Diseases Of Cardiovascular System Short Answers

Diseases Of Cardiovascular System Short Answers

Question 1. Coronary vasodilators

Answer:

Coronary vasodilators

They reduce the mortality in patients with cardiac failure

They are:

• Arteriolar dilators – hydralazine, minoxidil
  • They relax arterial smooth muscles thus reducing peripheral vascular resistance and afterload
• Venodilators – nitrates
  • They reduce the venous return to the heart
  • This reduces the stretching of the ventricular walls and myocardial oxygen requirements
• Arteriolar and venular dilators – sodium nitro- pride, ACE inhibitors, prazosin, calcium channel blockers
  • They reduce both preload and afterload

Question 2. Four causes of acute left ventricular failure

Answer:

Four causes of acute left ventricular failure

1. Left ventricular outflow obstruction
   • Systemic hypertension
   • Coarctation of aorta
   • Aortic valvular stenosis
2. Left ventricular inflow obstruction
   • Mitral stenosis
3. Left ventricular volume overload
   • Mitral valve prolapsed
   • Mitral regurgitation
   • Aortic regurgitation
   • Ventricular septal defect
4. Reduced left ventricular contractility
   • Cardiomyopathy
   • Anterior wall myocardial infarction

Question 3. Cyanosis.

Answer: Cyanosis

Definition: Bluish discoloration of skin and mucous membrane is called cyanosis.

Cyanosis Sites Involved:

• Lips a Nail beds
• Fingertips
• Ear lobule.
• The undersurface of the tongue.
• Malar eminence
• Creases of palms.

Cyanosis Types:

1. Peripheral cyanosis.
2. Central cyanosis.

Question 4. Causes of central cyanosis.

Answer:

Causes of central cyanosis

1. Pulmonary causes
   • High altitude
   • Pneumonia
   • Pneumothorax
   • COPD
   • Severe acute asthma
   • Respiratory failure.
2. Cardiovascular causes.
   • Acute pulmonary edema.
   • Cyanotic heart disease.
3. Blood disorders.
   • Methaemoglobin.

Read And Learn More: General Medicine Question and Answers

Question 5. Mid-diastolic murmur.

Answer:

Mid-diastolic murmur

Mid-diastolic murmur is a trembling murmur heard at the apex.

• It is a flow murmur.

Mid-diastolic murmur Causes:

• Dilatation of left ventricle,
• Functional mitral regurgitation.

Question 6. Bradycardia – causes.

Answer:

Sinus node dysfunction:

• Myocardial infarction.
• Hypothermia.
• Hypothyroidism.
• Obstructive jaundice.
• Raised intracranial pressure
• Typhoid fever
• Drugs like digoxin, calcium channel blockers, and beta-blockers.

Question 7. Tachycardia.

Answer:

Tachycardia

A heart rate of more than 100 per minute due to any cause is called tachycardia.

Tachycardia Causes:

1. Physiological
   • Exercise
   • Emotion
   • Fear
   • Smoking.
   • Excessive consumption of tea, coffee, etc.
2. Pathological.
   • Anxiety.
   • Fever
   • Thyrotoxicosis.
   • Anaemia.
   • Heart failure
   • Hypo or hypertension
   • Pheochromocytoma.
   • Drugs – bronchodilators.

Tachycardia Types:

1. Supraventricular tachycardia.
2. Ventricular tachycardia.

Question 8. Atrial fibrillation.

Answer:

Atrial fibrillation

Atrial fibrillation is the most common cardiac arrhythmia.

• The atrial rate is more than 350 beats/min.

Atrial fibrillation Causes:

• Coronary artery disease
• Rheumatic valvular disease
• Idiopathic
• Cardiomyopathy
• Thyro toxicosis.
• Alcoholism.
• Congenital heart disease.
• Pulmonary embolism.

Atrial fibrillation Treatment:

• Treat the cause
• Anti-arrhythmic drugs,
• Anti-coagulant.
• Defibrillation.

Question 9. Cardiac arrest.

Answer:

Cardiac arrest

Definition: It is defined as the sudden complete arrest of heart function.

Cardiac arrest Causes:

• Ventricular fibrillation
• Ventricular asystole.
• Electromechanical dissociation.

Cardiac Arrest Clinical Features:

• Absence of pulses.
• Cold extremities.
• Loss of consciousness.
• Cessation of respiration.
• No heartbeat.

Cardiac arrest Management:

• ABC support.

1. A – airway.
   • Clear mouth and airway.
   • Extend neck and raise chin.
2. B-breathing.
   • Direct mouth-to-mouth breathing.
   • Indirect mouth-to-mouth breathing.
3. C-circulation.
   • Cardiac massage.

Question 10. Heart failure.

Answer:

Heart failure

Heart failure denotes a pathophysiologic state when the heart is not able to maintain its cardiac output to meet the demands of metabolizing tissues.

Heart failure Types:

• Acute and chronic.
• Compensated and decompensated
• Right, left, and biventricular heart failure.
• Forward and backward heart failure.
• Systolic and diastolic heart failure.
• High and low output failure.

Question 11. Treatment of cardiac failure.

Answer:

Treatment of cardiac failure

1. General measures.
   • Bed rest
   • Regular isotonic exercises
   • Low-calorie intake.
   • Salt restriction.
2. Drug therapy.
   • Digitalis – digoxin – 0.25 – 0.5 mg/ day
   • Sympathomimetic amine – dopamine, dobutamine.
   • Diuretics – thiazides, loop diuretcis, potassium sparing.
   • Vasodilators – ACE inhibitors – captopril – 12.5 – 25 mg TID.
3. Cardiac transplantation.

Question 12. Complications of heart failure.

Answer:

Complications of heart failure

• Acute renal failure.
• Hypokalemia.
• Hyponatraemia.
• Jaundice.
• Deep vein thrombosis.
• Arrhythmias.
• Systemic embolism.

Question 13. Congenital heart disease.

Answer:

Congenital Heart Disease Clinical Features:

• Central cyanosis.
• Growth retardation.
• Syncope
• Stature

Etiology:

• Infections – rubella infection.
• Chromosomal defects – Down’s syndrome.
• Connective tissue disorders,
• Alcohol abuse.

Question 14. Classification of congenital heart disease.

Answer:

Classification of congenital heart disease

1. Acyanotic.
   • Acyanotic with left to right shunt.
     • Atrial septal defect.
     • Ventricular septal defect.
     • Patent ductusarteriosus.
   • Acyanotic without shunt.
     • Pulmonary stenosis.
     • Aortic stenosis.
     • Coarctation of aorta.
2. Cyanotic.
   • Complete transposition of great vessels.
   • Tetralogy of Fallot
   • Persistent truncus arteriosus.

Question 15. Atrial septal defect.

Answer:

Atrial septal defect

It is a cyanotic heart disease with a left to right shunt through a defect in the interatrial septum.

Atrial Septal Defect Types:

1. Ostium secundum defect – Involves fossa ovalis.
2. Ostium primum defect.
   • Lies in the common atrioventricular canal.

Atrial Septal Defect Features:

• Asymptomatic.
• Good volume pulse
• Systolic murmur.
• Diastolic flow murmur.
• Wide and fixed splitting of the second heart.
• Chest X-ray – shows an enlargement of the heart.
• ECG – shows incomplete or complete right bundle branch block.
• Echocardiogram – shows right ventricular dilatation, hypertrophy.
• Color Doppler – measures flow velocities.

Atrial Septal Defect Treatment:

• Surgical closure of the defect.

Question 16. Fallor tetralogy.

Answer:

Fallot Tetralogy Components:

• Pulmonary stenosis.
• Ventricular septal defect.
• Over-riding of the aorta.
• Right ventricular hypertrophy.

Fallot Tetralogy Clinical Features:

• Cyanosis – develops after 1 year of age.
• The child may become apnoeic and may fall unconscious.
• Growth retardation.
• Grade 4 clubbing.
• Polycythaemia.
• Ejection systolic murmur.

Question 17. Rheumatic fever/Jone’s criteria.

Answer:

Rheumatic fever/Jone’s criteria

It is an acute inflammatory disease that occurs as a complication of group A streptococcal infection.

Rheumatic Fever Clinical Features:

• Jone’s criteria.
• Major criteria.
• Carditis
• Polyarthritis
• Chorea
• Erythema marginatum
• Subcutaneous nodules.
• Minor criteria.
• Fever
• Arthralgia.
• Raised ESR
• Previous history of rheumatic fever.
• Positive CRP.

Question 18. Aortic regurgitation – signs.

Answer:

Collapsing or good volume pulse:

• Bounding peripheral pulses.
• Corrigan’s sign-dancing carotids.
• Quincke’s sign-capillary pulsation in nail beds.
• Duroziez’s sign.
• Pistol shots sound.
• De Musset’s sign – head nodding with a carotid pulse.
• Cyanosis.
• Pitting ankle oedema.
• Tender hepatomegaly.

Question 19. Infective endocarditis.

Answer:

Infective endocarditis

It is a microbial infection of the mural endocardium a heart valve or valves or lining of blood vessels.

• Clinical Features:

Question 20. Complications of infective endocarditis.

Answer:

Complications of infective endocarditis

If not treated, infective endocarditis may lead to.

• Stroke
• Organ damage
• Spread of infection to other body parts
• Heart failure.
• Septic embolization
• Mycotic aneurysm.
• Neurologic complications.
• Renal complications.
• Musculoskeletal complications.

Question 21. Complications of hypertension.

Answer:

Complications of hypertension

1. Central nervous system.
   • Cerebral atheroma
   • Transient cerebral ischaemic attacks
   • Stroke.
   • Hypertensive encephalopathy
   • Subarachnoid hemorrhage.
2. Retinopathy.
3. Heart
   • Left ventricular hypertrophy.
   • Cardiac failure.
4. Kidney
   • Proteinuria
   • Uraemia.

Question 22. Hypertensive retinopathy.

Answer:

Hypertensive retinopathy

It is an ophthalmic complication of hypertension.

Grades:

1. Cardiac causes
   • Malignant arrhythmias.
     • Ischaemic heart disease
     • Heart blocks
     • Valvular heart disease
     • Infective endocarditis
     • Myocarditis
     • Cardiomyopathy.
   • Thromboembolism.
2. Idiopathic.

Question 23. Causes of sudden death in myocardial infarction.

Answer:

Causes of sudden death in myocardial infarction

• Noncardiac causes
  • Cerebral hemorrhage.
  • Ruptured aortic aneurysm.

Question 24. Risk factors for coronary artery disease.

Answer:

Old age:

• Sex – common in males
• Family history
• Smoking, alcohol.
• Hypertension.
• Mental stress Hypercholesterolemia.
• Diabetes mellitus.
• Sedentary habits
• Obesity
• Polyunsaturated fatty acid deficiencies
• Hyperfibrinogenaemia.
• Low levels of anti-oxidant vitamins
• Protein S and C deficiency.

Question 25. Aspirin.

Answer:

Aspirin

Aspirin is a non-selective COX inhibitor.

Aspirin Uses:

• As analgesic
• Fever
• Arthritis, fibromyositis
• Acute rheumatic fever
• Rheumatoid arthritis
• Osteoarthritis.
• Postmyocardial infarction.
• Inflammatory bowel disease.

Aspirin Adverse Effects:

• Nausea, vomiting, epigastric distress.
• Headache, dizziness, confusion.
• Allergic reactions – rashes, urticaria, photosensitivity.
• Hemolysis.
• Nephrotoxicity.
• Hepatotoxicity.
• Reye’s syndrome.
• Salicylism.

Question 26. Oral anticoagulants.

Answer:

Oral anticoagulants

Oral anticoagulants are drugs given orally to reduce the coagulability of blood.

Oral Anticoagulants Classification:

1. Coumarin derivative.
   • Bishydroxycoumarin, warfarin sodium, acenocoumarol.
2. Indanedione derivative.
   • Phenindione.

Oral Anticoagulants Uses:

• Venous thrombosis
• Pulmonary embolism.
• Post-operative, post-stroke patients.
• Rheumatic valvular disease.
• Unstable angina.
• Vascular surgery.

Question 27. Beta-blockers – uses.

Answer:

Hypertension:

• Angina pectoris.
• Cardiac arrest
• Myocardial infarction.
• Congestive cardiac failure.
• Obstructive cardiomyopathy.
• Pheochromocytoma.
• Thyrotoxicosis.
• Glaucoma.
• Prophylaxis of migraine.
• Anxiety.

Question 28. Nitrates.

Answer:

Nitrates.

Nitrates are vasodilators. They are

• Nitroglycerin
• Isosorbide dinitrate
• Isosorbide mononitrate
• Pentaerythritol tetranitrate.

Nitrates Uses:

• External angina
• Vasospastic angina
• Unstable angina
• Cardiac failure.
• Myocardial infarction.
• Cyanide poisoning.
• Relieves oesophageal spasm.
• Spasmolytic.

Question 29. Anti-anginal drugs.

Answer:

Anti-anginal drugs

Anti-anginal drugs are used to improve the balance between oxygen supply and demand.

• Drugs used in the treatment of angina are as follows.

1. Nitrates
   • Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate.
2. Calcium channel blockers.
   • Verapamil, diltiazem, amlodipine, nifedipine.
3. Beta-blockers
   • Propranolol, atenolol.
4. Potassium channel openers.
   • Nicorandil, pinacidil.
5. Miscellaneous.
   • Dipyridamole, aspirin, ivabradine.

Question 30. Calcium channel blockers (CCB).

Answer:

Calcium channel blockers (CCB) are.

1. Dihydropyridines.
   • Nifedipine.
   • Nimodipine.
   • Amlodipine.
   • Nicardipine.
   • Felodipine.
2. Others.
   • Verapamil.
   • Diltiazem.

Calcium channel blockers Use

• Angina pectoris
• Hypertension.
• Arrhythmia.
• Peripheral vascular disease.
• Hypertrophic cardiomyopathy.
• Migraine.
• Subarachnoid hemorrhage.
• Preterm labor.

Question 31. ESR, erythrocyte sedimentation rate.

Answer:

ESR, erythrocyte sedimentation rate

It was first demonstrated by Edmund Beirnacki in 1897.

Erythrocyte Sedimentation Rate Definition:

The rate at which the erythrocytes settle down in a vertical tube is called ESR.

Erythrocyte Sedimentation Rate  Normal values:

• According to Westergren’s method.
  • Males -3-7 mm in 1 hour.
  • Females – 5 – 9 mm in 1 hour.
  • Infants – 0 – 2 mm in 1 hour.

Erythrocyte Sedimentation Rate  Significance:

• Confirms diagnosis.
• Helps to assess the patient’s response to treatment for certain chronic inflammatory diseases.

Factors Affecting ESR:

• The specific gravity of RBC ais  Rouleaux formation.
• Size of RBC
• Viscosity of blood.
• RBC count.

Question 32. Heart sounds.

Answer:

Heart sounds

Mechanical activities of the heart during each cardiac cycle produce some sounds called heart sounds.

Heart sounds Types

Question 33. Pericarditis.

Answer:

Etiology:

• Infection.
• Immunological reaction.
• Trauma
• Neoplasm.
• Idiopathic.

Pericarditis Clinical Features:

• Retrosternal pain.
• Pain radiates to the shoulder and neck.
• Aggravated by deep breathing, movement, changes of position, exercise, and swallowing.

Pericarditis Management:

• Aspirin – 600 mg 4 hourly.
• Indomethacin – 25 mg 8 hourly.
• Paracentesis.
• Surgical drainage.

Question 34. Collapsing pulse.

Answer:

Collapsing pulse

It is a pulse characterized by a rapid upstroke, rapid downstroke, and a high volume.

Factors Effecting it:

• Increased stroke volume.
• Diastolic leak back into left ventricle
• Low systemic vascular resistance

Collapsing pulse Significance:

• It occurs in.
  • Aortic regurgitation
  • Patent ductusarteriosus
  • Ruptured sinus of Valsalva
  • Large arteriovenous fistula
  • Hyperkinetic circulatory states,

Question 35. Treatment of deep vein thrombosis.

Answer: Bed rest with legs elevated to 15 degrees

• Physiotherapy
• Graduated elastic stockings.
• Use of heparin.
• Thrombolysis with streptokinase.
• Thrombectomy.

Question 36. Corrigan’s sign.

Answer:

Corrigan’s sign

Described by Sir Dominic John Corrigan.

• It is a sign of severe aortic valve regurgitation.
• It is a jerky carotid pulse characterized by full expansion followed by quick collapse.
• It appears in the advanced form of the disease.
• By this time, the patient is usually symptomatic.

Corrigan’s sign Causes:

• Rheumatic fever.
• Infective endocarditis,
• Marfan’s syndrome.
• Ehlers – Danlos syndrome.
• Collagen vascular disease.

Question 37. Cardiopulmonary resuscitation.

Answer:

Cardiopulmonary resuscitation

Position the patient on a firm surface such as the floor.

• The heel of the hand should be placed over the lower end of the sternum and with the other hand above it depress the sternum for 3-4 cm,
• It should be maintained at the rate of 60 per minute.
• It should be continued as long as cardiac resuscitation remains feasible and cerebral function is intact.
• It may take a few minutes or even a few hours.

Question 38. Intermittent claudication.

Answer:

Intermittent claudication

It is a symptom occurring due to chronic arterial occlusion.

Intermittent claudication Features:

• Pain occurs during exertion and gradually disappears within minutes upon cessation of activity.
• The group of muscles which will be affected depends on the site of arterial occlusion.

Boyd’s Classification:

VIVA VOCE

1. The most common congenital heart disease is a ventricular septal defect
2. The commonest cause of ventricular tachycardia is acute myocardial infarction
3. The commonest cyanotic heart disease is tetralogy The commonestRheumatic fever mostly results in mitral regurgitation
4. Markers the commonesfirstst in myocardial infarction is CPK-MB
5. The pacemaker of the heart is the SA node
6. The first symptom of heart failure is dyspnoea
7. In atrial flutter P wave of ECG sarees a saThe pacemaker appearance
8. Preload is the first diastolic filling pressure of the ventricle just before,e contraction
9. The force against which the ventricular contracts is termed  as afterload
10. Kussumaul’s sign is an increase of jugular venous pressure during inspiration.