in calf
- Change in skin colour of leg- such as red or purple
- Warmth
75
DVT prognosis
- Complications include pulmonary embolism, phospholipidic syndrome and treatment complications
- See a doctor if shortness of breath, feeling lightheaded, fainting, rapid breathing, coughing up blood
76
Hypertension
- High blood pressure
- Heart needs to work harder to pump blood
- 130/80 mm Hg or higher
- Normal- 120/80
- Elevated- 120-129/below 80
- Stage 1 hypertension- 130-139/80-89
- Stage 2- 140 or higher/90 or higher
- Above 180/120 mm Hg is hypertensive emergency or crisis
- Need 3 months of consistent readings to diagnose
77
Hypertension cause
- Primary- no identifiable cause, develops gradually over many years, plaque builds up in arteries
- Secondary- underlying condition, tends to appear suddenly and cause higher blood pressure than primary (adrenal gland tumour, congenital heart defect, kidney disease, etc)
78
Hypertension population
- Older people
- Obese people
79
Hypertension risks
- Age (inc with age)
- Family Hx
- Obesity
- Lack of exercise
- Tobacco use
- High sodium
80
Hypertension S+S
- Most asymptomatic
- Headaches
- Shortness of breath
- Nose bleeds
81
Hypertension prognosis
- Untreated can lead to inc risk of heart attack, stroke, and other serious health problems
Lifestyle changes- cut down on salt, fat. inc activity
Under 55- ACE inhibitors
Over 55- calcium channel blockers
82
Stroke
- Occurs when blood supply to brain is interrupted or reduced
- Prevents brain tissue from getting oxygen and nutrients
- Brain cells die in minutes
83
Stroke cause
- Ischemic- blocked artery- most common
- Haemorrhagic- leaking or bursting of vessel- result of other condition such as uncontrolled high blood pressure, overtreatment with blood thinners, trauma
- Transient ischemic attack- mini stroke, doesn’t cause permanent damage, temporary block of blood supply
84
Stroke population
- 55+
- African Americans
- Men
- Hormones- birth control
85
Stroke risk
- Obesity
- Physical inactivity
- Heavy or binge drinking
- High blood pressure
- High cholesterol
- Diabetes
86
Stroke presentation
- Trouble speaking
- Paralysis of numbness of face, arm or leg
- Problems seeing in one or both eyes
- Headache
- Trouble walking
87
Stroke prognosis
- Seek immediate attention
- FAST- face, arms, speech, time
