Term
| forward failure and backward failure result in? |
|
Definition
1) increased end-diastolic ventricular volume
2) increased end-diastolic ventricular pressure
3) elevated venous pressure |
|
|
Term
| left sided cardiac failure causes: |
|
Definition
1) hypertension
2) mitral/aortic valve disease
3) ischemic heart disease
4) primary disease of myocardium |
|
|
Term
| Right sided cardiac failure causes |
|
Definition
1) left sided failure *most common
2) intrinsic lung disease with emphysema
3) primary disease of pulmonary vasculature
4) pulmonic or tricuspid valvular disease |
|
|
Term
| Compensatory mechanisms in CHF |
|
Definition
1) increased sympathetic activity
2) activation of renin-angiotension system
3) ANP release
4) hypertrophy of myocardium
5) dilation of heart -Frank Starling relationship |
|
|
Term
| Congestion of venous system as a result of CHF causes: |
|
Definition
1) L-sided pulmonary congestion-pulmonary edema
2) increased load on R-side - R-sided failure |
|
|
Term
| Renal compensation of CHF? |
|
Definition
1) decreased perfusion-renin-angiotension system activation
2) increased BP
3) sodium/water retention |
|
|
Term
| clinical features of L-sided CHF? |
|
Definition
1) Dyspnea - worse w/activity and recumbent
2) enlarged heart
3) third heart sound
4) mitral regurg |
|
|
Term
| clinical features of R-sided heart failure |
|
Definition
1) venous congestion and edema
2) JVD
3) Enlarged liver
4) increased DVT
5) weight gain-fluid retention
6) pleural effusions |
|
|
Term
| Pathogenesis of Ischemic Heart Disease |
|
Definition
1) stenosis of artery
2) changes in plaque morphology
3) platelet aggregation
4) inflammation
5) Coronary Artery thrombosis
6) Coronary Artery Spasms - prinzmetal's angina (not w/exercise) |
|
|
Term
| What occurs in typical coronary artery occlusion? |
|
Definition
1) sudden plaque rupture
2) plattlet aggregation - cytokines released
3) vasospasm secondary to platelet aggregation and mediator release
4) extrinsic pathway activated-thrombus formation
5) within minutes-thrombus evolves to occlude artery |
|
|
Term
|
Definition
1) excertion induced crushing/squeezing chest pain
2) reversible ischemia
3) Prinzmetal's angina - pain at rest or sleep (Coronary artery spasm)
4) unstable angina - increasing angina w/less exertion - MI soon |
|
|
Term
|
Definition
1) caused by coronary artery thrombosis *
2) LAD - anterior and apical L ventricle anterior 2/3 interventricular septum
3) RCA - posterior L ventricle, posterior 1/3 interventricular septum
4) Circumflex - lateral wall L ventricle |
|
|
Term
|
Definition
1) coagulation necrosis - 18-24hrs
2) macrophages, fibroblasts, capillaries enter 4-5 days
3) most of necrotic removed - end of 4th week
4) scar present - week 8 |
|
|
Term
| Chronic Ischemic Heart Disease |
|
Definition
1) progressive heart failure as a consequence of long-term myocardial injury
2) dilated heart chambers
3) arrhythmias |
|
|
Term
| Sudden Cardiac Death causes |
|
Definition
1) heart Disease *
2) pulmonary embolus
3) ruptured AA
4) CNS disease/infections
5) defined as instantaneous - 24hrs |
|
|
Term
| Hypertension and affected organs and heart affects |
|
Definition
1) heart, brain, kidneys
2) Heart-L ventricular hypertrophy, thicker myocardium-more nutrient requirements, decreased compliance and stroke volume from stiffness, increased risk of MIs from atherosclerosis |
|
|
Term
| Hypertension Clinical Features |
|
Definition
1) L ventricular hypertrophy found on ECG
2) CHF
3) Myocardial ischemia
4) increased risk of death |
|
|
Term
|
Definition
| caused by pulmonary hypertension (R-sided) |
|
|
Term
|
Definition
1) Caused by pulmonary embolism
2) dilated but not hypertrophied R ventricle |
|
|
Term
|
Definition
1) Cause COPD
2) R ventricular Hypertrophy
3) CHF may develop |
|
|
Term
| Rheumatic fever and heart disease |
|
Definition
1) immunologically mediated disease that follows Strep A pharyngitis
2) hypersenstivity rxn that cross reacts with glycoproteins in heart
3) all three layers of heart involved
4) mitral and aortic scarring |
|
|
Term
|
Definition
1) occurs w/aging, calcification of valve
2) mitral/aortic most common
3) may occur w/bicuspid aortic valve
4) symptoms: angina, syncope, CHF |
|
|
Term
|
Definition
1) most common cause of reguritation
2) ballooning of valve
3) mostly asymptomatic
4) increased risk of endocarditis, arrythmias, and sudden death |
|
|
Term
| nonbacterial thrombotic endocarditis |
|
Definition
1) fibrin, platelet, and other blood component deposition
2) aortic valve
3) may also develop DVT
4) lesions may disappear |
|
|
Term
|
Definition
1) acute-staph A
2) sub acute-abnormal valve seeding-a-hemolytpic strep
3) increased risk with: cardiac abnormalities, prosthetic heart valves, IV drug abusers
4) valves avascular-hard to kill infection
5) systemic emboli can occur |
|
|
Term
| clinical features of infectious endocarditis |
|
Definition
1) low virulence: low fever, malaise, and weight loss
2) virulent: high fever, chills, septeceima
3) murmurs
4) spleen enlarged
5) systemic emboli
6) Petechia
7) diagnosis: blood cultures |
|
|
Term
| Prosethetic cardiac valves |
|
Definition
1) mechanical deterioration
2) thrombi - coumadin
3) paravalvular disease
4) hemolysis with hemochromatosis |
|
|
Term
| Primary mycardial disease |
|
Definition
1) inflammatory disease of cardiac muscle
2) causes: Virus*, Parasites, Bacteria
3) dilated and flabby heart
4) severe/progressive CHF or arrhythmias may be caused |
|
|
Term
|
Definition
1) progressive hypertrophy, dilation, and contractile dysfunction
2) causes: infections, alcohol, toxins, pregnancy, idiopathic**
3) flabby and enlarged heart
4) ineffective contraction w/decreased ejection |
|
|
Term
| Hypertrophic cardiomyopathy |
|
Definition
1) hypertrophy, abnormal diastolic filling, intermittant ventricular outflow obstruction
2) inherited
3) ejection forceful, decreased ejection volume, myocardial ischemia and arrhythmias common |
|
|
Term
| Restrictive Cardiomyopathy |
|
Definition
1) decreased ventricular compliance results w/impaired ventricluar filling during diastole
2) caused by endomyocardial fibrosis
3) stiff ventricle, decreased output, exertional dyspnea, conduction blocks |
|
|
Term
| 4 most common Congenital Heart Disease *(form of heart disease in US) |
|
Definition
1) Ventricular septal defect (42%)
2) Atrial septal defect (10%)
3) Pulmonary Stenosis (8%)
4) Patent ductus arteriosus (7%) |
|
|
Term
|
Definition
1) lacks early cyanosis
2) leads to right-to-left shunting |
|
|
Term
| Atrial Septal Defects (ASD) |
|
Definition
1) ostium secondum defect*- failure of ostium secondum to enlarge and cover ostium secondum
2) Ostium primum: failure of septum primum and endocardial cushion to fuse
3) sinus venous: unknown causes
4) may progress to R-to-L shunt |
|
|
Term
| Ventricular Septal defect* (VSD) |
|
Definition
1) most common in membranous partition
2) R ventricular hypertrophy with pulmonary hypertension
3) most close in childhood
4) large develop L-to-R, then R-to-L
5) infective endocarditis can develop |
|
|
Term
| Patent Ductus Arteriosus (PDA) |
|
Definition
1) shunt b/t pulmonary artery and aorta
2) closes at birth from increased oxygen, decreasing vascular resistance, and declining prostaglandin E2
3) L-to-R shunt w/murmur heard in back
4) pulmonary hypertension and CHF
5) increased risk of infective endocarditis |
|
|
Term
|
Definition
1) cyanosis at birth
2) may develop clubbing of fingers and polycythemia
3) may have paradoxical embolism |
|
|
Term
|
Definition
1) most common cause of cyanotic congenital heart disease
2) VSD, dextraposed aortic root, R ventricular outflow obstruction, R ventricular hypertrophy
3) decreased lung blood flow, cynaosis at birth, increased risk of infective endocarditis |
|
|
Term
| Transposition of the great vessels |
|
Definition
1) aorta from right ventricle
2) must have shunt to survive (ASD, VSD, PDA)
3) R ventricle hypertrophy |
|
|
Term
|
Definition
1) Narrowing of aortic lumen
2) preductal-infancy, CHF, weak femoral pulse
3) Postductal-older children, hypertension of upper extremities |
|
|
Term
| Pericardial disease (pericarditis) |
|
Definition
1) viruses most common cause
2) anything that disturbs pericardium
3) atypical chest pain, friction rub, pericardial tamponade (distant heart sounds, JVD, shock) |
|
|
Term
| Pericardial Disease (pericardial effusion) |
|
Definition
1) fluid in percardial space
2) serous causes: CHF, hypoablbuminemia
3) cardiac tamponade and death |
|
|
Term
|
Definition
1) Carcinoma of the lung*, lymphoma, breast cancer, leukemia - metastasized cancers
2) benign tumor: myxomas
3) rhabdomyomas: most common in children |
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