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Cardiovascular Medicine - Coggle Diagram

- - - - Causes: IHD, HTN, Aortic and mitral valve disease
      - Decreased LV out put --> increased LV pressure --> increased LA pressure --> increased pulmonary vein pressure
      - Acute: hydrostatic pressure of pulmonary capillaries --> pulmonary HTN --> fluid moves from caps to alveoli --> pulmonary oedema
      - Chronic: reflex pulmonary vasoconstriction --> pulmonary HTN
      - Clinical Features: pulmonary edema, cough, Dyspnea, Frothy sputum, cyanosis, orthopnea, PND
    - - Most commonly caused by LHF
      - Less frequently by cor pulmonale
      - Clinical Features: peripheral sacral edema, increased JVP, Ascites, hepatomegaly
- - - - Reduced renal excretion of Na+. Increased fluid volume. Increased CO. Peripheral vasoconstriction. HTN
      - Increased TPR
      - Increase SNS via angiotensin II
      - Ethnicity
      - Environment: Na+ intake, EtOH intake, smoking, Decreased exercise, Barkers hypothesis - impaired intrauterine growth
  - - - • Urinalysis: blood, protein +glucose
      - • Bloods: UEC (kidney, function)
      - • Fasting BGL(Diabetes)
      - • Serum,Total,Chol,+,HDL,
      - • 12-lead,ECG (LVH, coronary artery disease)
    - - CXR (cardiomegaly, heart failure, CoA)
      - 24hr Ambulatory BP (borderline/whitecoat” BP)
      - Echo (LV hypertrophy)
      - Renal U/S (renal disease)
      - Renal angiography (renal artery stenosis)
      - Urinary catecholamines (Pheochromocytoma)
      - Urinary cortisol, dexamethasone suppression test (Cushing's)
      - Plasma renin activity & aldosterone (1°hyperaldosteronism)
    - - Non Pharm: Smoking cessation, diet, weight loss, decrease alcohol, increase exercise
      - Treatment Failure: Non adherence, inadequate therapy, failure to recognize underling cause.
      - Pharm: MAP - CO x TPR: Reduce CO (beta blockers, ACE, ARB, CA blockers; Reduce volume (diuretics); Decrease TPR (vasodilators)
- - - - Usead as energy, stored as fat
    - - transports cholesterol to cells, in in excess --> atherosclerosis
    - - Removes excess cholesterol
  - - - Diabetes, diuretics, beta blockers, estrogens
        
        Hypothyroidism, renal failure, nephrotic syndrome, alcohol consumption
- - - - Arises from R aortic sinus (ascending aorta), runs in R atrioventricular groove, descends between RA and RV
      - Branches: Atrial branch, SA nodal branch Right marginal branch, Posterior IV branch/RAD
      - RCA supplies: RA, RV, SA node, AV node, portion of LA, infero-posterior LV
      - ECG infarct (inferior) leads II, III and aVF
      - Posterior descending supplies inferior 1/3 IV septum
      - ECG infarct ST depression in V1 and V2,
    - - Originates in L aortic sinus (ascending aorta)
      - Branches: LAD in IV groove, circumflex in AV groove. marginal artery.
      - LAD supplies: Ant 2/3 IV septum, ant wall and apex of LV
      - ECG infarct (septal) leads V1 - V4
      - Circumflex supplies: lateral, posterior, inferior LV, LA
      - ECG infarct (lateral - leads V5, V6, aVL, I
  - - - Central, diffuse v's peripheral, localized
    - - jaw, neck, shoulders, arm v's nil
    - - Tight, squeezing, crushing v's sharp, stabbing, catching
    - - Exertion/emotion v's spontaneous, not related to exertion, provoked by posture, respiration or palpation
    - - Rest, GTN v's not relieved by rest, non response to nitrates
    - - Breathlessness v's SOB, GI, locomotor, psych
  - - - Fixed stenosis v's dynamic stenosis
      - Demand-led, predictable, long term symptoms, related to effort v's supply-led, unpredictable. short term symptoms, occurs at rest
      - Low to medium risk of MI v's high risk of MI
- - - - Assessment: BMI, Diet, EtOH, Hx of recent weight gain, identify complications, identify medical/iatrogenic causes