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BRS Y2 > Structural Heart Disease > Flashcards

Structural Heart Disease Flashcards

(49 cards)

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1
Q

When there is heart failure, what stage of the cardiac cycle fails first?

A

Isovolumetric contraction

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2
Q

What are the 2 determinants of cardiac stroke volume?

A

Energy of contraction

Arterial pressure

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3
Q

What is Starling’s law?

A

Increased stretch of the heart increases calcium sensitivity and therefore energy of the contraction

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4
Q

Starting at the bottom left corner of a pressure volume loop, describe which valve opens and closes at each of the 4 points

A

Bottom left: mitral valve opens
Bottom right: mitral valve closes
Top right: aortic valve opens
Top left: aortic valve closes

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5
Q

What is stenosis of valves?

A

Their narrowing

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6
Q

What is the medical name for dilation of the heart valves?

A

Regurgitation lesion

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7
Q

One which side of the heart are valve problems more important?

A

Left

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8
Q

How is stenosis of heart valves assessed?

A

Transthoracic echocardiogram

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9
Q

How do transthoracic echocardiograms work? What result indicates severe stenosis?

A

They look at blood flow velocity, if blood flow is <4mm stenosis is severe

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10
Q

What are some causes of aortic stenosis?

A

Biscuspid aortic valve
Infective endocarditis
Hyper urethemia

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11
Q

What is a biscuspid aortic valve?

A

When the aortic valve has 2 flaps instead of 3

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12
Q

What are some causes of mitral stenosis?

A 
Rheumatic fever
Congenital
SLE
Whipples
Rheumatoid arthritis
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13
Q

What affect does aortic valve stenosis have on the heart?

A

It causes increased pressure/higher after load in the left ventricle leading to left ventricular hypertrophy

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14
Q

What effect does mitral valve stenosis have on the heart?

A

It causes increased pressure in the left atrium which can cause left atrial dilation and further cause atrial arrhythmia

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15
Q

Name all the heart valves, what structures they separate and include alternate names for them if they have any

A

Mitral valve: also known as the left atrio-ventricular valve and separates the left atrium and ventricle
Aortic valve: separates the left ventricle and the aorta
Bicuspid valve: also known as the right atrio-ventricular valve, separates the right atrium and ventricle
Pulmonary valve: separates the right ventricle and the pulmonary artery

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16
Q

What side of the heart is the aorta associated with?

A

Left

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17
Q

What side of the heart is the pulmonary artery associated with?

A

Right

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18
Q

When can aortic stenosis be heard?

A

When the heart is contracting

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19
Q

When can mitral stenosis be heard?

A

When the heart is relaxing, but its harder to hear than aortic stenosis

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20
Q

What type of murmur does aortic stenosis cause?

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A

Systolic heart murmur

21
Q

What is regurgitation in terms of the heart?

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A

Abnormal dilation

22
Q

How does aortic regurgitation cause in terms of blood flow?

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A

It causes back-flow of blood from the aorta to the left ventricle which causes dilation and makes the ventricle less effective

23
Q

When must the aortic valve be replaced if theres stenosis?

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A

If the patient presents with heart failure, fluid in the legs or fluid in the lungs

24
Q

How is mitral regurgitation treated?

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A

Replacing the valve if it gets serious

25
What complications can mitral regurgitation cause?
Heart failure or congestion
26
What is congested heart failure?
Heart failure due to fluid build up around the heart
27
How is mitral regurgitation treated?
Medication for heart failure and diuretics
28
What causes hypertrophic cardiomyopathy?
Genetic, screen first degree relatives for risk
29
What may be seen in someone with hypertrophic cardiomyopathy?
Abnormal ECG Left ventricle thickening Septum thickening Systolic murmur
30
What is dilated cardiomyopathy?
Chambers are dilated and have poor contractility
31
What are some causes of dilated cardiomyopathy?
Stress induced Infectious Peri partum (last few months of pregnancy) 50% is genetic
32
How is dilated cardiomyopathy diagnosed?
Via angiogram
33
What is arrythmogenic right ventricular cardiomyopathy?
Dilation in the right ventricle that affects left ventricle function too
34
What type of cardiomyopathy is deadly? Why?
Arrythmogenic right ventricular cardiomyopathy as it can cause ventricular arrythmia which can lead to sudden death
35
When are metallic valve replacements used?
In children as they give longevity and durability
36
What medication must be given with metallic valves?
Warfarin
37
How many years of longevity do biological valve replacements give?
20 years
38
The replacement of which valve is complicated?
Mitral
39
Define cardiogenic shock?
Impairment of cardiac systolic function resulting in reduced cardiac output which will cause end organ dysfunction
40
Why does cardiogenic shock result in end organ failure?
As the reduced systolic output of the heart leads to the body not receiving enough glucose, oxygen or blood
41
How is cardiogenic shock different to other shocks?
Giving fluid will make things worse not better as the contractility of the heart is already reduced
42
How is cardiogenic shock recognised and confirmed?
Via bedside transthoracic echocardiogram
43
How is cardiogenic shock treated?
Percutaneous coronary intervention- stents are placed in arteries to open them up Ionotrophs are given as the first line treatment, they alter the force of muscle contraction
44
How do ionotrophs work in cardiogenic shock?
They alter the force of muscle contraction
45
What effect will giving ionotrophs have on the pressure volume loop?
Increased height Increased width Leftward shift
46
Give an example of an ionotroph drug
Dopamine
47
What is used when ionotrophs dont work in cardiogenic shock?
Mechanical support devices
48
What must be given alongside mechanical support devices for the heart?
Anticoagulants
49
What will the pressure volume loop look like for someone in cardiogenic shock before treatment?
It will be small in terms of height and width, it will also be shifted more to the right than should be normal

BRS Y2 (85 decks)

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