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41 Cards in this Set
- Front
- Back
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Etio LSHF |
Ischemic heart disease- MI, cardiomyopathy Disease of aortic and mitral valves Cardiomyopathy, myocarditis, serious disorders of rhythm and conduction, hypertonic crisis |
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Etio rshf |
Copd Pulmonary thromboembolism Disease tricuspid and pulmonary valves Tricuspidalisation mitral and aortic valve Cardiomyopathy Constructive pericarditis |
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Main symptoms lshf |
Shortness of breath |
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Main symptoms rshf |
Oedema, fatigue |
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PE lshf |
Often orthopnoic position Lungs- decreased vb w/ crepe (cardiac asthma) non resonant ronchi (pulmonary odema) Often tachycardia and tachyarythmia Poss. 3rd sound and gallop rhythm Usually systolic murmur from mitral valves insuf |
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PE rshf |
Periph cyanosis, symmetrical swollen legs, high neck veins, large painful liver Lungs- poss hydrothorax both sides Heart- usually tachycardia and tachyarythmia. Systolic murmur from tricuspid insuf. |
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Instrumental and lab tests for w/ heart failure |
ECG Echocardio X ray Bg Electrolyte K Na Creatine |
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Clinical form of rheumatism |
Arthritis Endo/myo/pericarditis Chorea minor- Sydenham's chorea Subcutaneal nodes, erythema marginatum |
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Symptoms of Rheumatoid Arthritis |
Monoathritis Affects big js w/ normal Inflam signs- redness, oedema, increase local temp, pain Fever No permanent damage to J |
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Pathogenesis of Mitral Valve Stenosis |
Incomplete opening causes bf obstruction from LA to LV |
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Stages and symptoms of Mitral Valve Stenosis |
I - hypertrophy and dilation of the left atrium usually followed by atrial flutter or fibrillation; lung congestion with shortness of breath (cardiac asthma, possibly lung edema) II increased pressure in the pulmonary artery followed by dilation of the right ventricle and relative tricuspid valve insufficiency with symptoms of right side heart failure |
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Spec. Changes in PE mitral valve stenosis |
Mitral face, usually tachyarrythmia increased I sound on the apex with additional sound of mitral valve opening, diastolic murmur, in patients in sinus rhythm with presystolic acceleration, heard on the apex, best when the patient lies on his left side, no propagation; in rare cases diastolic fremissement (cat’s murmur) on the apex |
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Path of Mitral Valve Insufficiency |
Incomplete closure mitral valve Regurgitation from LV to LA in systole |
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Stages and Symptoms of Mitral Valve Insufficiency |
I – dilation LA LV , same symptoms as mitral stenosis often appear later and milder II - increased pressure in the pulmonary artery followed by dilation of RV and relative tricuspid valve insufficiency with symptoms of rshf;
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Spec. Changes found on PE of Mitral valve insufficiency |
Mitral face, often Ictus Cordis left ICS6 enlarged left border of the relative dullness area, often tachyarrhythmia, decreased I sound, blowing systolic murmur on apex, propagating toward the armpit, and sometimes on Erb’s point |
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Path of aortic valve stenosis |
Incomplete opening aortic valve Obstructs BF LV to aorta in systole |
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Stages and symptoms aortic valve stenosis |
I stage - hypertrophy of LV and peripheral hypoperfusion – ventricular extrasystoles, chest pain or tightness, easy tiredness, vertigo, possibly syncope II stage – dilation of the LV w/ relative mitral valve insufficiency- dyspnea III stage – increased pressure in the pulmonary artery followed by dilation of rv and relative tricuspid valve insufficiency w/ signs rshf
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Spec.changes PE of aortic valve stenosis |
Aortic face- pale low bp w/ small pulse amplitude (often around 110/80 mmHg), pulsus parvus and tardus (low and slow pulse), pushing ictus cordis (apex beat) w/ enlarged area; systolic fremissement (cat’s murmur); often extrasystolic arrhythmia w/ coarse systolic murmur, best heard on aortic valve, but also on Erb’s point and even on the apex, it propagates toward the right carotid artery |
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Path of Aortic valve insufficiency |
Incomplete closure Regurgitation blood back into lv from aorta in diastole |
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Stages and symptoms of aortic valve insufficiency |
Same as stenosis but with faster and severe onset |
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Spec. Changes pe aortic valve insufficiency |
pale aortic face, high systolic and low diastolic blood pressure (common values 180/60-40 mmHg), pulsus celer and altus (steep and high pulse), jumping carotid arteries (rapid upstroke and collapse); displacement of the apex beat (ictus cordis) to VI or VII intercostal space to the left of the medioclavicular line, enlargement of the area of relative dullness; tachycardia or tachyarrhythmia often extrasystoles, decreased II sound on the aortic valve point, diastolic murmur at Erb point, with transversal propagation, best heard in sitting position; |
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Lab and instrumental tests on patients with valve disease |
Echo and Angio Normal ecg, x ray Eventually- AST, CRP, blood culture and count |
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Most common complication valve disease |
Endocarditis |
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Etiology of tachycardia |
physical exercise, stress, emotions, fever, anemia, dehydration, heart failure (compensatory reaction), pericardial effusion, respiratory failure, lung embolism, hyperthyroidism, intoxication, medication; |
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Etiology of Supraventricular Extrasystoles |
diseases of mitral and tricuspid valve, ischemic heart disease, myocarditis, hyperthyroidism, infections (abscess), intoxications (drugs, alcohol, etc), medication, electrolyte disorders - hypokalemia |
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Etio of Ventricular Systoles |
disorders of aortic and pulmonary valves, prolapsed mitral valve, ischemic heart disease, myocarditis, cardiomyopathy, cardiac aneurism; hyperthyroidism, infections (abscess), intoxications (drugs, alcohol, etc.), medication, hypokalemia, digoxin intoxication, sleep apnea |
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Characteristics of Supraventricular Extrasystoles |
premature beats w/ deformed/no P wave (nodal) normal QRS complexes incomplete compensatory pause |
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Characteristics of Ventricular Extrasystoles |
premature beats without P wave deformed QRS complexes complete compensatory pause |
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Classification of Ventricular Extrasystoles |
frequent multifocal grouped early –Q/T phenomenon |
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Etio of absolute arrhythmia due to atrial fibrillation or flutter |
diseases of mitral and tricuspid valve, most common mitral valve stenosis, ischemic heart disease, possibly cardiomyopathy or myocarditis; hyperthyroidism, pulmonary thromboembolism, intoxications, hypokalemia; |
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Symptoms of tachyarrhythmia |
the higher frequency aggravates the condition of the patient: easy tiredness, fatigue, weakness, in severe cases shortness of breath during physical exercise or even at rest, pain or tightness in the chest, in rare cases cardiac shock or loss of consciousness; |
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Complications of tachyarrythmia |
systemic (brain, limbs, etc.) or pulmonary thromboembolism usually during regularization (recovering of the SA rhythm |
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Etio of Ventricular tachycardia, flutter and fibrillation |
ischemic heart disease, especially acute myocardial infarction, cardiomyopathy, aortic valve diseases, myocarditis; intoxication (drugs or alcohol abstinence), medication (chinidin, cordaron), hypokalemia, sleep apnea |
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Etio Bradycardia |
medication (antiarrhythmic drugs, beta-blockers, etc) hypothyroidism increased intracranial pressure hyperkalemia |
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Diagnosis of Sick Sinus Syndrome |
episodes with sinus tachy- and bradycardia or pauses with lack of both P wave and QRS complex |
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Etio AV Block |
ischemic heart disease, cardiomyopathy myocarditis intoxications medications (antiarrhythmic drugs, digoxin) |
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Diagnosis and Stages of AV Block |
I stage – only increased PQ interval over 0.20 s, usually normal heart rate II stage – type Mobitz I – progressively increasing PQ interval with periodical loss of QRS complexes although a P wave is present,II stage – type Mobitz II – increased PQ interval with loss of QRS complexes at fixed intervals; heart rate usually between 50 and 40, mild to moderate symptoms III stage – complete AV block – regular P wave with normal frequency, abnormally shaped and dilated QRS complexes due to ventricular automatia with heart rate under 40, moderate or severe symptoms; (there would be no P waves if the patient is with atrial fibrillation)
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Symptoms of Sick Sinus Syndrome and AV Block |
the lower heart rate and the larger pauses aggravate the condition of the patient - easy tiredness, weakness, fatigue, pain or tightness in the chest, vertigo, headache, high blood pressure, in patients w/ heart rate under 40 per minute possible shortness of breath due to lshf, shock, loss of consciousness, transitory ischemic disorders of the cerebral circulation - syncope, MAS (Morgani-Adams Stokes) syndrome (loss of consciousness with relieve of the pelvic reservoirs); |
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Diagnosis of left and right bundle branch block |
left - dilated QRS complexes over 0.10 s in the left leads (V5 and V6) right - dilated QRS complexes over 0.10 s in the right leads (V1 and V2); |
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Etio left and right bundle branch block |
left - often caused by hypertrophy of the lv in patients w/aortic valve stenosis, hypertrophic cardiomyopathy, arterial hypertension; also ischemic heart disease oft MI right: hypertrophy of rv in patients with cor pulmonale, pulmonary valve stenosis, also lung thromboembolism and ischemic heart disease, mi
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Spec. Instrumental and lab tests for patients with disorders rhythm and conduction |
ECG, Holter ECG Angio w/ mapping K, CPK, Troponin T for MI D- Dimer for lung embolism Thyroid hormones |
