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60 Cards in this Set
- Front
- Back
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What is cardiac dilation?
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enlargement of the chamber size
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What is cardiac hypertrophy?
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enlargement of cardiac wall thickness (muscle)
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Small amounts of ventricular dilation have what effect on pumping strength?
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increases strength by increasing space between sarcomere fibers = increased sarcomere shortening
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Function of ANP (atrial natriuretic peptide)
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vasodilation and water/sodium excretion from kidneys into urine
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Why don't heart valves have many blood vessels?
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they are thin enough to get blood by diffusion from blood in the heart
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Why does a dilated aortic root lead to regurgitation?
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the valve function is reliant on the coordinated movements of the surrounding structures. a dilated root will lead to more turbulent flow around the valve
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What structure ensure that atrial contraction precedes ventricular contraction?
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AV Node
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3 major epicardial arteries
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right coronary; left anterior descending; left circumflex
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What are Lambl excrescenes?
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small filliform processes on the mitral/aortic valves from thrombi
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What causes brown atrophy of cardiac muscle to appear brown?
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lipofuschin
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What is the Frank-Starling Mechanism?
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increased blood return to the heart = enhanced contractility
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Sympathetics have what effect on heart rate?
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increase
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What is systolic dysfunction?
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deterioration of contractile function
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What is diastolic dysfunction?
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inability of myocardium to relax and fill (caused by fibrosis or pericarditits perhaps)
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What can cause a diastolic dysfunction?
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pericarditis or fibrosis of the myocardium
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What changes in the myocardium occur with pressure over-load hypertrophy?
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increase in wall thickness/contractile muscle force
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What changes in the myocardium occur with volume over-load hypertrophy?
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ventricular dilation
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Why does excess cardiac hypertrophy lead to cardiac failure?
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increase in muscle size without more capillaries = more oxygen demand without supply; coupled with elevated oxygen demand due to higher workload
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Why is over-expression of mir-195 associated with heart failure?
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mir-195 = more hypertrophy/dilation = weaker heart = cardiac failure
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In heart failure, what is "forward failure"?
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inability to pump blood forward (decreased cardiac output)
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In heart failure, what is "backward failure"?
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since heart can't pump blood out, blood pools in the vessels and chambers behind it (can cause edema)
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What is physiological cardiac hypertrophy?
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in athletes, they have lower resting heart rates, more capillaries and have an increased ability to increase cardiac output
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Which side heart failure is more common? Right or Left.
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Left
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Causes of left-heart failure
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systemic hypertension, ischemic disease, aortic/mitral valve disease, left ventricular hypertrophy
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What are heart failure cells?
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hemosiderin filled macrophages that form when blood backs up into the pulmonary capillaries. lung macrophages take up the blood/hemosiderin
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What is orthopnea?
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dyspnea when lying down
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What is PND (paroxysmal nocturnal dyspnea)?
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dyspnea occurring at night that may lead to feeling of suffocation
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What is flash pulmonary edema?
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with diastolic dysfunction, the ventricle cannot expand to fill with blood and all filling pressure forces blood into the pulmonary capillaries.
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What is hypoxic encephalopathy?
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cerebral hypoxia due to heart failure
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What is the most common cause of right sided heart failure?
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left sided heart failure causes the blood to back up into the right side and increases workload
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What is Cor Pulmonale?
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right side heart failure caused by pulmonary hypertension
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Which sided heart failure most likely leads to pulmonary edema?
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Left
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Pulmonary hypertension can lead to failure of which side of the heart?
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Right
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Why does heart failure lead to congestive hepatomegaly?
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right-sided heart failure will cause congestion of the portal veins
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Why can right sided heart failure lead to ascites?
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venous back up into the portal vein = ascites
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Cardiac precursors are derived from what germ layer?
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lateral mesoderm
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The first heart field is present after how many days of fetal development?
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15
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Heart chambers begin to form by what day of fetal development?
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28
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Heart chambers are completed by what day of fetal development?
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50
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Tetralogy of Fallot is associated with regulation problems of which genes in the Notch signalling pathway?
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JAGGED1 and NOTCH2
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Most common genetic cause of congenital heart defects?
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trisomy 21 (Down's Syndrome)
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What is a shunt?
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pathological communication between chambers of the heart
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Cyanosis and hypoxia are associated with what types of shunts?
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Right to left shunts (deoxygenated blood enters systemic circulation)
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What is a paradoxical embolism?
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a venous embolism that ends up in systemic circulation, rather than being caught in the pulmonary artery. Caused by a septal defect in the heart
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What is Eisenmenger's Syndrome
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A left to right shunt (ASD or VSD) that persists long enough to become a right to left shunt as right sided heart pressure increases
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Coarctation of the aorta is what type of congenital heart defect?
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obstructive heart defect
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Why might we heart a murmur in the tricuspid valve with an atrial septal defect?
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Excess high pressure blood is flowing through the valve (compared to normal right side low pressure)
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A patent foramen ovale in an adult is what type of shunt (direction)?
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Left to right, but can become right to left as pulmonary pressure rise
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What is the cause of a complete Atrioventricular septal defect?
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failure of the AV canal to fuse = hole in the middle of the heart
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Tetralogy of Fallot is what type of shunt?
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Right to left
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4 components of Tetralogy of Fallot
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Ventricular spetal defect, pulmonary artery stenosis, aorta near VSD, right ventricle hypertrophy
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Transposition of the Great Arteries is what type of shunting?
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Right to Left; the aorta is pumping deoxy blood form the right ventricle
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When might a patent foramen ovale, ductus arteriosus or VSD be beneficial?
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Transposition of the great arteries; this way some oxygenated blood can get to systemic circulation
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What is a persistent truncus arteriosus?
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right to left shunt of blood in the heart. aorta and pulmonary artery are 1 fused vessel. deoxy blood enters systemic circulation
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What is tricuspid atresia?
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right to left shunt where blood form the right atrium has nowhere to go since the AV valve is closed off. an ASD is helpful since it can get some blood out, but mortality is high in infants
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What is total anomalous pulmonary venous connection?
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the pulmonary vein doesn't attach to the left atrium. right to left shunt occurs when pulmonary veins takes oxygenated blood into the right atrium (high pressure in the right and this is associated with a septal defect = right to left shunt)
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What is coarctation of the aorta?
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Obstructive congenital defect of descending thoracic aorta.
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What is pulmonary stenosis?
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bad pulmonary valve = right ventricular hypertrophy. blood has a difficult time getting to the lungs (patent ductus arteriosus can be helpful)
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What is hypoplastic left heart syndrome?
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in aortic stenosis, there can also be open ductus arteriosus and this leads to disuse of the left ventricle. quickly fatal in infants when the ductus closes. when the ductus closes, the left ventricle is unable to get enough blood out. the patent ductus was the only thing keeping the infant alive
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Aortic stenosis would lead to what changes in the patient's heart?
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left ventricular hypetrophy
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