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50 Cards in this Set
- Front
- Back
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Reduced blood flow through one of the coronary arteries causes _______ then ________ then ________
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ischemia
cell injury infarct |
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WHAT HAPPENS TO Cardiac TISSUE during infarct: (MI)
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Reduced contractility and abnormal wall motion
Altered Lf vent compliance w/ decreased SV and ejection fraction Elevated Lf vent end diastolic pressure or Lf vent systolic dysfunction |
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With MI: Ischemia = __________________ = _________________
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Inflammation
Scar Tissue |
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With MI: Cell injury trigger ____________________
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inflammatory response
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With MI Scar tissue inhibits __________________ – this triggers
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contractility
compensatory mechanism |
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what are the compensatory mechanism related to ischemia due to MI
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1. Vascular constriction
2. increased heart rate 3. renal retention of Na and H2o in order to maintain cardiac output |
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Signs and symptoms of MI
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1. crushing chest pain, referred pain down the L arm, jaw, neck and nausea
2. Fatigue and SOB 3. Nausea and vomiting-biggest reason for misdiagnosis 4. Anxiety, feelings of doom, restlessness, perspiration |
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What is the biggest reason of misdiagnosis in MI
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nausea and vomiting
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Treatment of MI
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Oxygen, Vasodilators, Thrombolytic agents
If arrhythmia then antiarrhythmic agents IV morphine(important vasodilator) Beta 1 blockers help reduce re-infarction but…monitor for heart failure |
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3 Mitral Valve Disorders
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Mital Stenosis
Mitral Regurgitation Mitral Prolaspe |
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cor pulmonae
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Rt sided heart failure
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What is affected with Mitral Stenosis
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left artia to left ventricle, narrowed valve, obstructed
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Mirtal stenosis is characterized by (pressure gradient)
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abnormal left atrial-ventricular pressure gradient during diastole
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Mitral stenosis results in
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chronic pulmonary HTN,
Rt vent. Hypertropy Rt sided heart failure |
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mitral reguration
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backflow from lf vent into rt atrium due to valve not closing all the way
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mitral regurgitation pressure
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pressure gradient during vent systole
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mitral regurgitation results in
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chronic pulmonary HTN
Rt vent. Hypertropy Lt sided heart failure. |
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s/sx mitral stenosis:
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increased HR, a-fib due to excessive atrial volume, atrial clots leading to systemic embolization and stroke. Secondary sumptoms to pulmonary congestion orthopnea, cough, dyspnea on exertion, abnormal breath sounds, poor arterial oxygenation
Lf vent stroke volume: fatigue, poor activity tolerance, and weakness |
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s/sx mitral regurgitation:
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chronic weakness and fatigue
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s/sx Aortic Stenosis:
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angina (due to thickening of ventricle), syncope, fatigue, low systolic BP, faint pulse
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s/sx Atrial regurgitation:
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bounding peripheral pulsation, pounding heart
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Atrial Stenosis (Aortic):
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Lt ventricle to aorta impaired: obstruction
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Atrial Stenosis: Pressure gradient:
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Lt ventricular/aorta during systole
Lt Ventricular pressure higher |
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Atrial Stenosis Patho
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: chronic pulmonary HTN, Lt vent. failure
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s/sx atrial stenosis
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angina (due to thickening of ventricle), syncope, fatigue, low systolic BP, faint pulse
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Atrial Regurgitation
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Circulation: Lt ventricle to aorta impaired: leaking
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Atrial Regurgitation pressure
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Pressure gradient: Lt ventricular/aorta diastole
Lt Ventricular pressure higher |
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Atrial Regurgitation Patho:
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Lt vent. Hypertrophy and dilatation. Lt sided heart failure
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s/sx: Atrial regurgitation:
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bounding peripheral pulsation, pounding heart
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Endocardium: Rheumatic Heart Disease Pathogen:
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group A β-hemolytic streptococcus
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Endocardium: Rheumatic Heart Disease Pathology:
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1. Proteins on cardiac myosin, valves, skin, joints, brain resemble bacterial epitomes.
2. Results in endocardial inflammation with valve destruction. |
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Endocardium: Rheumatic Heart Disease Clinical Manifestations:
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1. Joint inflammation
2. Sydenham chorea-TICS OR NOISES, 3. truncal rash-AROUND BACK AND AB. |
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Dx: Endocardium: Rheumatic Heart Disease
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1. LABS: Elevated antibody titer: antistreptolysin O, anti-Dnase B
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Tx: Endocardium: Rheumatic Heart Disease
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Prophylactic antibiotics for life- DURING DENTAL, SMALL SIGNS OF INFECTIONS, OR FULL TIME
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Endocardium: Infective Heart Disease, Pathogen:
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Several microbes
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Infective heart disease: Pathology:
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Antigen antibody recognition with resulting cascade. Results in endocardial inflammation with valve destruction- ANY OF THE 4 VALVUES.
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Infective heart disease: Clinical Manifestations:
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Acute and subacute presentations.
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EVALUATE VALVE infective heart disease BY:
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12 LEAD ECG, NUCLEAR STUDIES, XRAY
positive blood culture of infective agent, pathogen |
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Tx: infective heart disease
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Surgical replacement of valves. Match the drug to the bug.
Prophylactic antibiotics for life |
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symptoms of subacute infective heart disease
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subacute: low grade fever, wt. loss, nonspecific fatigue, flulike symptoms
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symptoms of acute infective heart disease
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fever, chills, malaise, frequently a heart murmur
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Myocarditis
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Inflammatory disorder due to virus
Acute and stormy clinical picture Histology: necrosis |
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Myocarditis prognosis
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recovery or death
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s/sx Myocarditis
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Pain, fast breathing
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Cardiomyopathy
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Non-inflammatory disorder
Evolves insidiously over years Histology: hypertrophy or atrophied |
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Pathogen:Cardiomyopathy
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virus, genes, autoimmune
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Cardiomyopathy prognosis
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Heart failure
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Pericardial Effusion
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Fluid in the pericardial sac exceeding 50 ml.
Need 15-20 ml in pericardial sac, book says normal is 30-50 ml |
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Cardiac Tamponade-
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Accumulation of pericardial fluid resulting in tamponade which refers to external compression of heart chambers such that filling is impaired.
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Pericarditis
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Inflammation of the pericardium by viral or post MI
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