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56 Cards in this Set

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Right vent. hypertrophy and/or dilatation due to lung dse. or primary dse. of pulm. vasculature(primary pulm. HPN,emphysema);charact. by pulm. art. HPN(most common characteristic)
Cor pulmonale
Stage in the progression of MI in w/c Arrythmia is most likely to occur
0-6 hours
Most common cause of left vent. hypertrophy
HPN & aortic or mitral valvular dse.
Cause of most deaths occuring during the early stages of acute rheumatic fever
-lead to cardiac failure
Noninflammatory dse. of the pericardium charact. by serous transudate in the pericardial space often caused by CHF or edematous conditions due to hypoproteinemia(nephrotic synd.,chronic liver dse.)
-may result from any condition causing systemic edema
Stage in the progression of MI w/ the 1st appearance of neutrophils in viable tissue adjacent to the lesion
After 12hours
Stage in the progression of MI w/ the replacement of neutrophils by macrophage & phagocytosis of debris begins;yellow color of infarct
By 3rd day
Stage in the progression of MI w/ the beginning of growth of young fibroblast & newly formed vessels into the lesion;risk for myocardial rupture
From 7days
Stage in the progression of MI w/ well developed gay white scar;mature fibrous tissue replaces area of infarction
Within 3-6months
Multisystem infl. dse. w/ major cardiac manifestations affecting often children ages 5-15yrs.;charact. by transient mild migratory polyarthritis;occurs 1-4wks after infection of group A B-hemolytic streptococci
Rheumatic Fever
-elevated titer of antistreptolysin O(ASO) is evidence of recent infection
Area of focal interstitial myocardial infl. charact. by fragmented collagen & fibrinoid material by large cells(Anitschkow myocytes) & multinucleated giant cells(Aschoff cells)
Aschoff body
-classic lesion of rheumatic fever
Episodic chest pain caused by inadequate oxygenation of the myocardium
Angina pectoris
Most common form of angina precipitated by exertion & relieved by rest or vasodilators(nitroglycerin); results from sever narrowing of atherosclerotic coronary vessels
Stable Angina
Intermittent chest pain at rest caused by vasospasm
Prinzmetal Angina
Most imp. cause of morbidity from ischemic heart dse. charact. by myocardial coagulative necrosis caused by coronary art. occlusion;has 2 patterns of necrosis
Myocardial Infarct
-separated into transmural infarct(traverses the entire vent. wall from the endocardium to epicardium) & subendocardial infarct(inf. 1/3 of the left vent. wall)
Complications of MI
Arrythmia(most common cause of death in 1st few hours),Myocardial pump failure(lead to CHF or shock),Myocardial rupture(usually occurs w/ in 4-7 days;result in death from cardiac tamponade),Rupture of papillary muscle,Mural thrombosis, Vent. aneurysm
Accumulation of bld. in the pericardial sac caused by traumatic perforation of the heart or aorta or by myocardial rupture assoc. w/ acute MI
Acute pericarditis charact. by a fibrin rich exudate caused by uremia, myocardial infarction, or acute rheumatic fever
Acute pericarditis commonly caused by bact. infection & charact. by purulent inflammatory exudate
Type of acute pericarditis assoc. w/ SLE,RHF, & a variety of viral infections charact. by production of clear,straw colored,protein rich exudate containing small #'s of inflammatory cells
Serous Pericarditis
Most common form of cardiomyopathy of unknown origin charact. by 4 chamber hypertrophy & dilataion w/ both right & left sided intractable heart failure
-assoc. w/ alcoholism(alcohol cardiomyopathy),thiamine def(beriberi heart), or prior myocarditis
Cardiomyopathy caused by infiltrative process w/in the myocardium~stiffening of heart muscle w/c interferes w/ pumping action;cardiac amylodosis resulting in right&left sided heart failure
Restrictive Cardiomyopathy
Autosomal dominant cardiomyopathy charact. by hypertrophy of all chamber walls,especially the vent. septum(asymmetric septal hypertrophy), disoriented,tangled,& hypertrophied myocardial fibers
Hypertrophic Cardiomyopathy
-results in left vent. outflow obstruction~syncope & sudden death w/c often occurs in young athletes
Dse. of the myocardiium presenting as biventricular heart failure in young people who do not have valvular,rheumatic,or congenital heart dse.charact. by diffuse myocardial degeneration & necrosis w/ an inflamatory infiltrate
-caused often by viral(coxsackievirus) infection
Acute pericarditis resulting from tumor invasion of the pericardium, tuberculosis or other bact. infxn. & charact. by bloody inflammatory exudate
Hemorrhagic Pericarditis
Pericarditis charact. by thickening & scarring of the pericardium~loss of elasticity~interferes w/ cardiac action & venous return~mimicking signs & symptoms of right sided heart failure
-caused by tuberculous & pyogenic staphylococcal infxn. & marked by proliferation of fibrous tissue w/ occasional small foci of calcification
Refers to dse. of heart muscle that are noninflammatory,not assoc. w/ HPN, congenital heart dse.,valvular dse, coronary dse;charact. by unexplained vent. dysfunction(heart failure unresponsive to digitalis,vent. enlargement,vent. arrythmias)
-classified into congenita(dilated), restrictive, & hypertrophic cardiomyopathy
Viral infxn. affecting preg. women in 1st trimester~congenital heart dse.(patent ductus arteriosus,aortic stenosis,vent.septal defect,pulmonary infundibular or valvular stenosis) along w/ microcephaly w/ mental retardation,deafness,cataracts, & growth retardation
Rubella(german measles)infxn.
-presence of IgM antibodies(indicates recent promary infxn) & IgG(indicates recent primary infxn,past infxn,& reinfection
Congenital heart dse. w/c present w/o cyanosis
(Aortic stenosis,coarctation of the aorta)-no shunts;(Patent ductus arteriosus,atrial & vent. septal defect)-left to right shunts
Congenital heart dse. w/c present w/ cyanosis
Transposition of great vessels(survival depends on left-right shunt);Tetralogy of Fallot-right to left shunt;Left to Right shunts w/c reverse to right-left shunts due to inc. pulmonary art. press.(late cyanosis,cyanosis tardive)
Most frequently occuring cardiac tumor found most often in adults
Myxoma of the left atrium
Most frequently occuring cardiac tumor in infants & young children notable for its assoc. w/ tuberous sclerosis
Atrial septal defect assoc. w/ mitral stenosis w/c is often of rheumatic origin
Lutembacher synd.
Congenotal heart dse. characterized by narrowing of the aorta(usaully distal to origin of subclavian art.) & development of collateral ciculation w/ dilataion of intercostal art.
Coarctation of Aorta
-presents w/ HPN limited to upper extremities & cerebral vessels, notching of the ribs on x-ray;assoc. w/ Turner synd.
Congeniotal heart dse. due to failure of closure of the fetal ductus arteriousus;patent during fetal life due to low O2 & prostaglandin synthesis;can be closed sugically or pharma.(indomethacin)
Patent Ductus Arteriosus
-if not closed~pulmonary HPN,right vent. hypertrophy,reversal of blood flow,late cyanosis;assoc. w/ living in high altitudes & rubella infxn
Chromosomal abnormality involving endocardial cushion defects~atrial & vent. septal defects w/ atrioventricular valve deformities
Down Synd.(trisomy 21)
Anatomic changes charact. of pulmonary infundibuluar or valvular stenosis, vent. septal defects,overriding aorta, right vent. hypertrophy
Tetralogy of Fallot
-present w/ cyanosis @ birth,tendency to squat to lessen right to left shunting;has genetic predisposition
Endocarditis resulting in thickened endocardial plaques involving the mural endocardium or valvular cusps of the right side of the heart
Endocarditis of the carcinoid synd.
-caused by secretory products of tumors(serotonin,vasoactive peptides),rarely involves the left side bec. secretory products are detoxified in the lung
Charact. of rheumatic heart dse. in w/c the mitral & aortic valves often are affected by the form. of MacCallum plaque & warty,bead-like,rubbery vegetations(verrucae) along the lines of the closure of the valve leaflet
Rheumatic Endocarditis
-verrucae are nonfriable,not a source of peripheral emboli;valves become thickened,deformed,fibrotic,calcified w/ fusion of valve cusps & thickening of the chordea tendineae
Noncardiac manifestations of acute rheumatic fever
Fever,malaise,inc. erythrocyte sedimentation rate,arthralgia, arthritis,migratory polyarhtritis, skin lesions(subcutaneous nodules, erythema marginatum),Sydenham Chorea(involuntary,purposeless muscular movements,bizarre grimace,emotional lability)
Bact.,rarely fungal,infxn. of the endocardium;involvement of valvular surface;charact. by large,oft,friable, easily detached vegetations; cmplicated by ulceration w/ perforation of valve cusps or rupture of one of the chordea tendineae
Infective Endocarditis
-classified into Acute(caused by Staph. aureus-50%;2nd to infxn anywhere else in the body) & subacute(caused by Strep. virians-50%;occurs w/ congenital heart dse.,often rheumatic in origin)
Causes of right vent. hypertrophy
Left vent. failure,chronic lung dse., mitral valve dse.,congenital heart dse w/ left to right shunt
Complications of infective endocarditis
Distal embolization(fragmented vegetation) resulting in septic infarcts in the brain & other organs; focal glomerulonephritis due to immune complex dse. or by septic emboli
Nonbacterial thrombotic endocarditis(marantic endocarditis)
Assoc. w/ debilitating disorders(metastatic cancer,wasting conditions resulting in peripheral embolization(sterile emboli);charact. by sterile fibrin deposits along the line of closure of valve leaflets
Endocarditis w/c occurs in SLE charact. by small vegetations on either of both surfaces of the valve leaflets
Libman-Sacks Endocarditis
Causes & manifestations of left sided heart failure in CHF
(Ischemic heart dse.,hypertension, aortic & mitral valvular dse., myocardial dse.)-cause;(dyspnea & orthopnea due to pulm. congestion & edema,pleural effusion w/ hydrothorax, dec. renal perfusion,cerebral anoxia)-manifestations
Causes of right sided failure in CHF
Left sided heart failure(most common),left sided lesion(mitral stenosis),pulmonary HPN due to chronic lung dse.(corpulmonale), cardiomyopathy,diffuse myocarditis, tricuspid or pulmonary valvular dse.
Clinical manifestations of right sided heart failure
Renal hypoxia~fluid retention, peripheral edema(pitting edema of ankles),pleural effusion,ascites, hydrothorax(also in left sided failure);enlarge & congested liver & spleen;distention of neck veins
Most frequent valvular lesion,often in young women,charact. by myxoid degeneration of the ground substance of the valve(component of Marfan synd.)~stretching of post. mitral valve leaflet~floppy cusps(parachute def.) w/ prolapse into the atrium during systole~sytolic murmur w/ midsystolic click
Mitral Valve Prolapse
-benign,asymptomatic~mitral insufficiency;assoc w/ arrythmias & predisposes to infective endocarditis
Causes of mital valve insufficiency
Rheumatic heart dse.,mitral valve prolapse,infective endocarditis,damage to pappilary muscle due to MI,due to left vent. dilatation w/ stretching of the mitral valve ring
Causes of aortic valve stenosis
Degenerative calcific aortic stenosis(most common cause >60yrs;used when valve is 3 cusps),Congenital bicuspid aortic valve,Rheumatic heart dse.(fusion of the valve commisures)
Common causes of aortic valve insufficiency
Nondissecting aortic aneurysm(cystic medial necrosis),Rheunatic heart dse.(assoc w/ mitral valve),Syphilitic aortitis(dilatation of aortic valve ring)
Congenital heart dse. w/c may close spontaneously,lead to pulmonary hypertension~right sided heart failure;reversal of flow & late cyanosis
Ventricular septal defects
-vary in size
Congenital heart dse. characterized by the aorta arizing from the right vent. & pulmonary art. from the left vent; patent ductus arteriosus necessary for survival
Transposition of the great vessels
Atrial septal defect w/c affects lower part of the septum;if large~assoc. w/ deformaties of atrioventricular valves
Septum Primum
-presents in adult life w/ pulmonary HPN,reversal of flow~cyanosis;can lead to paradoxic embolism
2 types of atrial septal defect w/c affects the fossa ovalis & one w/c affects the upper part of the septum near the entrance of the superior vena cava
Septum secundum & Sinus venosus
-presents in adult life w/ pulmonary HPN & reversal of flow~cyanosis;can lead to paradoxic embolism