Term
| What are causes of aortic regurgitation? |
|
Definition
idiopathic aortic root dilation
rh. Heart dz
collagen vascular dz |
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Term
|
Definition
| You can see the capilary pulsation in nail beds |
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Term
|
Definition
| headbobbing in time with each heartbeat due to increased pressure |
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Term
| What is the #1 cause of mitral regurgitation? |
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Definition
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Term
| What sex is most affected by mitral valve regurgitation? |
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Definition
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Term
| What used to be the #1 cause of mitral valve regurgitation? |
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Definition
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Term
| What goes wrong in mitral valve prolapse? |
|
Definition
| chordae tendinae can rupture |
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Term
| What is a possible side effect of vegetations that have appeared on heart valves? |
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Definition
| they can be released into the blood stream and cause emboli --> stroke |
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Term
| What are the s/sx of mitral regurgitation? |
|
Definition
palpitations
left ventricular failure
systemic embolization |
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Term
| What can occur with ANY incompetent valve? |
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Definition
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Term
| What is the best way to visualize heart valves for diagnosis? |
|
Definition
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Term
| If the heart is enlarged, what is best way to diagnose? |
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Definition
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Term
| What is the tx for valvular dysfunction? |
|
Definition
diuretics
digitalis
anticoagulants
vasodilators |
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Term
| what is a homograft or allograft? |
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Definition
| a human transplant sourced from a human |
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Term
|
Definition
using the competent pulmonic valve over to the aorta and replacing the pulmonic valve with a homograft.
Greatest success rate!! |
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Term
| Do mechanical valves work as well as human valves? |
|
Definition
No, but they do not have a waiting list.
They have a short service life |
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Term
|
Definition
| using a valve from another animal, such as pork |
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Term
| What is a commissurotomy? |
|
Definition
| tx for mitral stenosis, surgeon cuts open valve, works well for mitral valve, but does NOT work for aortic |
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Term
| What is a balloon valvuloplasty? |
|
Definition
using a catheter balloon to break open a mitral stenosis
Does not work well on aortic valve |
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Term
| What is infective endocarditis? |
|
Definition
| infection of endocardial surface and valves |
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Term
| What are the #1 causes of infective endocarditis? |
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Definition
| staph aureus is without a doubt #1, candida albicans is the most common fungal cause |
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Term
| What are the s/sx of infective endocarditit? |
|
Definition
fever, new or changed heart murmur, feel "like crap"
splinter hemorrhages of conj, Roth spots |
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Term
| What is a common etiology for infective endocarditis? |
|
Definition
infection introduced to blood stream by small surgical procedures, such as removal of an eyelid bump.
Be sure to follow up with any pt you work on! |
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Term
|
Definition
| fibrin and WBC in the center of a hemorrhage in the retina |
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Term
| Is a Roth spot exclusive to infective endocarditis? |
|
Definition
| no, can appear with diabetic retinopathy, SLE, etc |
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Term
| How is infective endocarditis diagnosed? |
|
Definition
blood culture
echocardiography
janeway lesions, emboli, hemorrhage, fever |
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Term
| What is the prognosis of infective endocarditis? |
|
Definition
| high morbidity and mortality if tx is delayed |
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Term
| What is proper prophylaxis against infective endocarditis? |
|
Definition
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Term
|
Definition
| By definition, these are not the result of compensatory mechanism |
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Term
| What can cause cardiomyopathy? |
|
Definition
previous viral myocarditis
EtOH abuse
pregnancy
genetic |
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Term
| What is the prognosis for dilated cardiomyopathy? |
|
Definition
| 35% die within 5 years; 70% within 10 years |
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Term
| What is proper tx for dilated cardiomyopathy? |
|
Definition
salt restriction
high dose fish oil
remove any offending agent
digitalis, diuretics, vasodilators, beta blockers |
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Term
| What are surgical ways to treat cardiomyopathy? |
|
Definition
cardiac transplantation
surgical ventricular restoration (piece of cow heart to strengthen dilated ventricle) |
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Term
| What is hypertrophic cardiomyopathy? |
|
Definition
| decreased ventricular volume and hypercontracting heart |
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Term
| Who is most likely to get hypertrophic cardiomyopathy? |
|
Definition
| young adults, strong family history |
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Term
| What are s/sx of hypertrophic cardiomyopathy? |
|
Definition
extertional dyspnea
angina at rest
syncope after exercise
SCD possible |
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Term
| What is used to treat hypertrophic cardiomyopathy? |
|
Definition
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Term
| What are surgical ways to treat hypertrophic cardiomyopathy? |
|
Definition
myoectomy to reduce thickness of septum
pacemaker and defibrillator implantation
intentional septal infarction to reduce obstruction (inject alcohol into tissue to kill it) |
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Term
| What is Takosubo cardiomyopathy? |
|
Definition
"broken heart syndrome", stress cardiomyopathy
non-ischemic cardiomyopathy triggered by emotional stress
Most common in women |
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Term
| What is acute pericarditis? |
|
Definition
| look at slide 120 for etiology |
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|
Term
| What are s/sx of acute pericarditis? |
|
Definition
inspiratory chest pain on left side
friction rub during systole and diastole |
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|
Term
| What is the tx for acute pericarditis? |
|
Definition
treat underlying disorder
NSAID's, steroids, colchicine |
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|
Term
| What is pericardial effusion? |
|
Definition
| inflammation from acute pericarditis |
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|
Term
| What are s/sx of pericardial effusion? |
|
Definition
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|
Term
| How is pericardial effusion treated? |
|
Definition
treat pericarditis
may involve aspiration of fluid |
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Term
| What is cardiac tamponade? |
|
Definition
rapid fluid buildup from pericarditis --> compress heart reducing filling
life threatening!! |
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Term
| What are s/sx of cardiac tamponade? |
|
Definition
shock
decreased systolic pressure during inspiration |
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|
Term
| What is the tx for cardiac tamponade? |
|
Definition
| emergency pericardiocentesis |
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Term
| What is constrictive pericarditis |
|
Definition
| thickened pericardium due to inflammation |
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Term
| What are s/sx of constrictive pericarditis? |
|
Definition
dyspnea on exertion or orthopnea
edema, ascites, hepatice tenderness with jaundice |
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|
Term
| What is the tx for constrictive pericarditis? |
|
Definition
pericardiectomy (removal of the pericardium)
relief of symptoms may not be appreciated for up to 6 w |
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|
Term
| What is carotid artery dx? |
|
Definition
lumen blocked 50-90%
caused by atherosclerosis |
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|
Term
| What can cause thickening of pericardium? |
|
Definition
| constrictive pericarditis due to fibrosis of tissue |
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Term
| How is carotid artery dz diagnosed? |
|
Definition
| auscultation (bruit); though not definitive |
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Term
| What is the risk of early death or stroke with carotid artery dz? |
|
Definition
risk of death goes up 3-5x
Risk of stroke is 2-3% per year |
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Term
| What does a completely occluded artery sound like? |
|
Definition
| Nothing, there is not blood blow, therefore no turbulence, therfore no sound |
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Term
| What is the definition of a carotid TIA? |
|
Definition
| blockage of carotid artery |
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Term
| What are s/sx of carotid TIA? |
|
Definition
hollenhorst plaques (cholesterol emboli in ocular arterioles, near bifurcations)
Amaurosis fugax
hemiparesis, monoparesis, clumsiness of one limb (numbness, loss of sensation, paresthesia)
ataxia (irregular voluntary muscle coordination)
aphasia (impairment of speech center in brain)
dysarthria (paralyzed tongue/speech muscles)
diplopia
vertigo |
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|
Term
| What are risk factors for carotid TIA? |
|
Definition
| smoking, alcohol, obesity, HTN |
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|
Term
|
Definition
| removal of plaque from cartery, only used of lumen more than 75% occluded |
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|
Term
| What is peripheral arterial dz? |
|
Definition
| atherosclerosis, thrombosis, or embolism causing lower limb ischemia |
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|
Term
| What are s/sx of peripheral arterial dz? |
|
Definition
pain, limping while walking
pallor, paralysis, pulselessness
hair loss
secondary to diabetic foot and Raynaud dz |
|
|
Term
| What are pt education points for lower limb ischemia? |
|
Definition
avoid trauma
careful foot and toe hygiene
cessation of smoking |
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|
Term
|
Definition
| distal neuropathy caused by vascular insufficiency |
|
|
Term
| What are risks from diabetic foot? |
|
Definition
50-75% require lower amputation
insensate, poorly perfused foot is at risk for ulcers |
|
|
Term
| How is diabetic foot treated? |
|
Definition
adequate foot care can help
intensive AB
crutches, wheelchairs, bed rest |
|
|
Term
|
Definition
dilated, tortuous superficial veins in lower extremities
Often caused by prolapse of venous valves |
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|
Term
| What are s/sx of varicose veins? |
|
Definition
| pain, usually with periods of standing |
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|
Term
| What are nonsurgical treatments for varicose veins? |
|
Definition
use compression socks
leg elevation
limit long periods of standing |
|
|
Term
| What is surgical treatment for varicose veins? |
|
Definition
sclerotherapy and compression (by chemical agent)
removal of varicosity (by laser)
endovenous laser therapy
radiofrequency ablation |
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