Test #2 Cardiac Structural Disorders

Front 1

Heart valves open passively to ___ & ____ changes

Back 1

pressure, volume

Front 2

Valve diseases can be congenital, from old age, or mostly from ___

Back 2

Rheumatic Fever

Front 3

Regurgitation aka ___ . It means?

Back 3

valve insufficiency; valve cannot close properly; aka leaky valve

Front 4

Stenosis or ____ . It means?

Back 4

narrowing; Valve cannot open properly

Front 5

Mitral valve is between ___ and ___

Back 5

LA & LV

Front 6

Tricuspid valve is between ___ & ____

Back 6

RA & RV

Front 7

Aortic valve lets blood from ___ pass into Aorta and into systemic circulation

Back 7

LV

Front 8

_______ lets blood from RV pass into pulmonary arteries to lung circ.

Back 8

Pulmonary valve

Front 9

Mitral valve prolapse?

Back 9

valve leaflets are enlarged and protrude (prolapse) into LA

Front 10

- Mitral Stenosis?
- Most common cause?

Back 10

- the valve leaflets fuse and become stiff; valve cannot open normally resulting in blood flow obstruction from LA-LV; LA pressure and size increases; RV size increases
- rheumatic fever is most common cause

Front 11

In mitral stenosis, pulmonary congestion and RHF can occur initially
- later cardiac output is decreased when LV doesn't get enough blood.
- Pt may dev A-fib T or F

Back 11

T

Front 12

A-fib throws off embolisms since blood isn't pumped, stasis develops and clots can form. T or F

Back 12

T

Front 13

murmur?

Back 13

abnormal sounds during heart beat cycle (swishing, wishing)

Front 14

1) Systolic murmur?
2) Diastolic murmur?

Back 14

1) occurs when heart is squeezing blood out; occurs between S1 & S2
2) occurs when heart is filling w blood - occurs between breaths

Front 15

Lub sound is S__ and is softer and longer; heard at the ___ of the heart

Back 15

1; apex

Front 16

Dub is S__ and is higher pitched; heard at ____ of heart

Back 16

2; base

Front 17

- most murmurs are harmless aka ___
- cardiologists grade murmurs from 1-6 with 1 is the faintest and 6 is the loudest. T or F

Back 17

- innocent
- T

Front 18

S1 sound created by _____ of ____ & ____ valves

Back 18

closure; mitral & tricuspid (AV valves)
- S1 marks beginning of ventricular systole (occurs after QRS complex

Front 19

S2 sound created by closure of __ & ___ valves

Back 19

aortic & pulmonary (semilunar valves)

Front 20

What is diagnostic tool of choice for valve disease?

Back 20

echocardiogram ( it's noninvasive)

Front 21

MTR PASS MVP are all systolic murmurs. Define?

Back 21

Mitral, Tricuspid, Regurgitation, Pulmonic, Aortic Stenosis = Systolic
Mitral Valve Prolapse

Front 22

MS ARD are all diastolic murmurs. Define?

Back 22

Mitral Stenosis & Aortic Regurgitation= Diastolic

Front 23

With mitral valve regurgitation, symptoms progress____ ; pt can remain ____ for decades.

Back 23

slowly; asymptomatic
- 75% of pts are in Atrial-Fib
- valve does not close completely during systole;
- blood flows back into the LA when LV contracts

Front 24

What is treatment for mitral valve regurgitation?

Back 24

- Diuretics
- ACE Inhibitors
- Na restricted diet

Front 25

Key assessments for mitral valve regurgitation?

Back 25

Weakness & fatigue, dyspnea on exertion all due to dec cardiac output

Front 26

Mitral Valve regurgitation generates ___ murmur

Back 26

systolic

Front 27

Mitral valve prolapse (MVP) generates a ____ murmur

Back 27

systolic

Front 28

Mitral valve prolapse is seen in pts w ____ Syndrome and is most commonly seen in _____

Back 28

- Marfan's which is an autosomal disease
- women 25-54
most pts are asymptomatic
- at risk for infective endocarditis

Front 29

Aortic Stenosis obstructs LV outflow during systole; so cardiac output becomes fixed and can't meet body's needs during exertion, and symptoms develop. The cause is _______
- Aortic stenosis ___ 02 demand on the heart to pump blood

Back 29

- old age

Front 30

Treatment for aortic stenosis is ___

Back 30

surgery ie valve replacement

Front 31

Anocrotic notch is related to ___ and is a ____ heartbeat

Back 31

aortic stenosis; double heartbeat

Front 32

With aortic regurgitation aka ____ pt remains asymptomatic for yrs,
- Causes ?

Back 32

- aortic insufficiency
- Rheumatic fever
- syphilis
- Marfan syndrome
-Aortic dissection

Front 33

The aortic valve is between the left ventricle and the aorta. Regurgitation means the valve doesn't close properly, and blood can leak backward through it. This means the left ventricle must pump more blood than normal, and will gradually get bigger because of the extra workload. Aortic regurgitation can range from mild to severe. Some people may have no symptoms for years. But as the condition worsens, symptoms will appear:
- fatigue (especially during times of increased activity)
shortness of breath
angina pectoris (chest pain or discomfort caused by reduced blood supply to the heart muscle. T or F

Back 33

T

Front 34

Aortic regurgitation generates a ____ murmur

Back 34

diastolic

Front 35

While there's a narrow pulse pressure in Aortic ____. there's a widened pulse pressure in Aortic _____

Back 35

- Stenosis
- Regurgitation

Front 36

Define pulse pressure?

Back 36

diff between systolic and diastolic blood pressures

Front 37

Pulmonary Stenosis is very rare and almost always congenital; assoc with Noonan's Syndrome and Fallot's tetralogy T or F

Back 37

T

Front 38

Tricuspid Stenosis & Tricuspid Regurgitation very rare
- may be seen w IV drug users
- RA enlargement T or F

Back 38

T

Front 39

All valve diseases are diagnosed with the following 6 tests?

Back 39

1- History & Physical
2- EKG
3- Echo
4- CXR
5- cardiac cath
6- TEE- Trans Esophageal Echo

Front 40

With valve diseases, give antibiotic treatment for any invasive procedure. T or F

Back 40

T

Front 41

What meds do you give for any valve disease?

Back 41

- Diuretics
- Digitalis
- Anticoagulants
- also los Na diet

Front 42

Valvuloplasty?

Back 42

Surgery to reconstruct and repair damaged valve

Front 43

Open Commissurotomy?

Back 43

during open heart surgery w CPB (Cardio Pulmonary Bypass), this removes thrombi and cuts leaflets, debride calcium form leaflets

Front 44

Annuloplasty?

Back 44

surgery to dilate a narrowed valve with a ring

Front 45

What are pros & cons of mechanical valves and tissue valves?

Back 45

Mech valves: durable but require lifelong anticoagulation
Tissue valves: don't last as long but don't need anticoagulants

Front 46

Name 3 Nursing Dx for valve disease?

Back 46

- Dec Cardiac Output (CO) related to altered stroke volume
- Impaired Gas Exchange related to ventilation perfusion imbalance
- Activty Intolerance related to inability of the heart to meet metabolic demands during activity.

Front 47

Cardiomyopathy?

Back 47

disease process of heart muscle that affects the structure and function of heart

Front 48

With Cardiomyopathy, pt is at risk for ___

Back 48

sudden death

Front 49

All valve diseases are diagnosed with the following 6 tests?

Back 49

1- History & Physical
2- EKG
3- Echo
4- CXR
5- cardiac cath
6- TEE- Trans Esophageal Echo

Front 50

With valve diseases, give antibiotic treatment for any invasive procedure. T or F

Back 50

T

Front 51

What meds do you give for any valve disease?

Back 51

- Diuretics
- Digitalis
- Anticoagulants
- also los Na diet

Front 52

Valvuloplasty?

Back 52

Surgery to reconstruct and repair damaged valve

Front 53

Open Commissurotomy?

Back 53

during open heart surgery w CPB (Cardio Pulmonary Bypass), this removes thrombi and cuts leaflets, debride calcium form leaflets

Front 54

90% of all cardiomyopathy is this type?

Back 54

Dilated cardiomyopathy - dilation of both ventricles resulting in impaired systolic function

Front 55

3 types of cardiomyopathy?

Back 55

- Dilated
- Hypertrophic
- Restricted

Front 56

Describe Hypertrophic Cardiomyopathy?

Back 56

ventricles are hypertrophied and stiff
- see more in men than females

Front 57

What type of cardiomyopathy is common cause of death in young healthy athletes?

Back 57

Hypertrophic Cardiomyopathy
-can be checked via CXR

Front 58

what are causes of Hypertrophic Cardiomyopathy?

Back 58

-Genetic - autosomal
- HTN

Front 59

2 types of Hypertrophic Cardiomyopathy?

Back 59

- Obstructive - LV outflow obstruction
- Non-obstructive

Front 60

Describe Restrictive Cardiomyopathy?

Back 60

rarest form of cardiomyopathy, is a condition in which the walls of the lower chambers of the heart (the ventricles) are abnormally rigid and lack the flexibility to expand as the ventricles fill with blood.

Chest pain or pressure (occurs usually with exercise or physical activity, but can also occur with rest or after meals).
Heart failure symptoms (shortness of breath and fatigue).
Swelling of the lower extremities.
Fatigue (feeling overly tired).

A restrictive cardiomyopathy is not usually inherited and its cause is often unknown. Known causes may include:

Build-up of fat and proteins (amyloidosis) in the heart muscle.
Excess of iron (hemochromatosis) in the heart.
- Sarcoidosis

Front 61

Amyloidosis?

Back 61

Build-up of fat and proteins in the heart muscle.

Front 62

Sarcoidosis?

Back 62

Fibrosis of lungs; Bernie Mac died of that

Front 63

Symptom that is always present with all types of Cardiomyopathy?

Back 63

Fatique

Front 64

Initial treatment for pts with either Restricted or Dilated Cardiomyopathy is the same
- when Heart Failure occurs, give drugs to increase cardiac output: digitalis, diuretics T or F

Back 64

T

Front 65

Don't give digitalis, nitrates or vasodilators with _____ Cardiomyopathy.

Back 65

Obstructed Hypertrophic

Front 66

What are criteria to make the heart transplant list?

Back 66

- lfe expectancy < 1yr
- Age <65 yrs old
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