Term
stable angina
- when
- % stenosis
- EKG
- relief |
|
Definition
- on exertion or emotional stress
- stenosis >70%
- ST segment depression due to subendocardial ischemia
- rest or NG |
|
|
Term
unstable angina
- cause
- EKG
- relief |
|
Definition
- rupture of atherosclerotic plaque with thrombosis and incomplete occlusion of a coronary artery
- ST depression due to subendocardial ischemia
- NG |
|
|
Term
prinzmetal angina
- cause
- EKG
- relief |
|
Definition
- coronary artery vasospasm
- ST elevation 2/2 transmural ischemia
- NG of CCB |
|
|
Term
|
Definition
| thrombosis and complete occlusion of a coronary artery, coronary artery vasospasm, emboli and vasculitis |
|
|
Term
|
Definition
| severe, crushing chest pain lasting >20 min that radiates to left arm or jaw, diaphoresis, and dyspnea |
|
|
Term
Part of hear effected with:
- LAD
- RCA
- Left circumflex |
|
Definition
- anterior wall and anterior septum of the LV
- posterior wall, posterior septum and papillary muscles of the LV
- lateral wall of the LV |
|
|
Term
| initial phase of MI necrosis type |
|
Definition
| subendocardial involving <50% of thickness; ST depression |
|
|
Term
| severe ischemia necrosis type |
|
Definition
| transmural involving most of the myocardial thickness |
|
|
Term
troponin I
- rise
- peak
- return |
|
Definition
- 2-4 hrs
- 24 hrs
- 7-10 days |
|
|
Term
|
Definition
| for reinfarction because return to normal by 72 hrs |
|
|
Term
|
Definition
| ASA/heparin, supplemental O2, nitrates, beta-blocker, ACEI and fibrinolysis or angioplasty |
|
|
Term
|
Definition
| results in calcium influx, leading to hyper contraction of myofibrils and may lead to free radial generation, further damaging myocytes |
|
|
Term
< 4 hrs after MI:
- gross
- microscopic
- complications |
|
Definition
- none
- none
- cardiogenic shock, congestive heart failure, and arrhythmia |
|
|
Term
4-24 hrs after MI:
- gross
- microscopic
- complications |
|
Definition
- dark discoloration
- coagulative necrosis
- arrhythmia |
|
|
Term
1-3 days after MI:
- gross
- microscopic
- complications |
|
Definition
- yellow pallor
- neutrophils
- fibrinous pericarditis; with friction rub |
|
|
Term
4-7 days after MI:
- gross
- microscopic
- complications |
|
Definition
- yellow pallor
- macrophages
- rupture of ventricular free wall, inter ventricular septum or papillary muscle |
|
|
Term
1-3 weeks after MI:
- gross
- microscopic
- complications |
|
Definition
- red border emerges as granulation tissue enters from edge of infarct
- granulation tissue with plump fibroblasts, collagen and blood vessels
- non |
|
|
Term
months after MI
- gross
- microscopic
- complications |
|
Definition
- white scar
- fibrosis
- aneurysm, mural thrombus or Dressler syndrome |
|
|
Term
|
Definition
| occurs without symptoms or <1 hr after symptoms; acute ischemia with fatal ventricular arrhythmia |
|
|
Term
|
Definition
| poor myocardial function 2/2 chronic ischemic damage, progresses to CHF |
|
|
Term
| causes of left-sided heart failure |
|
Definition
| ischemia, HTN, dilated cardiomyopathy, MI and restrictive cardiomyopathy |
|
|
Term
| clinical features of left heart failure |
|
Definition
| pulmonary congestion leads to pulmonary edema, decreased flow to kidneys leads to activation of RA system -> fluid retention |
|
|
Term
| causes of R sided heart failure |
|
Definition
| left sided heart failure, Left-to-right shutns and chronic lung disease (cor pulmonale) |
|
|
Term
| clinical features of R sided heart failure |
|
Definition
| jugular venous distention, painful hepatosplenomegaly with characteristic 'nutmeg' liver, may lead to cirrhosis, pitting edema |
|
|
Term
|
Definition
| increased flow through pulmonary circulation results in hypertrophy of pulmonary vessels and pulmonary HTN, increased pulmonary resistance eventually results in reversal of shunt, leading to late cyanosis with R ventricular hypertrophy, polycythemia and clubbing |
|
|
Term
| most common congenital heart defect |
|
Definition
|
|
Term
| associated with fetal alcohol syndroem |
|
Definition
|
|
Term
|
Definition
|
|
Term
| associated with down syndrome |
|
Definition
|
|
Term
| congenital anomaly with split S2 |
|
Definition
|
|
Term
| associated with congenital rubella |
|
Definition
|
|
Term
| holosytolic machine-like murmur |
|
Definition
|
|
Term
|
Definition
| indomethacin which decreases PGE resulting in PDA closure |
|
|
Term
| characteristics of metrology of fallot |
|
Definition
| stenosis of R ventricular outflow tract, RVH, VSD and overriding aorta |
|
|
Term
|
Definition
|
|
Term
| pt squats in response to cyanotic spell |
|
Definition
|
|
Term
| associated with maternal DM |
|
Definition
| transposition of great vessels |
|
|
Term
| presents with early cyanosis |
|
Definition
| transposition of great vessels, truncus arterioles |
|
|
Term
| infantile coarctation of aorta |
|
Definition
| coarctation lies after the aortic arch but before the PDA; with Turner syndrome |
|
|
Term
| adult coarctation of aorta |
|
Definition
| lies distl to aortic arch; presents with HTN in upper extremities and hypotension with weak pulses in lower extremities |
|
|
Term
|
Definition
| adult coarctation of aorta |
|
|
Term
| cause of acute rheumatic fever |
|
Definition
| GAS 2/2 molecular mimicry to M protein that resembles human tissue |
|
|
Term
| Major criteria of rheumatic fever |
|
Definition
| migratory polyarthritis, pancarditis, subcutaneous nodules, erythema marginatum, sydenham chorea |
|
|
Term
| minor critera for rheumatic fever |
|
Definition
|
|
Term
| valve in chronic rheumatic heart disease |
|
Definition
| 'fish mouth' of mitral valve; thickening of chord tendinae and cusps |
|
|
Term
| fusion of commissues with what valve in chronic rheumatic heart disease? |
|
Definition
|
|
Term
|
Definition
| wear and tear; presents in late adulthood |
|
|
Term
|
Definition
| systolic murmur with ejection click followed by crescendo-decrescendo murmur |
|
|
Term
| complications of aortic stenosis |
|
Definition
| concentric LVH, angina and syncope with exercise, microangiopathic hemolytic anemia |
|
|
Term
| cause of aortic regurgitation |
|
Definition
| syphilitic aneurysm, aortic dissection, infectious endocarditis |
|
|
Term
|
Definition
| early bolding diastolic murmur |
|
|
Term
| bounding pulse and head bobbing |
|
Definition
|
|
Term
| valve defect that leads to LV dilation and eccentric hypertrophy |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| myxoid degeneration of the valve making if floppy; may be seen in Marfan, Ehlers Danlos |
|
|
Term
|
Definition
| mid systolic click; louder with squatting |
|
|
Term
|
Definition
| complication of MVP, LV dilation, infective endocarditis, acute rheumatic heart disease and papillary muscle rupture after an MI |
|
|
Term
|
Definition
| holosystolic blowing murmur, louder with squatting and expiration |
|
|
Term
|
Definition
| volume overload and L sided heart failure |
|
|
Term
| murmur with mitral stenosis |
|
Definition
| opening stap followed by a diastolic rumble |
|
|
Term
| complications of Mitral stenosis |
|
Definition
| dilation of left atrium resulting inf pulmonary congestion with edema and alveolar hemorrhage, pulmonary HTN and eventual R sided HF, Afib with associated risk for mural thrombi |
|
|
Term
| low virulence endocarditis |
|
Definition
| S viridans, Damaged endocardial surface develops thrombotic egetations |
|
|
Term
| high virulence endocarditis |
|
Definition
| S aureus, infects normal valves, most commonly tricuspid; large vegetations |
|
|
Term
| endocardiis with prosthetic valves |
|
Definition
|
|
Term
| endocarditis with colon cancer |
|
Definition
|
|
Term
|
Definition
| Hamophilus, actinobacillus, cardiobacterium, eikenella, kingella |
|
|
Term
| clinical features of bacterial endocarditis |
|
Definition
| fever, murmur, janeway lesions, Osler nodes, splinter hemorrhages, anemia of chronic disease |
|
|
Term
| nonbacterial causes of endocarditis |
|
Definition
| hyper coagulable state, underlying adenocarcinoma, libman-sacks (SLE) |
|
|
Term
| libman-sacks endocarditis features |
|
Definition
| on surface and undersurface of mitral valve and results in MR |
|
|
Term
| complications of dilated cardiomyopathy |
|
Definition
| systolic dysfunciton, mitral and tricuspid valve regurge and arrhtymia |
|
|
Term
| causes of dilated cardiomypathy |
|
Definition
| genetic mutation, myocarditis (Coxsackie A or B), alcohol abuse, drugs (doxorubicin), pregnancy |
|
|
Term
| cause of hypertrophic cardiomyopathy |
|
Definition
| genetic mutations in sarcomere proteins; AD |
|
|
Term
| clinical features of hypertrophic cardiomopathy |
|
Definition
| decreased CO (diastolic dysfunction), sudden death 2/2 ventricular arrhythmias (young athletes), syncope with exercise |
|
|
Term
|
Definition
| hypertrophic cardiomyopathy |
|
|
Term
| causes of restrictive cardiomyopathy |
|
Definition
| amyloidosis, sarcoidosis, hemochromatosis, endocardial fibroelastosis and Loeffler syndrome |
|
|
Term
| endocardial fibroelastosis |
|
Definition
| restrictive cardiomyopathy in children |
|
|
Term
|
Definition
| endomyocardial fibrosis with eosinophilic infiltrate and eosinophilia |
|
|
Term
| low voltage EKG with diminished QRS amplitude |
|
Definition
| restrictive cardiomyopathy |
|
|
Term
|
Definition
| benign, mesenchymal tumor with gelatinous appearance; pedunculated mass in left atrium causing syncope 2/2 obstruction of mitral valve |
|
|
Term
|
Definition
| benign hamartoma of cardiac muscle; most common primary tumor in children |
|
|
Term
| cardiac tumor with tuberous sclerosis |
|
Definition
|
|
Term
| metastases to the heart come from where? |
|
Definition
| breast, lung, melanoma, and lymphoma |
|
|
