Nbde Microbiology/pathology Hrt Disord

Front 1

Life-threatening, slow or rapid compression of the heart due to the pericardial accumulation of fluid, pus, blood, clots, or gas, as a result of effusion, trauma, or rupture of the heart.

Back 1

Cardiac Tamponade

Front 2

What are the signs and symptoms of cardiac tamponade?

Back 2

Beck's triangle
Diaphoesis
cool clammy skin
anxiety
restlessness
syncope
weak rapid pulse
tachypnea
orthopnea

Front 3

What are the three aspects of Beck's triad?

Back 3

Muffled Heart sounds
Distended Neck Veins
Decrease Mean Arterial pressure (MAP)

Front 4

Cardiac tamponade is the most serious complication of what?

Back 4

Pericarditis

Front 5

A name given to a variety of diseases, all of which have a major characteristic of inflammation of the pericardium and an increase volume of the pericardial fluid.

Back 5

Pericarditis

Front 6

What are the two types of Pericarditis?

Back 6

Acute and Chronic

Front 7

Disease that is accompanied by symptoms of sharp, stabbing chest pains, shortness of breath, fever, perspiration, chills, and the symptoms of the underlying illness.

Back 7

Acute pericarditis

Front 8

Where can the chest pains associated with pericarditis radiate to?

Back 8

Neck, back, left shoulder and upper arm.

Front 9

When can the pain associated with Acute pericarditis intensify?

Back 9

Respiration
coughing
swallowing
lying supine or turning

Front 10

If acute pericarditis persists for _____ following the acute episode, it is considered chronic.

Back 10

6-12 months

Front 11

Serious form of pericarditis in which the pericardium becomes so thickened and scarred that it loses some of its elasticity.

Back 11

Constrictive pericarditis

Front 12

What are the results that come from the damage to the pericardium in Constrictive Pericarditis?

Back 12

Compresses the heart
Interferes with heart filling w/ blood
Reduces amount of blood pumped out

Front 13

What can Constrictive pericarditis cause or eventually lead to?

Back 13

Heart failure or kidney disease

Front 14

What are the symptoms of constrictive pericarditis?

Back 14

Chest pain
Difficulty breathing
Swelling of the feet and ankles
fatigue
weakness

Front 15

What results in aortic rupture, most often into the pericardial sac, causing a fatal cardiac tamponade?

Back 15

Aortic Dissecetion
or
Dissecting Aneurysm

Front 16

What is the most common cause of Right side heart failure?

Back 16

Left Sided heart failure?

Front 17

Always a chronic, long-term condition, although it can sometimes develop suddenly. The condition can either be on the Rt. or the Lt. or both sides.

Back 17

Heart failure

Front 18

In heart failure what goes first?
What is this followed by?

Back 18

Lt. Ventricle fails first
Followed by rt.-side heart failure

Front 19

What are the earliest and most common signs of Heart failure?

Back 19

Exertional dyspnea
Paroxysmal nocturnal dyspnea (patient wakes gasping for air)

Front 20

What are the other common signs of Heart failure besides Dyspnea?

Back 20

Peripheral edema (swollen ankles)
Cyanosis
Orthopnea
High venous pressure

Front 21

What are the causes of Lt.-Sided heart failure?

Back 21

- Ischemic heart disease (esp. MI)
- Hypertension
- Aortic and mitral valvular disease
- myocardial disease (myocardiomyopathies & myocarditis)

Front 22

What are the clinical manifestations of Lt.-Sided heart failure?

Back 22

- Dyspnea and Orthopnea
- Pleural effusion w/ hydrothorax
- Reduction in Renal Perfusion
- Cerebral Anoxia

Front 23

What are the causes of Rt-Sided heart failure?

Back 23

- Lt.-sided heart failure (most common)
- Pulmonary hypertension
- Tricuspid / Pulmonary valvular dis.
- Cardiomyopathies / Diffuse myocarditis

Front 24

What are the clinical manifestations of Rt.-sided heart failure?

Back 24

- Renal hypoxia (leads to fluid retention and peripheral edema)
- Enlarged/Congested liver & spleen
- Distension of the neck veins

Front 25

What position do CHF patients need to be in for dental treatment?
Why?

Back 25

Upright position
Decreases the collection of fluid in the lungs and makes it easier for them to breath.

Front 26

Chest pain that is precipitated by exertion but relieved by rest or vasodilators is called what?

Back 26

Stable Angina

Front 27

Recurring acute chest pain or discomfort resulting from decreased blood supply to the heart muscle. (Myocardial ischemia)

Back 27

Angina Pectoris

Front 28

What occurs when one has an angina?

Back 28

Occurs when the hearts need for oxygen is greater than the oxygen available.

Front 29

Angina is the classic symptom of what?

Back 29

Coronary Artery Disease (CAD)

Front 30

What are the symptoms of angina?

Back 30

Mild/Severe Pain
Pressure
Discomfort in the chest

Front 31

What are the different types of angina?

Back 31

Stable
Unstable
Prinzmetal's or variant

Front 32

A repeating pattern of chest pain which has not changed in character, frequency, intensity or duration for several weeks. The level of activity or stress that provokes it is predictable and pattern changes slowly. Most common form.

Back 32

Stable Angina

Front 33

What is the obvious vasodilator that is used to control angina?

Back 33

Nitroglycerin

Front 34

Defined by chest pain that is variable, either increasing in frequency or intensity and with irregular timing or duration.

Back 34

Unstable Angina

Front 35

What kind of pain does a patient with stable angina experience?

Back 35

It is prolonged or recurrent pain at rest.

Front 36

What is unstable angina often an imminent sign of?

Back 36

Myocardial infarction

Front 37

This is caused by vasospasm, which is a spasm that narrows the coronary artery and lessens the blood flow to the heart. It is intermittent chest pain at rest.

Back 37

Prinzmetal or variant angina

Front 38

Condition in which fatty deposits (plaques) accumulate in the cells lining the wall of a ______ artery and obstruct blood flow to the heart

Back 38

Coronary Artery Disease (CAD)
Coronary

Front 39

What are the major complications of coronary disease?

Back 39

Angina and Heart Attack

Front 40

What is the primary effect of coronary artery disease?

Back 40

Loss of oxygen and nutrients to myocardial tissues

Front 41

What is the usual cause of CAD?

Back 41

Atherosclerosis

Front 42

What supplies blood from the aorta to the right side of the heart?

Back 42

Rt. Coronary Artery

Front 43

What is the first cardiac marker to increase after a myocardial infarction?

Back 43

Myoglobin

Front 44

Substances in blood whose levels rise in the hours following a heart attack.

Back 44

Cardiac Markers

Front 45

What do increased cardiac markers mean?
What do persistent cardiac markers mean?

Back 45

Diagnose a heart attack
Rule out Heart attack

Front 46

What are the cardiac markers that are elevated after a myocardial infarction?

Back 46

Troponin
Creatine Phosphokinase (CPK)
Myoglobin
Glutamic oxaloacetic transaminase
Lactic Dehydrogenase (LDH)

Front 47

What are the cardiac marker stats for Troponin?

Back 47

Rises: 3-6 hours
Peaks: 20 hours
Duration: 14 days

Front 48

What are the subunits of troponin?

Back 48

1. Troponin T
2. Troponin I (>1.0 suggests acute MI)

Front 49

What are the cardiac marker stats for Creatine Phosphokinase (CPK)?

Back 49

Rises: 4-6 Hours
Peaks: 12-24 Hours
Duration: 4-5 Days

Front 50

What are the subunits of creatine phosphokinase (CPK)?

Back 50

CK-MB Fraction (duration 2-3 days)
CK-MB (>5% of total CPK suggests myocardial injury)

Front 51

What is the advantage of myoglobin as a cardiac marker?

Back 51

First to increase

Front 52

What is the disadvantage of myoglobin as a cardiac marker?

Back 52

Poor specificity (only helps if negative)

Front 53

What are the cardiac marker stats for myoglobin?

Back 53

Rises: 1-2 hours
Peaks: 4-6 hours
Duration: 1-2 Days

Front 54

What are the cardiac marker stats of Glutamic oxaloacetic transaminase (AST, SGOT)?

Back 54

Peaks: 24-36 hours
Duration: 5 days

Front 55

What are the cardiac marker stats for lactic Dehydrogenase (LDH)?

Back 55

Peaks: 24-48 hours
Duration: 14 Days

Front 56

What are myocardial infarctions most commonly caused by?

Back 56

coronary atherosclerosis

Front 57

Who are MI's most common in?

Back 57

Men and pregnant women

Front 58

Approximately 50% of cases of subacute (bacterial) endocarditis are caused by what?

Back 58

Streptococcus Viridans

Front 59

What is inflammation of the heart valves?

Back 59

Infectious endocarditis

Front 60

Endocarditis is distinguished from what two other infections of the heart?

Back 60

Myocarditis (infection of the heart muscle)
Pericarditis (infection of the lining of the heart)

Front 61

What percentage of endocarditis is streptococcus viridans responsible for?

Back 61

50%

Front 62

Besides streptococcus viridans what other bacteria can cause endocarditis?

Back 62

Staphylococcus aureus and enterococcus

Front 63

What are the less common organisms that can infective endocarditis?

Back 63

Pseudomonas
Serratia
Candida

Front 64

What is the most common form of infectious endocarditis in intravenous drug users?

Back 64

Staphylococcus Aureus

Front 65

What are characteristics of Infectious endocarditis?

Back 65

Large, friable, easily detached vegetations consisting of fibrin and bacteria

Front 66

What are the complications of infective endocarditis?

Back 66

Ulcerations
Perforation of the valve cusps
Rupture of the chordae tendineae

Front 67

What type of endocarditis is caused by staphylococcus aureus. Often secondary to infection occuring elsewhere in the body.

Back 67

Acute endocarditis

Front 68

What type of endocarditis is caused by less virulent organisms such as strp viridans? Tends to occur in patients with congenital heart disease or preexisting valvular heart disease, often of rheumatic origin.

Back 68

Subacute (bacterial) endocarditis

Front 69

What is a hallmark of both acute and subacute endocarditis?

Back 69

Fever

Front 70

Which valve is most frequently involved with infectious endocarditis?

Back 70

Mitral Valve

Front 71

What valves are involved in over 40% of cases together for infective endocarditis?

Back 71

mitral valve and aortic valve

Front 72

What valve is involved with infectious endocarditis in 50% of cases involved with IV drug users?

Back 72

Tricuspid valve

Front 73

What results from changes in blood flow across valves when vegetations collect on the valves?

Back 73

Murmurs