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53 Cards in this Set
- Front
- Back
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How can you tell someone is having stable angina?
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Can not meet o2 demand with increase exertion or emotional stress.
reversible injury to myocytes Coronary arteries are > 70% stenosis. Think fatty struggling to get up stairs. (note to self- do more cardio) |
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How can you tell someone is having Unstable angina?
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chest pain at rest!
incomplete occlusion of coronary aa. (KNOW THIS) ST depression on EKG reversible, give nitroglycerin |
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Prinzmetal angina is what?
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Coronary aa. vasospams.
chest pain at rest. reversible, Will have ST elevation on EKG |
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A patient has an occlusion to his LAD, what will this cause, besides a widow?
(see what I did there) |
infarction of anterior wall and anterior septum of the Left ventricle.
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What aa. is associated with posterior wall, posterior septum and papillary msucle of LV necrosis.
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Right Coronary A.
2nd most common for MI after LAD |
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When will see infarction of the lateral wall of the LV?
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occlusion of the left circumflex a.
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MI lab test... what enzymes are you looking for and what do they tell you?
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Troponin I- gold marker,
seen 2 hours after and lasts for a weekish Ck-MB rises 5hrs after and is normal in 72 hours. (good for recent MI) |
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What do you have to worry about if you try to treat an MI with angioplasty (opens blocked vessels)
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Reperfusion Injury!
Ca++ influx leads to hypercontraction of myofibrils. |
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General Rule of thumb for time table after MI?
3 steps |
Necrosis- 1 day
Inflammation- 1 week Scar- 1 month |
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At what time after an MI are you at greatest risk for Fibrinous pericarditis?
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1-3 days afer due to neutrophils
Will have yellow pallor look |
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What time after an MI are you at the greatest risk for a rupture of the ventricle?
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4-7 days after.
Macrophages be eating all the garbage in the walls like you were eating all that Mcdonalds |
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Dressler Syndrome
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Autoimmune disease where inflammation in the pericardium causes antibodies to attack the pericardium.
6-8wks after an MI |
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Sudden Cardiac Death associations?
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fatal ventricular arrhytmias
hypertrophic cardiomyopathy Cocaine (Glenn Bias) Italians (seriously look at their soccer players) |
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Hemosiderin-laden macrophages
are seem where? |
with left sided heart failure
They are called "heart-failure cells" |
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What time period do most cardiac abnormalities happen during development
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3-8 weeks
8=h 3=c heart cabnormalities |
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Eisenmenger syndrome is what?
(hint; its related to shunts) |
When you have a reversal of a shunt
most likely due to pulmonary hypertension developing |
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Ventricular Septal Defect
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Most common in the membrane of the septum
Most common congenital heart defect Associated with fetal alcohol syndrome |
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You're looking at a peds chest x-ray and you see a "boot shaped heart"
What does this child have? |
Tetralogy of Fallout
If you said a love for Italy (half points) |
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Whats the most common type of Atrial Septal Defect?
What syndrome is associated with the second most common type? |
Most common type is ostium secundum.
Down Syndrome is associated with ostium primum (its upset its not in first) |
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What kind of auscultation finding will you have with an ASD
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split s2 sound due to increase in blood in the right heart causes delay in pulmonary valve closing.
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Patent Ductus Arteriosus
You know you're in long distance relationship when you hear PDA and don't think of this. |
Associated with congenital rubella
Machine like murmur is the give away. may cause lower body cyanosis if pul HTN develops |
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How would one close a PDA
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Close with indomethacin (NSAIDS)
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You hear a machine like murmur and you have lower body cynosis
What's going on? |
PDA
may cause lower body cyanosis if pul HTN develops |
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What are the four things associated with Tetralogy of Fallot
What does the patient learn to do to help? |
stenosis of RV outflow, RVH, VSD, aorta overrides.
They squat allowing more blood to reach the lungs. |
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Mom is a fatty and has diabetes.
What heart disease are you expecting her unborn child to have? |
Transportation of the great arteries.
And you hope they have a shunt as well in order to survive after birth. |
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A child is born with Transportation of the great arteries and they are fine for the first few days. Then things go wrong, what happened?
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PDA closed, no more shunt, should have given prostaglandins to keep it open.
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What signs will you see with Truncus Arteriosus?
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One large vessel leaving the heart so you get mixing of the blood and results in cyanosis
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If you see notching of the ribs on a chest x-ray in a 5 year old girl, what else should you check for?
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Turner syndrome is associated with Coarctation of the Aorta
You know its C of the A because the rib notching results in hypertrophy of the aa on the ribs. |
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You find bounding pulses in the upper extremities and pretty much nothing in lower... First thought?
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Coarctation of the Aorta
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What pathogen is most likely to cause Rheumatic Fever
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Streph A. due to molecular mimicry (M proteins resemble human tissue proteins)
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You suspect rheumatic fever in a patient (bc you're awesome and know everything) What are you basing this on?
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Jone's Criteria
J- joint arthritis O- heart issues (yea I know) N- nodules E- erythema marginatum S- sydenham chorea (twitching) Mitral valve issues also a good indication |
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Aschoff bodies are seen with what pathology
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Rheumatic Fever
Will see Myocarditis with aschoff bodies |
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If you have aortic stenosis in a patient under the age of 60, what is most likely the cause?
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Bicuspid valve instead of Tricuspid.
Wear and tear quicker |
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Aortic Stenosis S&S
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systolic ejection click with <> murmur
LVH Angina or syncope with Exercise Can damage RBC when they cross the calcified valve |
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Aortic Regurgitation S&S
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diastolic murmur of the blowing type
Huge pulse pressure due to back flow of blood decreasing diastole and increasing systole |
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Ecentric Hypertrophy (enlargement of one area) in the LV is caused by what?
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Aortic Regurgitation
More blood in= volume overload |
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You notice classmate draws a larger then normal C wave on Dr. Browns cardiac thing... They quickly gunner you by pointing out its due to a?
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Mitral valve prolapse
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You hear a mid systolic click followed by a regurgitation murmur over the left MCL. What you got?
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Mitral valve prolapse
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Mitral valve regurgitation will sound like what?
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Holosystolic blowing murmur that gets louder with squatting
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If you get Mitral valve stenosis from rheumatic fever, what else are you expecting to follow?
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Volume overload-> LAH
LAH-> pul congestion Pul congestion-> CHF right side Right side CHF-> umm yea |
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What is the most common cause of endocarditis overall?
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Strept V.
note: low-virulence so most be previous valve damage |
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Acute Endocarditis is accused by what organism and what valve is it most likely to infect?
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Homosapien via IV drug use (didnt see that one coming)
also: Staph A. infects normal valves, most likely Tricuspid |
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If you find someone has endocarditis due to Strep bovis, what must you absolutely check for?
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Colorectal carcinoma
to make sure "ITS NOT A TUMOR" |
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Patients with what problems are you most likely to see with non bacterial thrombotic endocarditis?
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hypercoagulable state
maybe adenocarcinoma |
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Libman-Sacks endocarditis is associated with?
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Systemic Lupus
Will see vegetation on both sides of mitral valve |
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What are 5 possible causes of Dilated Cardiomyopathy other then the most popular one: Unknown
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1. genetic mutation
2. myocarditis due to coxsackie 3. Alcohol abuse 4. Drugs 5. Preggers |
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With a dilated cardiomyopathy what S&S are you expecting to see?
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systolic dysfunction leads to CHF
arrhythmias all four chambers dilated |
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You have a genetic mutation in the sarcomere proteins of the heart, name that myopathy...
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Hypertrophic
Will see diastolic dysfunction (tight ventricle cant fill) Most hypertrophy in the LV septum! |
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A patient comes in and has diminished QRS amplitude on their EKG, what myopathy causes this?
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Restrictive
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Name 3 causes of Restrictive cardiomyopathy?
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Endocardial fibroelastosis- full of fibrosis in children
Loffler syndrome- eosinophilic infiltrate amyloidosis- gets in between myocardial fibers. |
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Myxoma fun facts... Go!
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most common primary cardiac tumor in adults.
usually found in left atrium and causes syncope abundant ground substance on histology |
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What is the most common cardiac tumor in children?
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Rhabdomyoma
associated with tuberous sclerosis!!!!!!! |
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Are Mets common in the heart?
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Why yes they are, think of all that blood supply.
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