| Signs of heart disease | § Chest pain
§ Dyspnoea – shortness of breath
§ Orthopnoea – shortness of breath when lying flat
§ Paroxysmal nocturnal dyspnoea – waking up in the night gasping for breath
§ Pre(syncope) – presyncope is where you feel dizzy and light headed before you faint (syncope)
§ Palpation
Ankle swelling |
| what is angina pectoris | chest pain related to the heart |
| Pericardial pain presents as | Sharp, stabbing poin, quick onset, relieved by leaning forward made worse by lying flat |
| Pleuritic pain | Sharp stabbing pain upon inhalation |
| Ankle swelling indicates | indiacted right heart failure i.e. back pressure |
| difficuluty in breathing indicates | Ischeamia heart failure or both- |
| Pulm. oedema causes | increases distance for gas to diffuse across so process lsower therefore CO2 rises so hypercapnia which causes dysponea |
| Orthopnoea causes | Breathless when flat, inc LV pre load decreased vital capacity decreased pulm compliance |
| What is paroxysmal nocturnal dysponea | Waking up gasping for breath due to LV unable to match output of right ventricle |
| Palpitations are | Awareness of heart beat normally sign of arrthymia |
| Capillary refill time when pressing | Normal 25 secs abnormal 6 secs |
| Signs of hypercholesterolaemia | Corneal arcus i.e. white ring around iris and xanthalasma- vesicles around eyes containing lipid |
| oedema graded by height | Ankle midcalf sacral nipples |
| What are the heart noises from | AV vavle close semi lunar close any others are from turbulent blood |
| When get athsclero when can perfusion occur | Only in diastole |
| Stenosis causes....., occlusion causes ... | angina, heart attack MI |
| Microvasc disease mainly due to | Diabetes |
| Symptoms of heart disease | Chest pain angina pectoris and shortness of breath dysponea |
| Treatment of IHD | Meds. i.e. beta blocker, apririn etc.. to decrease TPR |
| What does nicrorandil, ivanradine and ranolazine do | Coronary vasodilator by hyperpol of endothelim, slow heart rate at SAN, and decreases peak intracellular Ca2+ so reduces contractility |
| What must you do if patient on clopid, prasugrel or ticagrelor | D/w cardiologist to see if safe then pause patietn on this drug for 5 days |
| Statins are | Cholesterol lowering |
| Stents unblock coronary arteries when is this suitable | If blocked artery is small and discrete not if long and diffuse |
| MI Tx | O2, Ns, antiplatelet drugs asp. and clopidigrol |
| Vasc heart disease causes what | Stenosis and regurg. increases work and ventricles to remodel caused by myxomaotus degen. endocardititis |
| Aortic INR target | 2.5 |
| Mirtal INR | target 3.5 |
| If stop warfarin what do you need for cover | IV heparin |
