Week 10 Flashcards by Ethan Wong

angina pain can be felt from __

ear lobe to epigastric

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coronary flow reserve assessed using __

Glagov’s coronary remodeling hypothesis

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how does stress test assess coronary flow reserve

exercise > increased HR & BP > hyperaemic response > augmented coronary flow

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what happens during sub total occlusion of acute coronary syndrome

sub-total occlusion > sub-endocardial ischaemia > sub-endocardial infarction

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what happens during total occlusion of acute coronary syndrome

total occlusion > transmural ischaemia > transmural infarction

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what does ST elevation mean

transmural ischaemia

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what does ST depression mean

subendocardial ischaemia

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what does non-Q wave mean

subendocardial infarction

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what does Q wave mean

transmural infarction

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what are pharmacological interventions for acute coronary syndrome

anti-thrombotics
statins
beta-blockers
ACE-I/ARB
revascularization

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what does MPI mean

myocardial perfusion imaging

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where are the rhythmic contractile myocardial cells found

myocardium

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BP formula

cardiac output x peripheral vascular resistance

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systolic BP measured during __

ventricular contraction

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diastolic BP measured during __

relaxation

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preload is recorded __

volume at end diastole

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afterload is recorded __

force needed for ejection

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key arteries of the heart are __

left anterior descending artery
left circumflex artery
right coronary artery

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types of acute coronary syndrome

unstable angina = ischemia without infarction
NSTEMI = sub-endocardial infarction
STEMI = full-thickness infarction

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what are the findings of aortic stenosis

murmurs, reduced valve area

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what are the findings of mitral regurgitation

murmurs, left atrial enlargement

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how to manage aortic stenosis

valve replacement
Transcatheter Aortic Valve Implantation

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how to manage mitral regurgitation

repair
mitraclip

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what are vasodilators used for

reduce pre/after load

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what are beta blockers used for

lower HR & BP

what are Ca2+ channel blockers used for

angina & hypertension

what are diuretics used for

increase urine output, reduce edema

what are ACE inhibitors

decrease BP & afterload

what are statins

lowers LDL & cholesterol

what are the different diagnositcs used

ECG stress test imaging blood tests

what are ECGs used to detect

arrhythmias, ischemia, infarction

what are stress tests used to evaluate

coronary flow reserve

what are the different imaging methods

x-rays for cardiac size, echocardiogram, angiography

what blood tests are used for heart

troponins, lipid profiles

what is the pathophysiology of coronary artery disease

atherosclerosis / plaque build up leading to ischemia

what is angina

recurrent chest pain due to oxygen deficit

what is myocardial infarction

ischemia causing muscle necrosis

symptoms of heart failure

dyspnea edema fatigue

how many classifications of NYHA are there

stages I - IV

treatments for heart failure

diuretics, beta blockers, ACE inhibitors, aldosterone antagonists, digoxin

types of arrhythymias

sinus, atrial, ventricular

management of arrhythymias

ECG monitoring, anti-arrhythmic drugs, pacemakers, defibrillation

when is BP considered hypertension

> 140/90

how to manage hypertension

lifestyle changes, antihypertensives (ACE inhibitors, ARBs, beta-blockers)

what leads look at inferior wall of the left ventricle

Lead II, III, aVF

what leads look at high lateral wall of the left ventricle

aVL, Lead I

what leads look at anterior wall of left ventricle

V1 - 6

x-ray indications of heart failure

perihilar congestion upper zone venous congestion Kerley B lines cardiomegaly pleural effusion

different modes used on echocardiography

2D echo, M-mode Echo, Colour Flow Doppler, Spectral Doppler

what parts of the heart are involved in ICDs

RA, RV, LV

HF is a syndrome characterized by

- elevated cardiac filling pressure - inadequate peripheral o2 delivery due to dysfunction

pulmonary edema

fluid accumulation in lungs

pleural effusion

fluid accumulation around lungs

what does parasternal short axis view assess

RV & LV

how is LV ICD implanted

through coronary sinus vein

secondary management of HF includes

- less water intake - less salt intake - exercise

what is electrical flow of the heart

sinoatrial node > atrioventricular node & Bachmann's bundle > right & left bundle branch

when is atrial fibrillation considered paroxymal

< 48 hrs

AF management involves

rate control, rhythm control, prevent thromboembolism

which drug is the most effective for rate control

beta blockers

why should digoxin be reserved for those with systolic HF

poor rate control during exertion

AV nodal blocking drugs can be used to control __

ventricular response

what is the most effective anti-arrhythmic drug but is highly toxic and reserved as last resort

amiodarone

patients taking amiodarone should be monitored for __

thyroid, hepatic & pulmonary toxicity

bradycardia causes

permanent structural damage to bundle branches

bradycardia associated with

extensive anterior myocardial infarction / sclerodegenerative conduction disease

site of conduction block is __

below His Bundle

AVNRT

atrioventricular nodal reentrant tachycardia

what is AVNRT very responsive to __

AV nodal blocking agents such as beta blockers, Ca2+ channel blockers, adenosine

what forms the 4 heart valves

endocardium

stroke volume

volume of blood pumped from the ventricle in one contraction

cardiac output

volume of blood ejected by the heart in 1 minute

cardiac reserve

ability of heart to increase cardiac output in response to increased demand

preload

volume of blood in the ventricle at the end of diastole (ventricle at largest volume)

issues related with increased preload

hypervolemia, HF, regurgitation

issues related with increased afterload

hypertension, vasoconstriction

what are the 3 layers of arteries & veins

inner to outer - tunica intima - tunica media - tunica externa/adventitia

what triggers vasodilation

acidosis, hypoxia release of histamine, increased temperature

what acts as beta1-adrenergic receptors in heart to increase HR & contractility

Sympathetic Nervous System & epinephrine

what stimulates alpha1-receptors in arterioles

SNS, epineprhine, norepinephrine

atherosclerosis characterized by

persistent inflammation, platelet aggregation, enlarging thrombus formation

atheroma in coronary arteries lead to __

angina / myocardial infarction

ahteroma in carotid arteries lead to __

transient ischemic attack / cerebral vascular accidents

myocardial fiber in necrotic area is replaced by __

non-functional fibrous tissue after 7 days

tachycardia

rapid HR

bradycardia

low HR

sick sinus syndrome

alternating bradycardia & tachycardia

atrial flutter

atrial rate 160 - 350 bpm

atrial fibrillation

atrial rate > 350 bpm

what is effect of cardiac arrhythmias

reduces cardiac pumping efficiency

anti-arrhythmic drugs

beta1-adrenergic blockers, Ca2+ channel blockers, digoxin

AV node abnormalities

1st, 2nd, 3rd heart blocks

ventricular conduction abnormalities

- premature ventricular contractions - bundle branch block - ventricular tachycardia - ventricular fibrillation

Ca2+ antagonist end with

-pine

ACE inhibitors end with

-pril

angiotensin receptor blockers end with

-sartan

beta-blockers end with

-lol

what is not recommended combination between blockers

angiotensin receptor blockers & ACE inhibitors

digoxin is what type of cardiac med

cardiac glycoside

Week 10 Flashcards

(99 cards)