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72 Cards in this Set

  • Front
  • Back
ischemic heart disease:
-disorder of myocardial blood flow due to coronary atherosclerotic plaques
What disease is the #1 cause of death in the U.S.?
cardivascular disease
5 factors that affect coronary perfusion:
1. coronary atherosclerosis
2. platelet aggregation and thrombus formation
3. coronary spasm
4. nonatherosclerotic coronary disease
5. hemodynamic alterations
What are the 2 types of CAD?
chronic ischemic heart disease and actue coronary syndrome
What are the 3 types of chronic ischemic heart disease?
1. stable angina
2. variant angina
3. silent myocardial ischemia
Causes of nonatherosclerotic coronary disease:
1. SLE
2. polyarteritis nodosa
3. cocaine vasospasm (can cause hole in septum)
polyarteritis nodosa:
-a serious blood vessel disease
-Small and medium-sized arteries become swollen and damaged when they are attacked by rogue immune cells
= Systemic Lupus Erythematosus
-an inflammatory disease of connective tissue
-primarily in women
-characterized especially by skin rash, arthritis and inflammation of different organs
List the 4 ischemic syndromes:
1. angina pectoris
2. myocardial infarction
3. chronic ischemic heart disease
4. sudden cardiac death
angina pectoris:
-chest pain form intermittent myocardial ischemia
-no cell death occurs
-referred pain is felt-neck, jaw, arm
What are the 3 patterns of angina pectoris?
1. stable angina
2. Prinzmetal's variant angina
3. unstable angina
stable angina:
-most common
-stenosed arteries dilate poorly
-occurs during stressed situation
Tx: rest and nitroglycerin
Prinzmetal's variant angina:
-unpredictable attacks
-unrelated to emotion
-significant atherosclerosis
Tx: Ca channel blockers
unstable angina:
-increasing frequency and severity
-close to causing death of myocaridal tissue
What is the risk of a myocardial infarction in males?
> 1 in 5 by age 65
What is the risk of a myocardial infarction in females?
the risk gradually equalizes to males after menopause
Describe the morphology of a myocardial infarction?
1. occlusion of left (40-50%) or right (30-40%)anterior descending artery occurs
2. changes are generally not detectable for 6-12 hrs
3. fibrous scar tissue in 6 wks
Causes of a myocardial infartion:
1. coronary atherosclerosis
2. plaque usually has caused at least 75% obstruction prior to MI
3. plaque rupture causing a thrombus
Symptoms of an MI:
1. pain and shortness of breath
2. ECG wave and location changes
3. can also be known as "silent MI"
4. does not dertermine extent of injury
5. enzyme indication
What enzymes are indicated with an MI?
SGOT and SGPT (nonspecific), AST, CK, LDH
Why do most pts with MI die prior to the hospital?
pt has either V-fib or a severe heart attack
List the 5 main complications of an MI.
1. arrhythmias
2. CHF
3. cardiogenic shock
4. ventricular ruture
5. thromboembolism
What is the mortality rate of MI's?
35% mortality within one year
Tx for an MI:
-rest and pain relief (morphine), oxygen, sympathetic antagonists and nitrates, thrombolytics, balloon angioplasty (w/in 90 minutes), or CABG
sudden cardiac death:
-caused by a lethal arrhythmia
-ischemia, fibrosis and scarring, and electrolyte imbalance
What is a pt with chronic ischemic heart disease most likely to die from?
endocardial diseases:
-causes inflammation and scarring and calcification
-mainly affects mitral and aortic valves (mostly left side)
-common with stenosis and regurgitation
List the disorders of the mitral valve.
1. stenosis
2. insufficiency
3. prolapse
mitral stenosis:
-Rh fever
-increases LA pressure
-causes pulmonary HTN, LA hypertrophy, atrial arrhythmias, diastolic murmurs
-decrease of stroke volume dt inadequate filling
mitral valve insufficiency:
-S/S similar to mitral stenosis
-LV dilates and hypertrophies trying to compensate
mitral valve prolapse:
-valve balloons into LA during systole
-mainly in women ages 20-40
-usually asymptomatic
-sometimes assoc with regurgitation
Name the (rare) complications of a mitral valve prolapse:
What are the 2 aortic valve disorders?
stenosis and insufficiency
aortic stenosis:
-high LV systolic pressure
-left hypertrophy
-SYSTOLIC murmur
-surgery needed for this condition
-age related calcification
aortic insufficiency:
-left heart failure
Rheumatic heart disease:
aka Rh fever
-caused by an infection of beta-hemolytic streptococcus
-an auto-immune disease
-antibiotic therapy
-can also affect joints and kidneys
infective endocarditis:
-vegitations found on endocardium and valves
-embolus formation
-strep and staph
-invasion of bloodstream by organisms (causes sepsis)
Which form of endocarditis has a high mortality rate?
acute endocarditis
What are some causes of infective endocarditis?
overt infection
surgical and dental precedures
IV drugs
subacute endocarditis:
-more insidious (spreadable)
-organisms less virulent
-occurs in hearts with preexisting cardiac disease
Diagnosis for endocarditis:
-positive blood cultures
-results vary according to the type and location of the damage
treatment for endocarditis:
-valve replacement thereafter
-inflammation of heart muscle
-dilation of all chambers occur
-caused mostly by viral infections and in immunosuppressed pts
-noninflammatory disorder, effects heart muscle
-primary or secondary
3 types of primary cardiomyopathies:
1. dilated or congestive
2. hypertrophic
3. restrictive (fibrosed, rigid)
dilated cardiomyopathy:
-decreased pumping ability of ventricles due to dilation
-slowly progressive heart failure
-heart transplantation may be necessary
4 causes of dilated cardiomyopathy:
1. alcohol toxicity
2. genetics
3. pregancy complications
4. postviral myocarditis
3 causes hypertrophic cardiomyopathy:
1. genetic
2. asymptomatic or outflow obstruction
3. uneven hypertrophy
Tx for hypertrophic cardiomyopathy:
-little cardiac change to CHF
-Rx: Ca channel blockers and beta-adrenergic antagonists
secondary cardiomyopathy:
-many known origins
-clinically similar to dilated type of primary
pericardial effusion:
-accumulation of fluid in the pericardial cavity
-compresses heart chambers
-generally indicates underlying disease process
cardiac tamponade:
-life threatening type of pericardial effusion
-systemic venous congestion that reduced SV
-aspiration is necessary for removal of fluid, pus, blood
2 types of pericarditis:
acute and chronic
chronic pericarditis:
-increase in inflammatory exudates longer term than acute
-adhesive, constrictive
-pericardiectomy may be necessary
-fluid released from the body with a high concentration of protein, cells, or solid debris
-classified as catarrhal, fibrinous, hemorrhagic, serous
acute pericarditis:
-sudden increase in inflammatory exudates
-accompanied by chest pain, pericardial friction rub, ECG changes
How does an ECG change with an acute pericarditis?
ST elevation
causes of congenital heart disease:
1. pregnant mother develops rubella w/in first trimester
2. drug and alcohol use by pregnant woman
3. genetic
List 6 types of acyanotic defects:
1. atrial septal defects
2. ventricular septal defects
3. patent ductus arteriosis
4. coarctation of aorta
5. pulmonary stenosis or atresia
6. aortic stenosis or atresia
congenital heart defects:
-produce their effects through abnormal shunting of blood and alterations in pulmonary blood flow
-classified as either acyanotic or cyanotic defects
acyanotic defects:
-generally asymptomatic as long as flow is from left to right
-requires surgical repair
Ex: left-to-right shunts
cyanotic defects:
-sufficient unoxygengated blood mixes with oxygenated blood in the left side of the heart
Ex: right-to-left shunts with obstruction
ventricular defects:
-most common
-frequently associated with other defects
-S/S depend on the size of the defect and shunting
-surgical repair is needed if it does not close
patent ductus arteriosis:
-shunts from pulmonary artery to aorta beyond prenatal period
-spontaneously closes within 24-72 hrs of birth
-systolic murmur (sounds like machinery)
Which are more likely to have coarctation of aorta-males or females?
males are 3-4 times more likely than females
Which acyanotic defect is associated with "notched ribs"?
coarctation of aorta
-the absence or closure of a normal body orifice or tubular passage such as the anus, intestine, or external ear canal
2 types of cyanotic defects:
1. tetralogy of fallot
2. transposition of great arteries
truncus arteriosis:
-the arterial "trunk" frm the embryonic heart
tricuspid atresia:
-closure of the tricuspid valve
Tetralogy of fallot consists of 4 congenital heart defects:
1. ventricular septal defect
2. overriding aorta
3. pulmonary stenosis
4. RV hypertrophy
What is the treatment for tetralogy of fallot?