Term
| Describe an aortic aneurysm. |
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Definition
| Swelling or distention of an arterial segment. Abdomnial portion is most susceptible to aneurysms. Therefore, AAA. |
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Term
| What are the two main risks of a AAA? Who is more suseptable to AAA's? |
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Definition
Rupture or Dissection
More common in men (2:1), smokers and former smokers, poorly treated hypertension, those with family histories of AAA, size of the aneurysm determines the risk of rupture or dissection |
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Term
| What are the symptoms of AAA and how do we treat it? |
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Definition
Back pain, abdominal pressure, palpate the pulsatile mass, diagnostic imaging confirms the conditions.
Treat it with surgical resection or endovascular repair. The endovascular repair is a much safer procedure. |
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Term
| What are the three different categories of cardiac arrhythmias? |
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Definition
| Rate abnormalities (trachy or brady cardia) , ectopic depolarizations, and deviant pathways (re-entry) |
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Term
| What are the anatomic associations with cardiac arrhythmias? |
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Definition
Atrial: flutter or fibrillations
Supraventricular: acute supraventricular trachycardia, AV nodal re-entry (wolff-parkinsons-white WPW)
Ventricular: acute ventricular tachycardia, ventricular fibrillation (causes the cardiac output to go to 0, then you can die) |
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Term
| What are the immediate causes of arrhythmias? |
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Definition
Disturbance of the impulse formation, conduction, or combination of the two.
These can be caused by ischemia, hypozia, ph problems, excessive catecholamines (scared to death), drug toxicity, overstretching of the cardiac fibers (CHF), scarred cardiac tissue (MI) |
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Term
How do we treat arrhythmias?
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Definition
| Correct causes of electrical impulse abnormalities, albate (destroy) areas where abnormal impulses originate, or use drugs that affect ion channels |
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Term
| What is amiodarone (corderone) used for and what are the side effects? |
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Definition
Useful in treatment of ventricular tachycardia and fibrillation, and atrial fibrillations.
Side effects include pulmonary fibrosis, liver toxicity, blocking of t4/3 conversion, blue-gray skin (photodermatitis), and thyroid dysfunction |
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Term
| What is the most common form of chronic arrhythmias? |
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Definition
| Atrial fibrillation. Loss of normal atrial contraction causes 20-30% drop in the left ventricular output, ventricular rate becomes rapid and irregular to try and make up for loss. |
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Term
| What is the etiology of atrial fibrillation? |
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Definition
| Risk increases with age (10% by age 80), linked to atrial (usually left) enlargement, alcohol is related in some cases especially those who binge or in withdrawals (holiday heart) |
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Term
| What are the two major health risks of atrial fibrillation? |
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Definition
Tachycardia to the point of hypotension.
Mural thrombi. Clot development in enlarged left atria, can cause an emoblic stroke. |
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Term
How do we treat atrial fibrillations?
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Definition
| Rate control thorugh beta blockers (digoxin), restore the sinus rhythm via cardioversion (shock the heart, to re-establish normal rhythm) or atrial ablation, and use anticoagulates to prevent to growing of the clot with drugs like warfarin (coumadin). |
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Term
| Describe peripheral vascular disease. |
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Definition
| Occlusive disease, non-artherosclerotic vascular disease, vericose veins arterial aneurysms, venous thrombophlebitis. |
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Term
| What are the symptoms of PVD? |
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Definition
| Depends on the vessel involved...but, erectile dysfunction is seen and intermittent claudication is also seen. |
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Term
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Definition
| Pain with exercise (usually walking), crampinh-type pain often severe in the calf muscles, thigh, butt, and may be bilateral. Usually relieved with rest. More common in males >50, most are smokers, usually their first clinical manifestation of atheroschletosis. Usually effects the common iliac, interal/external iliac, femoral, or popliteal artery. |
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Term
| How do we treat claudications? |
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Definition
| Lifestyle changes, hypertension and lipi treatment therapy, evaluate for any possibility of coronary disease, surgical treatment via a bypass graft |
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Term
| What valve do we tend to see the most problems with in the heart? |
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Definition
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Term
| What are the 4 main valve problems seen in the hear? |
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Definition
Narrowing, partial occlusion: stenosis
Leaking: regurgitation
Mitral valve prolapse
Valve infection: endocarditis |
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Term
What are the 8 possible heart valve problems?
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Definition
Mitral, tricuspid, aortic, or pulmonic stenosis.
Mitral, tricuspid, aortic, or pulmonic regurgitation. |
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Term
| What are the generalities of valvular conditions? |
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Definition
| Often asymptomatic during the first 4 decades of life unless it is a severe lesion. Exertion dypsnea often the first symptom. Surgical repair or replacement may ultimately be necessary. Can be congenital in nature, degenerative calcification, consecquence of rheumatic fever. |
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Term
| What is the most common valvular heart disease and what are the symptoms? |
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Definition
| Most common form is Aortic Stenosis, the symptoms are really none for mild stenosis forms, but in severe cases there will be syncope, chest pain (angina), and dyspnea. For severe cases, 50% chance of death in 5 years, 90% chance of death in 10 years. |
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Term
| Describe rheumatic fever. |
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Definition
| Immunologic complication of strep infection, peak age is 5-15 years old, damage to valves can begin 1-5 weeks after infection, mitral valve most commonly affected (75%), 100 times more common in developing countries!!! |
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Term
| Describe mitral valve prolapse. |
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Definition
| relatively common and relatively benign anomaly, usually young, thin women are most suseptable, produces distinctive murmor (click), rarely causes dyspnea and/or chest pain, repair is rarely needed |
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Term
| What is Infective endocarditis and what increases the risk of the condition? |
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Definition
| A life threatening condition/infection of a heart valve, organisms in blood stream lodge on the valve. Increased possibility in peopl ewho have had previous valve damage, or are IV drug users. Diagnosed by feverm malaise, new or changed heart murmur, postiive blood cultures, US of vegetations |
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