Understanding symptoms and signs Flashcards
(36 cards)
What happens to the pH in ishaemic muscle?
Decreases due to lactate production.
What substance is released in response to a pH drop?
Substance P, a neuropeptide
What does substance P do?
Increases the sensitivity to pain afferents in muscle.
Why can young people with normal coronary vessels and thyrotoxicosis develop angina or even MI?
Thyroid hormones increase BMR and HR which will increase the oxygen demand of the cardiac muscle.
Which words can be used to describe pain from ischaemia muscle?
Tight, constricting, heavy, crushing, cramping, pressure.
Where are some of the common sites of referred cardiac pain?
Chest, arms (particularly down the left arm), neck, jaw
Why can angina be brought on by cold weather or a meal?
Cold weather - vasoconstriction
After a meal - blood redirected away from the heart and to the GI tract.
What ECG changes may be present in unstable angina?
ST depression
T wave inversion
Would you expect cardiac markers to be raised in unstable angina?
No.
Unstable angina may be the precursor to _______.
MI
Why is a patient pale and sweaty with cold skin during an MI?
Over-activation of the sympathetic nervous system - vasoconstriction, sweat secretion.
Why do patients suffering from an MI feel nauseated?
Redirection of blood away from GI system
Increase of SNS stimulation
Why are patients suffering from an MI dyspnoeic?
There is reduced CO from the left ventricle, so there is a ‘back up’ of deoxygenated blood in the pulmonary circulation.
What might cause palpitations?
- Heightened awareness of normal heart beat
- Sinus tachycardia
- Atrial or ventricular ectopic beats
- Atrial tachycardias or fibrillation
- Ventricular tachycardia or fibrillation
What is dyspneoa?
Shortness of breath
What is othopnea?
Shortness of breath when lying down
What is paroxysmal nocturnal dyspnoea (PND)?
waking up short of breath during the night
What other disease causes dyspnoea which is worse a night?
Asthma
When does collapse/loss of consciousness occur?
No/low output
Brady/tachycardia which leads to cerebral hypo perfusion
What occurs immediately after recovery from LOC if the cause was arrhythmia?
Flushing
When would you hear an irregularly regular pulse?
2nd degree heart block
When would you hear an irregularly irregular pulse?
ventricular or atrial ectopics
atrial fibrillation
What is pulse pressure?
Systolic pressure - diastolic pressure
What causes a bounding pulse?
Widening of the pulse pressure
Associated with increased SV of LV and decrease in peripheral resistance which lowers the diastolic pressure.
