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Summary CVS Core Conditions
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A condensed summary of the CVS core conditions for the Leeds MBChB year 3 syllabus
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CVS CORE CONDITIONS SUMMARYCondition Summary Epidemiology Pathophysiology Prognosis Aetiology Risk Factors S/S Investigations DDs Treatment Complications
The heart tries to Cusp malformation Dyspnoea; fatigue;
Diastolic leakage of Bicuspid aortic valve; Physical Pulmonary/mitral Inotropes; Operative mortality;
compensate by increasing Death usually occurs (bicuspid valve); cusp orthopnoea; PND; mottled
Aortic blood from the aorta Less common than HR/contractility to keep up within a few years of erosion (e.g. from rheumatic fever; extremities; JVD; head examination; ECG; regurgitation; vasodilators; urgent CCF; arrhythmias;
regurgitation into the LV causing AS and MR endocarditis; Marfan’s CXR; echo; colour mitral/aortic valve replacement/ endocarditis; MI;
with increased preload; onset endocarditis); rheumatic bobbing; collapsing pulse;
an audible murmur syndrome flow doppler stenosis repair; TAVI sudden death
over time this causes LVH fever; arthopathies low diastolic pressure
Narrowing of the Most common Many patients die Initially asymptomatic; Medical therapy; Ventricular dilation;
valvular disease <65y/o most commonly Age; congenitally Aortic sclerosis;
aortic valve opening, Gradual progression, suddenly and death angina; exertional dyspnoea; valvuloplasty; valve acute CHF; sudden
calcified bicuspid (M>F); bicuspid aortic valve; IHD;
Aortic stenosis restricting blood flow causing obstruction to LV often occurs within a
>65y/o most commonly rheumatic heart
syncope; heaves; narrow ECG; echo
hypertrophic
replacement; TAVR; cardiac death; infection;
from the LV to the <65y/o M>F outflow with resultant LVH couple of years pulse pressure; systolic thrill prophylactic Abx; thrombosis secondary
senile calcific AS (M<F) disease; CKD cardiomyopathy
aorta during systole >65y/o M<F without surgery radiating to carotid anticoagulation to mechanical valve
Supraventricular Atrial dilation, with fibrosis Cardiac disease and
Related to
tachyarrhythmia, and inflammation, causes associated risk factors Age; CAD; HTN; DM; Palpitations; hypotension; Atrial flutter; Anti-coagulant;
AF Adults precipitating events,
characterised by a difference in refractory (AF can also occur in CCF; cardiac surgery; elevated JVP; added heart ECG; U&Es; TFTs; Wolf-Parkinson- beta-blocker;
Prevalence M>F underlying cardiac CVA; MI; CCF
(atrial fibrillation) irregularly irregular periods within atrial tissue; the absence of valvular disease; sounds; dizziness; irregularly CXR; echo White; atrial digoxin; CCB;
Mortality M<F status, VTE risk, and
QRS complexes and this promotes electrical re- underlying cardiac hyperthyroidism irregular pulse tachycardia amiodarone
type of AF
absent P waves entry, resulting in AF disease)
Inability of the Sustained neurohormonal COPD; PE;
Pleural effusion; chronic
CCF/CHF ventricles to fill with activation results in
Framingham criteria
Age; HTN; MI; DM;
Dyspnoea; orthopnoea; ECG; echo; CXR;
pulmonary Lifestyle changes;
renal insufficiency;
or eject blood; must increased ventricular dyslipidaemia; renal fibrosis; DVT; ACEi/ARB; beta-
(congestive include dyspnoea Adults stress, dilation and used to classify using CAD; HTN; valvular insufficiency; valvular PND; cardiomegaly; FBC; U&Es; blood pneumonia; blocker; digoxin; anaemia; acute
cardiac/heart major (PAINS) and disease; myocarditis hepatojugular reflux; rales; glucose; lipid profile; decompensation of
and abnormal Na+/ remodelling; mitral disease; cocaine cirrhosis; candesartan;
minor (PAIN) criteria nocturia; pedal oedema LFTs; BNP chronic heart failure;
failure) water retention, regurgitation develops, abuse nephrotic spironolactone
acute renal failure
resulting in oedema increasing LV overload syndrome
Well’s score;
Most begin to develop just Age; hospitalisation; Cellulitis;
DVT Development of a
above and behind a valve recent travel; surgery; Calf/entire leg swelling;
D-dimer; USS
Achille’s tear;
Anticoagulant PE; acute bleeding
blood clot in a deep Black people Greatest risk of during treatment;
(deep vein vein of the leg, thigh, M<F due to stasis, endothelial mortality a/w PE Virchow’s triad active cancer; OCP; asymmetric oedema;
+ INR, ATPP, U&Es,
haematoma; + physical activity, heparin-induced
injury or hypercoagulability leg trauma; clotting collateral superficial veins tumour; ruptured
thrombosis) pelvis or abdomen
(Virchow’s triad) disorders; pregnancy
LFTs, FBC, CT
popliteal cyst
gradient stockings thrombocytopenia
abdomen and pelvis
BP is a product of CO and CKD; renal
Increased CO/PRV; ACEi/ARB; CCB;
PVR and is affected by Uncontrolled HTN is a Age; CAD; HTN; DM; artery stenosis; CAD; CVA; LVH; CCF;
HTN High blood pressure Adults preload, contractility, major risk factor in excess Na+ intake/ obesity; inactivity; BP >140/90mmHg; signs of BP measurement Cushing’s; aortic thiazide-like retinopathy; PAD; CKD;
(hypertension) (>140/90mmHg) M<F retention; dysregulation retinopathy, neuropathy, etc. diuretic; lifestyle
vessel hypertrophy and many diseases black ancestry coarctation; neuropathy
of RAAS changes
peripheral vasoconstriction dysthyroidism;
Infection of valves results
FROM JANE
Infection involving in secondary endothelial
Prosthetic valves; (Fever, Roth spots, Osler’s
endocardial surfaces damage due to turbulent Often Staph. aureus, FBC; U&Es; LFTs;
Infective (valves, chordae Elderly flow; platelets/fibrin adhere CHF is major
Strep. viridans, or
heart transplant; nodes, Murmur, Janeway blood cultures; Rheumatic fever; Abx; surgery CHF; systemic
endocarditis M>F prognostic factor IVDU; poor oral lesions, Anaemia, Nails atrial myxoma embolisation
tendinae and to underlying collagen and enterococcal infection ECG; echo
hygiene; oral surgery (splinter haemorrhages),
endocardium) are colonised by bacteria,
Emboli)
developing vegetations
COPD; PE;
O2 resuscitation; Pleural effusion; chronic
Failure of the LV to Inability of the LV to Age; HTN; MI; DM; Tachycardia; tachypnoea; Echo pulmonary
LVF maintain proper CO properly eject blood during Cause must always be dyslipidaemia; LVH; peripheral cyanosis; fibrosis; DVT; morphine; ACEi/ renal insufficiency;
ARB; nitrates; anaemia; acute
(left ventricular in systole, leading to Adults systole leads to increased Ca. 50% 1y-mortality investigated (LVF is an valvular disease; renal cardiomegaly; pulmonary + FBC, U&Es, LFTs, pneumonia;
digoxin; beta- decompensation of
elevated LA LA pressure, causing the inadequate diagnosis) insufficiency; cocaine oedema; pleural effusion; cardiac biomarkers, cirrhosis;
failure) pressure majority of symptoms abuse fatigue; wheeze TFTs, ECG, CXR nephrotic blocker; warfarin; chronic heart failure;
spironolactone; acute renal failure
syndrome
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