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Cardiopulmonary Lecture > Cardiac Conditions > Flashcards

Cardiac Conditions Flashcards

1
Q

Cardiac Disease in Heart Muscle

A
  1. Coronary Artery Disease
  2. Myocardial Infarction
  3. Pericarditis
  4. Congestive Heart Failure
  5. Aneurysms
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2
Q

Cardiac Disease in Heart Valves

A
  1. Rheumatic Fever
  2. Endocarditis
  3. Mitral Valve Prolaps
  4. Congenital Anomalies
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3
Q

Cardiac Disease in Cardiac Nervous System

A
  1. Arrhythmias
  2. Tachycardia
  3. Bradycardia
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4
Q

CARDIOPULMONARY PATHOPHYSIOLOGY is due to the following processes:

A
  1. Obstruction or restriction of arterial lumen
  2. Inflammation
  3. Diilation or distention
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5
Q

Hyperlipidemia predisposes to many cardiopulmonary diseases. Metabolic abnormalities presenting as:

A
  1. High Serum Cholesterol
  2. High LDL
  3. High Triglycerides
  4. Low HDL
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6
Q

Statin therapy can cause dose-dependent statin-induced:

A

Myalgia and Myopathy

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7
Q

Myopathy Signs and Sx

A

Muscle Soreness
Muscle Pain
Muscle Weakness
Dyspnea

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8
Q

Myalgia Signs and Sx

A

Elevated CK Levels

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9
Q

Both Myopathy and Myalgia Signs and Sx

A

Unexplained Fever
Nausea
Vomiting
Liver Impairment

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10
Q

Liver Impairment Signs and Sx

A

Spider Angiomas
Palmar Erythema
Asterixis
Nail Bed Changes
Skin Changes
Dark Urine
Ascites
Bilateral CTS

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11
Q

Risk Factor for Statin-Induced Muscular Sx

A

Age of 80
Small body frame
Polypharmacy
Alcohol Abuse
Kidney/Liver Dse

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12
Q

Signs and Symptoms of Myositis

A

Muscle aches and pain
Unexplained Fever
Nausea
Dark Urine
Vomiting

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13
Q

Risk Factors of CAD: Modified Factors

A

Physical Inactivity
Obesity
Tobacco Smoking
Cholesterol
High BP
Diabetes
Deviated Serum

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14
Q

Risk Factors for CAD: Non modifiable risk factors

A

Postmenopausal (Female)
Family Hx
Age (65 or older)
Race
Male Gender

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15
Q

Risk Factors for CAD (SHAPPO)

A

Stress
Hormonal Status
Alcohol Consumption
Personally
Peripheral Vascular Disease
Obesity

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16
Q

Progressive Hardening of the arteries which is common in LE, kidney and brain

A

Atherosclerosis

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17
Q

Made up of fats, calcium, and fibrous scar tissues that line and narrow in the arterial lumen

A

Plaque Formation

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18
Q

T or F:
Narrowing-> Occlusion-> Ischemia-> Necrosis

A

T

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19
Q

Clot formation over the plaque due to slowing of blood flow

A

Thrombus

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20
Q

A clot that is dislodged and travels into different parts of the body.

A

Embolus

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21
Q

T or F: CAD
Angina-> Myocardia Ischemia-> Myocardial Infarction

A

T

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22
Q

Occlusion of the coronary artery leading to ischemia and necrosis of the myocardial tissue

A

Myocardial Infarction

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23
Q

Another name for your MI

A

Acute Coronary Syndrome

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24
Q

Results from a sudden decrease in coronary perfusion or an increase in myocardial demand without adequate blood supply which leads to death in the myocardium

A

Myocardial Infarction

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25
Q

In MI, NSTEMI and STEMI means?

A
  1. Non-ST- Elevated MI- good prognosis c medications but depends if refractory
  2. ST Elevated MI- actual necrosis which needs surgery
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26
Q

Zones of Infarct

A
  1. Zone of Ischemia
  2. Zone of Hypoxic Injury
  3. Zone of Infarction
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27
Q

Zone of Ischemia

A

Reversible- T-wave inversion

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28
Q

Zone of Hypoxic Injury

A

Reversible if with collateral circulation; ST Elevation

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29
Q

Zone of Infarction

A

Irreversible; Abnormal Q

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30
Q

Cardiac Enzymes Associated With Myocardial Injury and Infarction

A
  1. Creatine Kinase- Myocardial Band
  2. Lactic Dehydrogenase LDH
  3. Troponin
  4. Myoglobin
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31
Q

Normal, Minor, Major, & Peak Levels of CK-MB in MI

A

0-3%, 5%, 10% 14-36 hours

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32
Q

Normal, Minor, Major Dysfunction of Lactic Dehydrogenase LDH in MI

A

100-225 mL or 127 IU, 300-750 mL, >1,000 mL

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33
Q

Normal, Minor, Major Dysfunction of Troponin I

A

0-0.2 mg/mL, 5mg/mL, greater than or equal to 10 mg/mL, 24-36 hours

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34
Q

Normal, Minor, Major Dysfunction of Myoglobin

A

<100 ng/mL, 200 ng/mL, greater than or equal to 500 ng/mL

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35
Q

T or F: CK-MB quickly appears and disappears during MI, Troponin I elevates and is longer lasting

A

True

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36
Q

The most common cause of infarction

A

Coronary Thrombosis

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37
Q

Other Factors that causes MI

A

○ Coronary artery spasm
○ Platelet aggregation
○ Embolism
○ Aortic stenosis
○ Thrombus from RHD or prosthetic
valves
○ Endocarditis
○ Aortic spasm

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38
Q

Complications of MI

A

○ Pump failure
○ Hypovolemia
○ Cardiogenic shock
○ Arrhythmias
○ Sinus bradycardia
○ Free wall rupture
○ Recurrent chest discomfort
○ Pericarditis

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39
Q

Cardiac Arrest

A

○ Sudden loss of consciousness
○ No normal breathing
○ No signs of circulation
○ No movement or coughing

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40
Q

If patient has a cardiac arrest, what should you do?

A
  1. CPR
  2. AED
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41
Q

Prodromal Symptoms of MI

A
  1. Pallor
  2. Profuse Perspiration
  3. Nausea and Vomiting
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42
Q

Heart Attack Symptoms in Women: One month before a heart attack

A
  1. Unusual fatigue
  2. Sleep disturbance
  3. Dyspnea
  4. Indigestion or GERD
  5. Anxiety
  6. Heart racing
  7. Arms weak/heavy
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43
Q

Heart Attack Symptoms in Women: During a heart attack

A
  1. Dyspnea
  2. Weakness
  3. Unusual Fatigue
  4. Cold Sweat
  5. Dizziness
  6. Nausea
  7. Arms weak/heavy
44
Q

Inflammation of the pericardium
affecting the parietal and visceral layers

A

Pericarditis

45
Q

Clinical Signs and Sx of Pericarditis

A
  1. Substernal pain
  2. Difficulty in swallowing
  3. Pain referred by leaning forward or sitting upright
  4. Pain relieved or reduced by holding your breath
  5. Pain aggravated by movement associated with deep breathing (laughing, coughing, deep inspiration)
  6. Hx of fever, chills, weakness, or heart disease
  7. Cough
  8. Lower extremity edema
46
Q

Symptoms of Pericardial Effusion

A
  1. Chest Pain
  2. SOB
  3. Compression of Near Structures
47
Q

Cardiac Tamponade Beck’s Triad

A
  1. Hypotension
  2. Distended Jugular Veins
  3. Muffle Heart Sounds
48
Q

Sudden fluid accumulation and pericardium cannot adjust to the dramatic increase in pressure

A

Acute Pericardial Tamponade

49
Q

Causes of Acute Pericardial Tamponade

A
  1. Chest Trauma
  2. Ruptured Aorta
  3. Ruptured of Ventricle After Heart Attack
50
Q

What is the other known word for CHF?

A

Cardiac Insufficiency or Cardiac Decompensation

51
Q

The heart is unable to pump blood effectively thus cannot meet the metabolic needs of the body.
Ventricular Failure

A

CHF

52
Q

Pathophysiological Processes Commonly Leading to Heart Failure

A
  1. Disease processes directly impairing myocardial
    contractility
  2. Disease processes increasing afterload
  3. Disease processes increasing preload
  4. Disease processes impairing ventricular filling
53
Q

Causes of Cardiac Muscle Dysfunction

A
  1. Hypertension
  2. CAD
  3. Cardiac Dysrhythmias
  4. Valve Abnormalities
  5. Pericardial Pathology
  6. Cardiomyopathies
54
Q

Increased peripheral arterial pressure contributes to increased afterload and pathological
hypertrophy of the left ventricle.

A

Hypertension

55
Q

Acute injury to myocardial tissue damages ventricular contractility causing
systolic dysfunction. Scar formation seen in infarcted tissue alters relaxation and may lead to diastolic
dysfunction.

A

CAD

56
Q

Normal electrical conduction through the heart allows for normal mechanical
contraction of the ventricles. Altered electrical conduction alters the mechanical activity of the ventricles
exacerbating heart failure

A

Cardiac Dysrhythmias

57
Q

Cardiac valve pathology (stenosis or regurgitation) causes structural changes to the
chamber behind the valve resulting in cardiac muscle dysfunction and failure.

A

Valve Abnormalities

58
Q

Pericarditis (fluid in the pericardial space) with resultant cardiac tamponade
compresses the ventricles leading to cardiac muscle dysfunction and heart failure.

A

Pericardial Pathology

59
Q

Damage to the myocardial cells from various pathological processes alters the systolic
and/or diastolic function of the ventricles

A

Cardiomyopathies

60
Q

LEFT-SIDED CHF SYMPTOMS

A

● Dyspnea predominated
● Left-sided S3/S4 gallop
● Bilateral basilar rales
● Pleural effusions
● Pulmonary edema
● Orthopnea, paroxysmal nocturnal dyspnea

61
Q

RIGHT-SIDED CHF SYMPTOMS

A

● Fluid retention predominates
● Right-sided S3/S4 gallop
● JVD
● Hepatojugular reflux
● Peripheral edema
● Hepatomegaly, ascites

62
Q

NYHA / New York Heart Association Functional Classification:
No limitation of physical activity. Ordinary physical activity does not cause undue fatigue,
palpitation or dyspnoea

A

CLASS 1

63
Q

NYHA / New York Heart Association Functional Classification: Slight limitation of physical activity. Comfortable at rest but ordinary physical activity results in
fatigue, palpitation or dyspnoea.

A

CLASS 2

64
Q

NYHA / New York Heart Association Functional Classification:
Marked limitation of physical activity. Comfortable at rest but less than ordinary activity results in fatigue, palpitation or dyspnoea.

A

CLASS 3

65
Q

NYHA / New York Heart Association Functional Classification:
Unable to carry out any physical activity without discomfort. Symptoms at rest. If any physical
activity is undertaken, discomfort is increased.

A

CLASS 4

66
Q

ACCF/AHA Stages of Heart Failure : At high risk for HF but without structural heart
disease or symptoms of HF.
RF for Hypertension

A

Stage A

67
Q

ACCF/AHA Stages of Heart Failure: Structural heart disease but without signs or symptoms of HF. LV Dysfunction & LV Hypertrophy

A

STAGE B

68
Q

ACCF/AHA Stages of Heart Failure: Structural heart disease with prior or current symptoms of HF. Most forms of chronic HF

A

STAGE C

69
Q

ACCF/AHA Stages of Heart Failure: Refractory HF requiring specialized interventions. Advanced/End stage HF

A

STAGE D

70
Q

● Abnormal function of the heart muscle
● Presents with dyspnea and worsened by exertion (Dilated, Restrictive, Hypertrophic)
● Treatment is Beta Blockers

A

Cardiomyopathy

71
Q

Pathophysiology of Cardiomyopathy

A
  1. Impaired Systolic Function
  2. Impaired Ventricular Filling
  3. Septum Hypertrophy
72
Q

An abnormal dilation in the wall of an artery, vein, or the
heart due to the weakening of the vessel or heart wall as a
result of:
○ Trauma/Weight-lifting/Thoracic Surgery
○ Congenital vascular disease
○ Infection
○ Atherosclerosis

A

Aneurysms

73
Q

Aneurysms is the result of:

A

○ Trauma/Weight-lifting/Thoracic Surgery
○ Congenital vascular disease
○ Infection
○ Atherosclerosis

74
Q

Common aneurysm can be found at?

A

Abdominal Aorta, proximal to renal arteries then the cerebral vascular system

75
Q

Types of Aneurysm

A
  1. Thoracic Aneurysms
  2. Abdominal Aortic Aneurysms
  3. Peripheral Arterial Anuerysms
76
Q

● Common in hypertensive men
aged 40-70 years
● May occur in the ascending
arch or descending aorta
ABOVE the diaphragm

A

Thoracic Aneurysms

77
Q

● Most common site is the
popliteal artery
● Can lead to ischemic symptoms
of the area
● Presents with an easily
palpable pulse

A

Peripheral Aneurysms

78
Q

● 4x more common than thoracic
aneurysms
● Most common site is just
below the kidney (below the
renal arteries

A

Abdominal Aortic Aneurysms

79
Q

a tear develops between two layers of the intima causing blood to flow between the 2
layers than through the lumen

A

Aortic Dissection

80
Q

Impairment of the heart valves due to disease, congenital deformity or infection

A

Valvular Heart Disease

81
Q

● Narrowing or constriction that
prevents the valve from
opening fully
● Due to growths, scars or
abnormal deposits on the
leaflets

A

Stenosis

82
Q

● Valves do not close properly
and cause blood to flow back
into the heart chamber

A

Regurgitation

83
Q

● Only affects the MITRAL VALVE
● Enlarged valve leaflets bulge
backward into the left atrium

A

Prolapse

84
Q

CLINICAL SIGNS AND SYMPTOMS OF VALVULAR HEART DISEASE

A

○ Easy fatigue
○ Dyspnea
○ Palpitation (subjective sensation of throbbing, skipping, rapid or forcible pulsation of the heart)
○ Chest pain
○ Orthopnea or paroxysmal dyspnea
○ Syncope
○ Pitting edema

85
Q

SYSTOLE

A

● Left ventricle EMPTIED
● Passage of blood from ventricle to
Aorta/Pulmonary Artery
● VALVES OPEN: Semilunar Valves
● VALVES CLOSED: Atrioventricular Valves

86
Q

DIASTOLE

A

● Left ventricle FILLED UP
● Passage of blood from Atrium to Ventricles
● VALVES OPEN: Atrioventricular Valves
● VALVES CLOSED: Mitral Valves

87
Q

If there is a problem in opening the valves in stenosis? What will happen?

A

● Aortic and Pulmonic Valve - SYSTOLIC
● Mitral and Tricuspid Valve - DIASTOLIC

88
Q

If there is a problem in closing the valves in regurgitation? What will happen?

A

● Aortic and Pulmonic Valve - DIASTOLIC
● Mitral and Tricuspid Valve - SYSTOLIC

89
Q

● Commonly seen in kids
● An infection caused exclusively by group A Streptococci bacteria

A

Rheumatic Fever

90
Q

2 most common symptoms of RF

A
  1. Fever
  2. Joint Pains
91
Q

Most common cause of heart disease in children in
developing countries

A

Rheumatic Heart Disease

92
Q

The most typical initial clinical presentation of RHD

A
  1. Sore throat
  2. Painful Migratory Joint pain after 2-3 weeks
93
Q

CLINICAL SIGNS AND SYMPTOMS of Rheumatic Fever

A

○ Migratory arthralgias
○ Subcutaneous nodules on extensor
surfaces
○ Fever and sore throat
○ Carditis
○ Flat, painless skin rash (short duration)
○ Weakness, malaise, weight loss, and
anorexia
○ Acquired valvular disease

94
Q

○ May occur 1-3 months after strep infection and always AFTER polyarthritis
○ Rapid, purposeless, non repetitive movements that may involve all muscles EXCEPT the EYES

A

Rheumatic Chorea (St. Vitus’ Dance)

95
Q

Criteria for Rheumatic Fever

A

Joint pain (migratory)
Myocarditis
Nodules (subcutaneous), Erythema marginatum,
Sydenham Chorea (St. Vitus Dance)

96
Q

Hard, painless, non-pruritic, mobile nodules over bony prominence and extensor
surfaces

A

Subcutaneous Nodules

97
Q

Annular, evanescent eruptions with erythematous serpiginous borders and central
clearing

A

Erythema Marginatum

98
Q

● Bacterial or fungal infection of the heart causing inflammation of the cardiac endothelium and
damaging the tricuspid, aortic or mitral valves
● May be caused by bacteria entering the bloodstream from a remote area of the body OR
● As a result of abnormal growths (vegetations) on the surfaces of artificial valves

A

Infective Endocarditis

99
Q

Infective Endocarditis is common in patients c:

A

○ Previous valvular damage
○ Infection during users
○ Post-cardiac surgical patients
○ Invasive diagnostic procedures

100
Q

● CLINICAL SIGNS AND SYMPTOMS OF INFECTIVE ENDOCARDITIS

A

○ Arthralgia
○ Arthritis
○ Musculoskeletal symptoms
○ Low back/sacroiliac pain
○ Myalgias
○ Petechiae/splinter hemorrhages
○ Constitutional symptoms
○ Dyspnea, chest pain
○ Cold and painful extremities

101
Q

most common musculoskeletal symptoms

A

Arthralgia

102
Q

Most commonly affected site in Infective Endocarditis

A

Shoulder > Knee > Hip > Wrist > Ankle > MTT > MCP > AC joints

103
Q

Duke’s Criteria for Infective Endocarditis

A

Fever
Roth Spot
Osler Node
Murmur
Janeway Lesions
Anemia
Nail Bed Hemorrhage
Emboli

104
Q

Small, tender, palpable, erythematous lesions on the pads of the fingers and
toes

A

Osler Nodes

105
Q

Painless, hemorrhagic nodular lesions in the palms and soles, may ulcerate

A

Janeway Lesions

106
Q

Definite Endocarditis

A

○ 2 major criteria
○ 1 major criteria + 3 minor criteria
○ 5 minor criteria

Cardiopulmonary Lecture (12 decks)

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