AHD Flashcards
Hallmark of CAD, squeezing, heavy, burning, lasting 2-10 mins. Substernal pain with radiation to the shoulders, left arm, epigastrium, interscapular area, relieved by rest
Angina
Symptoms of Acquired heart disease
Fatigue, angina, dyspnea, edema, palpitations
Cardinal symptom of left HF ( exertional, Orthopnea, paroxysmal nocturnal dypsnea) cough, hemoptysis
Dyspnea
Common cause of palpitation, seen in mitral stenosis
Atrial fibrillation
Decreased perfusion of the brain
Syncope
Patients w/ cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity causes fatigue, palpitation, dyspnea or anginal pain.
Class 3
Patients w/ cardiac disease resulting in slight limitation of physical activity. They are comfortable at rest. ordinary physical activity result in fatigue, palpitation, dyspnea or anginal pain.
Class 2
Patients w/ cardiac disease resulting in an inability to carry on any physical activity w/o discomfort. Symptoms of cardiac insufficiency or the anginal syndrome may be present at rest. If any physical activity is undertaken, discomfort is increased.
Class 4
Patients w/ cardiac disease but w/o resulting limitation of physical activity. ordinary physical activity does not causes fatigue, palpitation, dyspnea or anginal pain.
Class 1
Major branches left anterior descending artery
Septal perforators, diagonal
Major branches circumflex artery
Obtuse marginal
Major branches RCA
Post. Descending artery, posterolateral artery
Symptoms of CAD
Angina, exertional dyspnea, epigastric pain, easy fatigability, D in exercise tolerance
Who anastomosed internal mammary to myocardium?
Arthur M. Vineberg
Who used saphenous vein grafts for bypass under CPB support?
Rene G. Favaloro/ Effler
Who- IMA to left anterior descending artery?
George Green
Fundamental cause of coronary artery disease?
Atherosclerosis
What are the 3 distinct changes MVS?
(1) commissural fusion,(2) chordal shortening/ fusion, (3) leaflet fibrosis/ calcification
Auscultatory triad?
Increased first heart sound, opening snap, apical diastolic rumble
Response is LV - dilatation, eccentric hypertrophy leading to cor bovinum
Aortic insufficiency
Almost always the result of rheumatic fever. Septic endocarditis( iv drug users)
Tricuspid stenosis and insufficiency
Blood leaks from the aorta to the ventricle during diastole
Aortic insufficiency
Visible forceful pulses
Waterhammer pulse
Quickly collapsing pulse
Corrigan pulse
Readily hear pulses by stethoscope over peripheral arteries
Pistolshot pulse
Head bobbing
Demuset’s sign
Fusion of parietal pericardium to epicardium. Scar tissue encases and constricts the heart. Diastolic filling is impeded, CO decreases
Chronic constrictive pericarditis
Obstruction of flow of blood from left atrium to left ventricle during left ventricular diastole.
Mitral Valve Stenosis
Pathophysiology of MS
Increase in left atrial pressure, pulmonary venous congestion, intact LV function , decrease cardiac output
Late effects
LA hypertrophy, atrial fibrillation, thrombus formation
Back flow of blood into the left atrium
Mitral Insufficiency
Third most common cause of aortic stenosis most frequent in older patients (7th,8th decade)
Calcific stenosis
Pathology of mitral insufficiency
Defect: mitral annulus, leaflets, chordae, and papillary muscle
Consequences of aortic stenosis
LV concentric hypertrophy and myocardial ischemia
Pathophysiology of mitral insufficiency
- regurgitation of a part of LV volume into the left atrium
- left atrial enlargement
- LV enlargement
- decrease in systolic function
Obstruction of blood flow from left ventricle to aorta during systole
Aortic stenosis
