CVS Disease Flashcards

(157 cards)

1
Q

Coronary Heart Disease causes include

A
increased LDL
smoking
bad diet
family history
increased BP
stress
anaemia
hyperthyroid
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2
Q

Coronary Heart Disease can cause

A
endothelial injury
fatty streaks
fibrous cap
foam cells
atherosclerosis
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3
Q

Coronary Heart Disease (CHD) signs include

A
anaemia
tar staining
bruits
reduced pulses
lipid arcus
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4
Q

Symptoms of CHD could be

A

(un)stable angina
raised JP
pre-syncope
dyspnoea

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5
Q

How can CHD be investigated?

A
angiography
echo
ECG
U&Es
liver enzymes 
FBC
CXR
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6
Q

What are the treatments for CHD?

A
NSAIDS
Statins
Treat underlying problem (smoking, diet etc) 
Bypass
GTN
CCBs
Stenting
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7
Q

What are the causes of an NSTEMI and STEMI?

A

Unstable angina

ACS (acute coronary syndrome)

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8
Q

What can an NSTEMI cause?

A

atheroma
rupture
necrosis

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9
Q

On an ECG, what can show an NSTEMI?

A

path Q waves
ST depression

also increases troponin

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10
Q

What are the symptoms of an NSTEMI?

A

(un)stable angina

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11
Q

What investigations should be done for an NSTEMI?

A

ECG
increased troponin and myoglobin tests
angio
echo

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12
Q

What can treat an NSTEMI?

A
Aspirin
Clopidogrel 
Heparin
Statins
B-blockers
CABG
ACE inhibitors
Pain meds
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13
Q

What can a STEMI cause?

A

Atheroma
Rupture (=thrombosis)
Necrosis
Ischaemia

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14
Q

What signs show a STEMI?

A

ST elevation
increased troponin
increased CK-MB

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15
Q

What physical symptoms can show a STEMI?

A
severe chest pain
dyspnoea
fatigue, sweaty
syncope
pale skin, clammy
decreased BP
brady/tachycardia
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16
Q

What investigations should be done for a STEMI?

A
ECG
increased troponin and CK-MB tests
FBC
Glucose
Lipid profile
Echo
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17
Q

What can treat a STEMI?

A
Aspirin
GTN
Oxygen
IV pain meds
ACE inhibitors
Beta Blockers
Streptokinase
Lifestyle changes
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18
Q

In Ischaemic Heart Disease (IHD), what can cause it?

A
atheroma
smoking
increase lipids
thrombosis or embolus
anaemia
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19
Q

What does IHD cause?

A
decreased oxygen
decreased lung function
tachycardia
increased lactate
myocardial necrosis
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20
Q

What signs may show IHD?

A

pallor
oedema
yellow infarct

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21
Q

What are the symptoms of IHD?

A

angina
dyspnoea
sweating
nausea/vomiting

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22
Q

What investigations should be done for IHD?

A

ECG
increased troponin
ST depression/flat

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23
Q

How do you treat IHD?

A

decrease the risk factors
angina meds
CHD treatments
control BP well

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24
Q

What causes aortic valve disease (stenosis)?

A

rheumatic fever
congenital causes
fusion of cusps
calcification

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25
What does aortic stenosis cause?
decreased ventricular emptying ischaemia (then left ventricle failure) arrhythmia
26
What are the signs of aortic stenosis?
ejection systolic murmur slow rising pulse carotid pulse with small volume
27
What are the symptoms of aortic stenosis?
``` angina dyspnoea heart failure palpitations syncope ```
28
What investigations should be done for aortic stenosis?
``` ECG CXR Echo ETT LV function Doppler ```
29
What is the solution for a stenosed aortic valve?
Insertion of prosthetic valve
30
What are the causes of aortic regurgitation?
``` rheumatic fever infective endocarditis syphilis spondylitis increase BP ```
31
What can aortic regurg. cause?
increase left ventricle size | decreased coronary perfusion
32
What are the signs of aortic regurg?
collapsing pulse dilated LV early diastolic murmur
33
What are the symptoms of aortic regurg?
asymptomatic dyspnoea angina pounding heart
34
How is aortic (and mitral) regurgitation and mitral stenosis investigated?
ECG CXR Echo Cardiac catheter
35
How is aortic regurg. treated?
Diuretics Antibiotics Prosthetic valve
36
What can cause mitral regurgitation?
``` rheumatic fever prolapse myocarditis increase BP IHD infective endocarditis ```
37
What does mitral regurg. cause?
atrial dilation increased LV size increased atrial pressure
38
What are the signs of mitral regurgitation?
pulmonary oedema lateral apex beat PS murmur (regurg during systole) S3 sound
39
The symptoms of mitral regurg are:
``` palpitations dyspnoea orthopnea fatigue (less CO2) forceful heart beat ```
40
Mitral regurgitation is treated by:
``` prophylaxis (infective endocarditis) surgical repair prosthetic valve ACE inhibitors diuretics ```
41
Hypertrophic cardiomyopathy is
familial
42
Hypertrophic cardiomyopathy causes
increased atrial pressure, size and dilatation
43
Hypertrophic cardiomyopathy signs include
asymmetric septal hypertrophy jerky carotid pulse ejection systolic murmur PS murmur, S4
44
Symptoms of Hypertrophic cardiomyopathy include
``` syncope asymptomatic dyspnoea pain palpitations ```
45
Hypertrophic cardiomyopathy may be looked into with
``` CXR ECG Echo Pedigree analysis ETT ```
46
Hypertrophic cardiomyopathy can by treated by
Beta blockers CCBs diuretics ablation
47
Mitral stenosis is caused by
rheumatic fever
48
Mitral stenosis causes
increased atrial pressure, size, dilatation
49
Mitral stenosis is characterised by
``` tapping apex beat pulmonary oedema increased RV size mitral facies flush raised JVP (in right heart failure) ```
50
Dilated cardiomyopathy causes include
idiopathic causes autoimmune inflammation metabolic
51
Dilated cardiomyopathy can cause
``` decreased systolic function heart failure (congestive) ```
52
Signs of dilated cardiomyopathy include
``` congestive heart failure raised JVP ankle oedema Creps gallop rhythm ```
53
Symptoms of dilated cardiomyopathy are
dyspnoea fatigue palpitations syncope
54
Investigations for dilated cardiomyopathy are
CXR ECG Echo Angiography
55
The treatment for dilated cardiomyopathy are
``` antiarrhythms anticoagulants diuretics ACE inhibitors ARBs BBs ```
56
The causes of myocarditis are
toxins drugs allergies HIV
57
Myocarditis causes
inflammation
58
In myocarditis there are what signs (if any)?
``` fatigue abnormal heart beat (fainting) SOB (exercise + lying down at night) sharp stabbing pain (radiates to neck/shoulders) light-headedness ```
59
What are the symptoms of myocarditis?
fatigue palpitations pain
60
What investigations should be done in suspected myocarditis?
CXR ECG Viral RNA/Ab titre Enzymes
61
What is the treatment for myocarditis?
``` Rest ACE inhibitors (in heart failure) ```
62
What can cause acute pericarditis (and pericardial effusion)?
``` viral TB bacteria an MI autoimmune neoplastic ```
63
What does acute pericarditis cause?
inflammation | infection
64
What are the signs of acute pericarditis?
``` raised JVP muffles heart sounds a rub fever lymphocytosis ```
65
What are the symptoms of acute pericarditis?
sharp pain when moving/respiring | sit forward for relief
66
What investigations should be done in acute pericarditis?
``` ECG T wave flat enzymes CXR Echo ```
67
What treats acute pericarditis?
Rest (self limiting) NSAIDS (non acute phase) steroids
68
Pericardial Effusion is also known as
Pericardial Tamponade
69
What does pericardial effusion cause?
right ventricle compression | tamponade
70
The signs of pericardial effusion are:
``` muffled heart sounds raised JVP on inspiration tachycardia decreased BP paradoxical pulse ```
71
The symptoms of pericardial effusion are:
Rub | Decreased heart sounds
72
Investigations for pericardial effusion are
ECG CXR Echo MRI
73
Causes of constrictive pericarditis are
TB Bacteria Rheumatic fever
74
Constrictive pericarditis causes
late stage cardiac filling thick fibrous & calcified loss of elasticity
75
Signs of constrictive pericarditis are
venous congestion oedema raised JVP on inspiration irregular pulse with regular heart beat
76
Symptoms of constrictive pericarditis are
``` decreased ventricle filling dysponea cough paroxysmal nocturnal dysponea (PND) orthopnea fatigue atrial dilation ```
77
Investigations for constrictive pericarditis include
``` CXR ECG Echo CT MRI Catheter ```
78
Treatment for constrictive pericarditis is
resection
79
Infective endocarditis is caused by
malignancy strep. virus staph. a group d strep
80
Infective endocarditis causes
abnormal structure that leads to: - turbulence - decreased pressure (Venturi effect) - thrombi and bacteraemia
81
Signs of infective endocarditis include
``` a new murmur Ruth spots (retina) January lesions Olsers nodes Clubbing ```
82
Symptoms of infective endocarditis include
``` malaise anorexia fever headache myalgia dyspnoea/orthopnea stroke ```
83
Investigations for infective endocarditis include
``` echo for endo ebscess oscillating intra cardiac mass new valve regurg increased CRP ECG U&Es CXR ```
84
The treatment for infective endocarditis includes
prophylaxis IV antibiotics surgery
85
What can be used in combo with gentamicin to treat infective endocarditis?
gentamicin with one of these three: - benzylpenicillin - vancomycin - flucloxacillin
86
Heart failure is caused by
``` LV dysfunction valve disease restrictive cardiomyopathy constrictive pericarditis arrhythmia MI ```
87
Heart failure (L and R) causes:
``` LV dysfunction increased preload & afterload increased myocyte necrosis decreased CO2 fibrosis ```
88
Signs of heart failure include:
``` Creps Oedema Tachycardia Raised JVP S3 ```
89
Symptoms of heart failure are:
dyspnoea orthopnea fatigue PND
90
Investigations done in heart failure (LHF and RHF) are:
Echo MRI Increased BNP (brain natriuretic peptide)
91
The treatment of heart failure (LHF and RHF) is
``` ACE inhibitors BBs ARBs transplant diuretics digoxin ```
92
Left heart failure (LHF) is caused by
IHD Raised BP Mitral/Aortic valve disease cardiomyopathy
93
Signs of left heart failure are
S3 S4 gallop apex disposition tachycarida
94
Symptoms of left heart failure are
fatigue dyspnoea orthopnea PND
95
Right heart failure (RHF) is caused by
LHF cor pulmonale tricuspid/pulmonary valve disease left to right shunt
96
Signs of RHF are
raised JVP hepatomegaly pitting oedema pleural trans
97
Symptoms of RHF include
fatigue dyspnoea anorexia nausea
98
An abdominal aortic aneurysm (AAA) can cause
tachycardia decreased BP (rupture) Bruit
99
Signs of an AAA are:
epigats --> backpain
100
Investigations for an AAA include
``` CT Ultrasound CXR FBC U&Es ```
101
Treatment of an AAA includes
surgery (>5.5cm) | endovascular repair
102
``` What can the following events cause? Cerebral infarct Embolus CHD AF Dilated Myopathy ```
A stroke
103
What does a stroke cause?
haemorrhage or thromboembolism
104
Symptoms of a stroke are
FAST abbreviation hemiparesis aphasia
105
What does FAST stand for?
Face Arms Speech Time to call 999
106
To investigate a stroke you would do a:
CT MRI Doppler/Duplex or carotid Angiography
107
Treatment of a stroke =
``` Statins Anticoags Thrombolysis Aspirin Chlopidogrel Surgery ```
108
Raynauds is more common in
females
109
Raynauds causes
vasoconstriction/spasm of digital arteries
110
Signs of raynauds include
cyanosis cole/pale digits red (after reperfusion)
111
Symptoms of raynauds are
numbness
112
To treat raynauds one should
stop smoking | keep warm
113
Atrial Fibrillation is caused by
``` rheumatic fever heart failure alcoholism infection valvular disease dilated myopathy hypertension ```
114
Atrial fibrillation leads to
stroke
115
Sign of atrial fibrillation are
irregular pulse tachycardia increased S1 waves absent a waves
116
Investigations for atrial fibrillation are
``` ECG TFTs FBC Echo Doppler ```
117
Treatment for atrial fibrillation is
treat underlying cause ablation antiarrhythms implantable cardiovert defib
118
Chronic peripheral arterial disease (PAD) is caused by
smoking dilated myopathy increased lipids hypertension
119
PAD can cause
atherosclerosis vasculitis buergers dilated myopathy
120
Signs of PAD are
cold dry skin no hair on limbs decreased pulses
121
A symptoms of PAD is
cramp
122
Investigations for PAD include
ankle-brachial pressure index | angiogram
123
Treatment of PAD (and acute limb ischaemia) =
``` surgery angioplasty amputate decrease blood glucose statins ACE inhibitors clopidogrel ```
124
Embolus and Thrombi can cause what CVS disease?
Acute Limb Ischaemia
125
Signs of acute limb ischaemia are
surgery | thrombolysis
126
The 5Ps of acute limb ischaemia are
``` pin pulseless pallor parathesia paralysis ``` (and perishing cold)
127
Investigating acute limb ischaemia involves
ECG CXR routine bloods angiogram
128
Sinus Bradycardia is caused EXTRINSICALLY by
``` hypothermia hypothyroid cholestasis drugs (BBs) digitalis ```
129
Sinus bradycardia is cause INTRINSICALLY by
SA node disease | atrial fibrosis
130
Sinus bradycardia causes less
CO2
131
Signs of sinus bradycardia are
PR interval 0.12 - 0.2 seconds | QRS
132
Symptoms of sinus bradycardia are
``` light headedness dizzy hypotension vertigo syncope ```
133
Sinus bradycardia is looked into using an
ECG
134
Heart rate in sinus bradycardia =
> 100bpm
135
Primary AV block is caused by
``` Av node disease increased vagal tone myocarditis post MI CCBs / BBs digitalis ```
136
Describe the PR interval in a primary AV block
0.22secs | every atrial deploy followed by ventricle contraction
137
A primary AV block is ______ and has ______ signs. | It requires _______ treatment.
asymptomatic no signs no treatment
138
Primary AV block investigations =
ECG drug screen electrolytes
139
Secondary AV block is caused by
post MI | some P waves conduct, some do not
140
Secondary AV block symptoms include
light headedness dizziness syncope
141
Factors affecting oxygen level supply are
``` inspired oxygen pulmonary function blood constituents blood flow vasculature integrity tissues mechanisms ```
142
Factors affecting oxygen demand are
tissues (all have different needs) | activity of tissue above baseline tissue
143
IHD supply issues are
``` coronary artery atheroma cardiac failure pulmonary disease/oedema/function anaemia previous MI ```
144
Hepatic cirrhosis =
regenerative nodules with intervening fibrosis
145
Hepatic cirrhosis results from
liver damage i.e. HBV, alcohol
146
Hepatic cirrhosis causes
loss of normal architecture portal blood flow blocked local chronic congestion
147
Congestive Cardiac Failure (CCF) is when the heart is unable to
clear blood from right and left ventricles
148
CCF causes
``` decreased CO increased fluid in body and veins RHF pulmonary oedema (LHF) both ventricles fail ```
149
Peripheral Oedema is when the heart
cannot empty the RV in systole
150
Bacteraemia causes:
brushing teeth, bowel movements invasive procedures extra-cardiac infections gingival disease
151
Marfan's Syndrome is a weakness in
connective tissues
152
Marfan's Syndrome can cause _____ in the eyes?
``` cataracts lens dislocation retinal detachment glaucoma myopia ```
153
Characteristics of Marfan's include
tall, slim long legs/arms/hands small lower jaw loose/flexy joints
154
Other issues caused my Marfan's include
``` scoliosis aortic aneurysm mitral/tricuspid issues stretch marks dural ectasia spondylolisthesis ```
155
Treatment of Arrhythmias includes
warfarin dabigatran rivaroxaban apixaban
156
Type 1A anti arrhythmic agents are ____ and affect ____ wave
fast K+ and Na+ channel blockers QRS complex
157
Type 1B anti arrhythmic agents are and ______ to the QRS?
fast Na+ channel blockers | prolong QRS in overdose