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15 Cards in this Set
- Front
- Back
Module 4 - logbook 2: definition |
Aortic stenosis is the obstruction of blood flow across the aortic valve |
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Module 4 - logbook 2: epidemeology |
2-7% of 65+ degenerative calcified stenosis. Aortic valve disease 3/1000 births. Rheumatic fever rare in Western countries |
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Module 4 - logbook 2: risk factors |
Congenital bicuspid valve and age |
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Module 4 - logbook 2: common presentation |
Asymptomatic for 10-20 years. shortness of breath on exertion, angina, dizziness, or syncope. Syncope may cause arrhythmia and sudden death. 'Classic triad' chest pain, heart failure and syncope |
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Module 4 - logbook 2: investigations |
Echocardiogram is key diagnostic test. ECG may show LV hypertrophy and CXR cardiomegaly |
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Module 4 - logbook 2: pathophysiology |
Stenosis raises pressure leading to LVH. Eventually pressure increases and is backed up into lungs. CO drops and heart failure ensues |
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Module 4 - logbook 2: anatomy |
Valves of the heart: L - aortic, mitral. R - pulmonary and tricuspid |
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Module 4 - logbook 2: prognosis |
With symptoms 15-50% survival at 5 years. Much better with surgery |
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Module 4 - logbook 2: management |
Manage risk of IHD and monitor. Sypmtomatic >>> surgery. 1. Aortic valve replacement. 2. Balloon valvuloplasty. 3. Transcatheter aortic valve implantation (TAVI - blend of two) |
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Module 4 - logbook 1: drugs - ASPIRIN |
Antiplatelet - Acetyl donor to COX rendering it inactive which reduces thromboxane A2 |
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Module 4 - logbook 2: drugs - AMITRIPTYLINE |
Tricyclic antidepressant - inhibits reuptake of norepinephrine + serotonin |
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Module 4 - logbook 2: drugs - RAMIPRIL |
Hypertension - ACE inhibitor: stops ATI converting to ATII. ATII is a potent vasdoilator. Dry cough. Monitor renal function eGFR |
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Module 4 - logbook 2: drugs - SIMVASTATIN |
Hypercholesterolemia - enzyme inhibitor HMG coA reductase, reducing quantity of mevalinic acid, a precursor of cholesterol |
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Module 4 - logbook 2: drugs - BISOPROLOL |
MI prophylaxis - beta blocker - blocks beta 1 receptors reducing sympathetic stimulation |
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Module 4 - logbook 2: eitology |
Degenerative calcific aortic stenosis, congenital (unicuspid or bicuspid valve) or rheumatic fever |