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75 Cards in this Set

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angina
chest pain, commonly used to imply hest pain caused by myocardial infarction/

3 types:
1. stable "Heberden"
2. unstable
3. Varient "prinzmetal's" vasospasm
.backward failure
that component of heart failure attributable to the inability of hte heart to move blood out of the large central veins
contraction band
an early sign of myocardial ischemia, dense transverse aggregates of contractile proteins, usually short irregularly spaced wavy eosinophilic bands
forward failure
that component of heart failure attributable to the hearts inability to move adequate quantities of blood into the large arteries with sufficient pressure to adequately perfuse vital organs
sudden cardiac death
an unexpected natural (non-traumatic) dysfunction in which vital functions suddenly cease, usually implies sudden unexplained instantaneous collaps due ot cardiac ischemia. Also includes, in many studies, deaths that occur within one to six hours of the onset of symptoms, and includes various non-ischemic etiologies, ofter relating to cardiac arrhythmias
cardiac arrhythmias
used as a general term for any abnomral heart rhythm. also used to describe abnormal patterns of electrical discharge in the myocardium, automaticity, re-entry, after potentials
atresia
congenital absense or closure of a normal body orifice or tubular structure. example aortic atresia, congenital absense of the orifice of the aortic valve, there is no aortic outflow passage, blood cannot exit the left ventricle through the usual flow tract
clubbing
an enlargement of the soft tix of the distal portions of the fingers and toes. usually implies low arterial oxygen saturation, ofter due to right to left shunt
concentric hypertrophy
the wall is thickened bu thte volume is reduced. the myocardium is hypertrophied/thickened in a uniform way, usualy because of chronic pressure overload
congenital heart disease
abnormal cardiac anatomy present from birth
cyanotic congenital heart disease
"blue baby" - congenital heat disease with persisten low arterial saturation, implies right to left shunt such as that seen in Tetrology of Fallot
Dilatation
the cardiac chambers of the heart are abnormally large and contain high volumes relative to their normal state
Eisenmengers syndrome/complex
ventricular septal defect with pulmonary hypertension, right ventricular hypertrophy and a right to left shunt
endocarditis
inflammation of the inner lining of the heart, ofter used to denote and infection of the valve leaflets with an associated vegetation
hypertensive heart disease
cardiac dysfunction realted to longstanding severe hypertension
jet lesion
endocardial thickenings, usually fibrous endocardial lesions, found where abnormal streams of blood have been directed through abnormal openings. often found in association with incompetent or regurgitant valves
late cyanosis (cyanosis tardive)
refers to forms of congenital heart disease where the lesion initially has an associated left to right shunt but as pulmonary vascular changes become progresively severe the shunt reverses and becomes right to left and cyanotic. may be found in ASD, VSD, and PDA
Paradoxical embolus (crossed embolus)
an embolus that arises in a systemic vein, crosses into the left hear thru ASD/VSD and cuases systemic disease (infarct) by blocking systemic arteries
polycythemia
an increase in red cell mass (measured as and increase in the number of RBDs per unit volume) caused by sustained hyperplasia of the erythroid elements of the bone marrow usually in response to chronic hypoxemia
pressure overload
the cardiac chambers, espeically the ventricles, are forced to contract in the face of abnormaly high resistance. HTN, aortic stenosis. see concentric hypertrophy.
reperfusion injury
refers to loss of myocytes that were alive when reperfusion began but were irreversibly damambed in the course of reperfusion. May relate to massive lethal calcium overload that occurs in damaged but not yet dead myocytes in a reperfused zone. course they would have died anyway if they hadn't been reperfused, confusing concept
shunt
abnormal cardiovascular connection between two chambers or vessels that are not normaly connected
transposition
the great vessels arise from the wrong chamber. the aorta arises from the right ventricle, the pulmonary artery from the left
cor pulmonade
right ventricular hypertrophy and or dilation odue to pulmonary dz, pulmonary HTN. In acute cor pulmonade due to sudden massive pulmonary emboli, there is dilation without hypertrophy
anitschkow cell
large mononucleate cells found in aschoof bodies
aschoff body
a unique type of granuloma found ususally in the interstitium of the myocardium in Acute Rheumatic Fever and other inflammatory myocardial processes
regurgitation
a valve which cannot perform its primary function, which is to prevent the backward flow of blood across its orifice during certain phases of the cardiac cycle
roth spots
round or oval white spots sometimes seen ithe retina early in the course of bacterial endocarditis
splinter hemorrhages
linear hemorhages beneath the finger and toe nails, usually located near the base o the nail
syndenham's chorea
movement disorder associated with acute rheumatic fever
tamponade -
usually refers to cardiac tamponade. an accumulation of fluid, blod, or aire of sufficient quantity to cause hemodynamic changes up to shock and death. a small amount of fluid can be fatal if it accumulated rapidlyy (hemopericardium associated iwth dissecting aneurysm or myocardial rupture)
valvular insufficiency
a valve is incomptetent with it has a congenital anomaly or acquired pathologic lesion wich impedes one or more components of the valve fromt he coming together. the falve thus cannot perform it's primary function, which is to prevent the backward flow of blood across its orifice during certain phases of the cardiac cycle
valvular stenosis
a valve which has an orifice so small that blood flow across it is restricted
vegetations
a thrombus attached to an endocardial surface
barlow's "syndrome"
synonym for floppy mitral valve
adriamycin
chemotherapy agent known to cause cardiac dysfunction
cariomyoptathy
primary disase of the cardiac muscle. ususally implies a non-ischemic, non-inflammatory process. Must rule out toxins, atherosclerosis, HTN, valvular heart dz, congenital heart dz, intrinsic pulmonary dz
chagas's disease
infectious myocarditis caused by parasite. the most common form of invections myocarditis in south america
daunorubicin
chemotherapy agen tknown to cause cardiac dysfunction
doxorubicin
chemotherapy agen known to cause cardiac dysfunction
effusioin
abnormal fluid collection
myocarditis
myocardial inflammation with necrosis
trypanosoma cruzi
parasite that causes chagas's disease
vascluar atocoids
include prostacyclin (relaxes smc and inhibits platelet aggregation) and endothelin(vasoconstrictor) and NO (endothelium derived relaxing factor)
APOE
apolipoprotein E: one ofthe main components of VLDL and HDL.

different forms of APOE are associate with different risks from hypercholesterolemia. APOE2 is good (lower LDL) and APOE4 is bad (higher cholesterol)
LP(a)
an ldl like lipoprotein particle. hgh levels ofLP(a) are associated with a high risk for atherosclerosis
raynaud phenomenone
intermittent attachs of severe arterial spasm leading to ischemia of distal fingers, toes and other body parts
ring abcesses
complication of endocarditis with infection of the valve ring
marantic endoarditis
another name for non bacterial endocarditis
lambl's excrescences
Lambl's excrescences are filiform fronds that occur at sites of valve closure. They originate as small thrombi on endocardial surfaces (where the valve margins contact) and have the potential to embolize to distant organs.
libman-sacks endocarditis
is a form of nonbacterial endocarditis that is seen in systemic lupus erythematosus. It is one of the most common cardiac manifestations of lupus (the most common being Pericarditis).

The vegetations are small and formed from strands of fibrin, neutrophils, lymphocytes, and histiocytes. The mitral valve is typically affected, and the vegetations occur on the ventricular and atrial surface of the valve. Libman-Sacks lesions rarely produce significant valve dysfunction and the lesions only rarely embolize.
constrictive endocarditis
Thickening of the endocardium due to inflammation of any origin that restricts the diastolic relaxation of one or both ventricles producing diastolic ventricular failure.
uremic pericarditis
is a form of pericarditis. It causes fibrinous pericarditis.

It is sometimes treated with dialysis.

Fibrinous pericarditis is an exudative inflammation. The pericardium is infiltrated by the fibrinous exudate. This consists of fibrin strands and leukocytes. Fibrin describes an amorphous, eosinophilic (pink) network. Leukocytes (mainly neutrophils) are found within the fibrin deposits and intrapericardic. Vascular congestion is also present. The myocardium has no changes. Sometimes referred to as having "Bread and Butter Appearance".
chylous effusion
A milky fluid consisting of lymph and emulsified fat extracted from chyme by the lacteals during digestion and passed to the bloodstream through the thoracic duct.
hemopericardium
to blood in the pericardial sac of the heart. It is a cause of pericardial effusion, and can also cause cardiac tamponade.[1]

The condition can be caused by trauma,[2] but it has also been observed in patients on anticoagulant therapy
cardiac tamponade
also known as pericardial tamponade, is an emergency condition in which fluid accumulates in the pericardium (the sac in which the heart is enclosed). If the fluid significantly elevates the pressure on the heart it will prevent the heart's ventricles from filling properly. This in turn leads to a low stroke volume. The end result is ineffective pumping of blood, shock, and often death
IHSS
Idiopathic Hypertrophic Subaortic Stenosis is another term used synonymously with hypertrophic obstructive cardiomyopathy (HOCM). It is an inherited disease that causes thickening of the heart muscle and other changes to the heart that significantly impair its function. Although the disease is rare, IHSS is the single most common cause of sudden cardiac arrest in seemingly healthy young people.
LCAT
is an enzyme that converts free cholesterol into cholesteryl ester (a more hydrophobic form of cholesterol), which is then sequestered into the core of a lipoprotein particle, eventually making the newly synthesized HDL spherical and forcing the reaction to become unidirectional since the particles are removed from the surface. The enzyme is bound to high-density lipoproteins (HDLs) and low-density lipoproteins in the blood plasma.
Orthopnea
is shortness of breath (or dyspnea) which occurs when lying flat,[1] causing the person to have to sleep propped up in bed or sitting in a chair. It is the opposite of platypnea.

Orthopnea is due to increased distribution of blood to the pulmonary circulation while recumbent,[2] but usually can be attributed to a more fundamental cause.

Orthopnea is often a symptom of left ventricular heart failure and/or pulmonary edema.[3][4] It can also occur in those with asthma and chronic bronchitis, as well as those with sleep apnea or panic disorder. It is also associated with polycystic liver disease
Myxoma
is a tumor of primitive connective tissue.[1] It is the most common primary tumor of the heart in adults, but can also occur in other locations.

The phrase "myxomatous degeneration" refers to the process in which connective tissue becomes filled with mucus

Myxomas are usually located in either the left or right atrium of the heart; about 86 percent occur in the left atrium.[2]

Myxomas are typically pedunculated, with a stalk that is attached to the interatrial septum. The most common location for attachment of the stalk is the fossa ovalis region of the interatrial septum
Rhabdomyoma
is a benign tumor of striated muscle. Cardiac rhabdomyomas are the most common primary tumor of the heart in infants and children.

It has an association with tuberous sclerosis.[1]

It is most commonly associated with the tongue[2] and heart,[3] but can also occur in other locations.

The malignant form of rhabdomyoma is called rhabdomyosarcoma.
what happens during diastoly
ventricular relaxation
what is each filiment composed of?

thick?
thin?
thick - myosin
thin - actin
what % of cells int he heart do myocytes comprise
25% ( BUT 90% volume)

remainder are endothelial cells and fibroblasts
Atrial distension causes relase of?
atrial natriuretic peptide (ANP or A - type) -->causes vasodilation and diuresis, which are helpful in removing extra fluid in heart failure and HTN
Ventricular distenstion cause relase of?
Brain natriuretic peptide (BNP or B-type)
What is C-type?
it is released by vascular endothelium in response to increased shear stress
where is each located

SA node:
AV node
SA node: at the junction of the R atrial appendage and SVC

AV node: in the R atrium along the atrial septum
when does most blood flow to the heart occur
during diastole
what is supplied by the LAD
apex
anterior LV
anterior 2/3 of ventricular septum
what is supplied by the Circumflex
lateral wll of the L ventricle
what is supplied by the RCA
posterior 1/3 of septum
R ventricular free wall
posterior/inferior wall of L ventricle
describe the semilunar valves
3 leaflets in aortic and pulmonary

open in systole, closed in diastole
describe atrioventricular valves
chordae tendineae in tricuspid and mitral

open in diastole, closed in systole
Describe the histological layers of teh valves
endothelium
fibrosa- gives strenght thru dense collagen
spongiosa- gives cushion
ventricularis- gives elasticity