Cardiac Conditions Flashcards by Josef Mikael Oclarit

Metabolic abnormalities in a pt with Hyperlipidemia

High serum cholesterol
High LDL
High triglycerides
Low HDL

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Side effects of statin therapy

Myalgia
Myopathy
Unexplained fever
Nausea
Vomiting

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RF of Statin-induced side-effects

> 80 y/o
Small body
Kidney or liver dse
Polypharmacy
Alcohol abuse

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A condition wherein a person has dark urine

Myoglobinuria

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Hardening of the arteries

Arteriosclerosis

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made up of fats, calcium and fibrous scar
tissue that lines and narrows the arterial lumen

Plaque formation

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Modifiable RF of CAD

Inactivity
Smoking
Cholesterol
High BP
Diabetes
Obesity

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Aka Heart Attack

Myocardial Infarction

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Another term used for Myocardial Infarction

Acute Coronary Syndrome

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A type of ACS/MI where there is actual necrosis

ST-elevated MI

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A type of ACS/MI that has good prognosis with medications

NSTEMI

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An area in infarction where damage is still reversible

Zone of Ischemia

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An area in infarction where damage is reversible with collateral circulation

Zone of Hypoxic Injury

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An area in infarction where there is irreversible damage

Zone of Infarction

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Peak hours of CK-MB

14-36 hours

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Peak hours of Troponin

24-36 hours

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Complications of MI

Pump failure
Hypovolemia
Cardiogenic shock
Arrythmias
Pericarditis
Sinus Brady

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A sudden loss of consciousness that presents with no normal breathing, no circulation, and no movement or coughing

Cardiac arrest

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Prodromal symptoms of cardiac arrest

Pallor
Profuse perspiration
Nausea and vomiting

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Inflammation of the pericardium affecting the
parietal and visceral layers

Pericarditis

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Clinical S/Sx of Pericarditis

Substernal radiating pain to the neck and back
Difficulty in swallowing
Pain exacerbated by leaning forward or sitting upright

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Pericardial fluid build up overtime

Pericardial effusion

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Sudden fluid accumulation of the heart

Acute pericardial tamponade

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

Congestive Heart Failure

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A consequence of failure to propel blood out of the heart

Congestion

L CHF S/Sx

Dyspnea predominated L-sided s3/s4 gallop Pleural effusion Pulmonary edema Orthopnea, PND

R CHF S/Sx

Fluid retention predominated R-sided s3/s4 gallop JVD Cyanosis of nail bed Hepatojugular reflex Peripheral edema Hepatomegaly, ascites

NYHA functional classification with no limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation or dyspnea.

NYHA Class I

NYHA functional classification with slight limitation of physical activity. Comfortable at rest but ordinary physical activity results in fatigue, palpitation or dyspnea

NYHA Class II

NYHA functional classification with marked limitation of physical activity. Comfortable at rest but less than ordinary activity results in fatigue, palpitation or dyspnea.

NYHA Class III

NYHA functional classification with inability to carry out physical activity without discomfort

NYHA Class IV

Max METs for NYHA Class I patients

6.5 METs

Max METs for NYHA Class II patients

4.5 METs

Max METs for NYHA Class III patients

3.0 METs

Max METs for NYHA Class IV patients

1.5 METs

Abnormal function of the heart muscle

Cardiomyopathy

Characteristics of a Dilated Cardiomyopathy

Pathophy: Impaired systolic function EF: < 30% LV wall dimension: Dilated LV thickness: Thin walls Sx: Exertional dyspnea

Characteristics of a Restrictive Cardiomyopathy

Pathophy: Impaired ventricular filling EF: 25-50% LV wall dimension: Normal to decreased LV thickness: Normal to increased Sx: Exertional dyspnea + RH failure

Characteristics of a Hypertrophic Cardiomyopathy

Pathophy: Septum hypertrophy EF: > 60% LV wall dimension: Decreased LV thickness: Thick Sx: Exertional dyspnea + Angina, Syncope

An abnormal dilation in the wall of an artery, vein, or the heart due to the weakening of the vessel or heart wall

Aneurysm

Causes of Aneurysm

Trauma Congenital vascular conditions Infection Atherosclerosis

m/c type of aneurysm

Abdominal aortic

In what population do Thoracic aneurysms commonly occur?

Hypertensive men aged 40-70 y/o

In what structures do Thoracic aneurysms occur?

Ascending arch or descending aorta above the diaphragm

A type of aneurysm that presents with an easily palpable pulse

Peripheral aneurysm

m/c site of peripheral aneurysm

Popliteal artery

m/c site of Abdominal Aortic Aneurysm

Just below the kidney

An infection caused exclusively by group A Streptococci bacteria

Rheumatic Fever

2 m/c S/Sx of Rheumatic Fever

Fever Joint pain

Progression of Rheumatic Fever

Rheumatic Heart Disease

Most typical initial clinical presentation of Rheumatic Fever

Sore throat Gradual onset of painful migratory jt pains after 2-3 weeks

Criteria for diagnosing Rheumatic Fever

Jones Criteria

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

Subcutaneous nodule

Annular, evanescent eruptions with erythematous serpiginous borders and central clearing

Erythema Marginatum

Bacterial or fungal infection of the heart causing inflammation of the cardiac endothelium and damaging the tricuspid, aortic or mitral valves

Infective Endocarditis

S/Sx of Infective Endocarditis

Arthralgia Arthritis Msk symptoms LBP Myalgia

m/c site affected by Infective Endocarditis

Sh > Knee > Hip > Wrist > Ankle > MTT > MCP > AC

Criteria for diagnosing Infective Endocarditis

Duke's Criteria

Components of Duke's criteria

Fever Roth Spot Osler node Murmur Janeway Lesion Anemia Nail bed hemorrhage Emboli

bulging of the valve leaflets that leads to insufficiency

Valvular prolapse

Another name for Mitral Valve Prolapse

Floppy valve syndrome Barlow's syndrome Click-murmur

Triad of symptoms in Mitral Valve prolapse

Dyspnea Palpitation Fatigue

Abnormal hole or opening of the fossa ovalis

Atrial Septal Defect

Complication of Atrial Septal Defect

R-sided heart failure

Is Atrial Septal Defect Cyanotic or Acyanotic?

Acyanotic

Abnormal opening in the ventricular septum, abnormally seen in babies

Ventricular Septal Defect

Is Ventricular Septal Defect Cyanotic or Acyanotic?

Acyanotic

Condition commonly associated with Ventricular Septal Defect

Down syndrome (Trisomy 21)

S/Sx of Tetralogy of Fallot

Pulmonary Trunk Stenosis (most impactful) Aortic overriding RV hypertrophy IVSD

Is Tetralogy of Fallot Cyanotic or Acyanotic?

Cyanotic

Children with Tetralogy of Fallot exhibit bluish skin during episodes of crying or feeding.

Tet spell

Intervention of children with Tet spell

Position knee to chest Oxygenate Sedate Hydrate

Presentation of ToF in X-ray

Boot-shaped heart

The ductus arteriosus fails to close properly, resulting in a persistent connection between the aorta and the pulmonary artery.

Patent Ductus Arteriosus

Is Patent Ductus Arteriosus Cyanotic or Acyanotic?

Acyanotic to Cyanotic

Narrowing of the aorta commonly AFTER the (L) subclavian artery

Coarctation of Aorta

The pulmonary valve is closed, leading to the backflow of deoxygenated blood from the right ventricle into the right atrium

Pulmonary Atresia

How does the heart compensate for Pulmonary Atresia?

Concomitant Ductus Arteriosus Foramen Ovale compensation

Is Pulmonary Atresia Cyanotic or Acyanotic?

Cyanotic

The tricuspid valve is closed and patent foramen ovale

Tricuspid Atresia

The aorta and pulmonary trunk are switched, leading to the aorta arising from the right ventricle and the pulmonary trunk arising from the left ventricle.

Transposition of Great Arteries/Vessels

Presentation of TGA in the X-Ray

Egg on a String

The aorta and pulmonary trunk fuse into one

Truncus Arteriosus

Damaged myocardial tissue from a previous MI can cause the atria or ventricles to fire dysregulated impulses that disrupt the normal conduction pathway.

Fibrillations

The most common cardiac dysrhythmia

Atrial Fibrillation

More dangerous and lethal dysrhytmia

Ventricular fibrillation

Represents atrial depolarization in the ECG

P wave

Represents atrial repolarization and ventricular depolarization in the ECG

QRS complex

Represents ventricular repolarization in the ECG

T-wave

Represents the beginning of atrial depolarization to the beginning of ventricular depolarization in the ECG

PR interval

Represents the end of ventricular depolarization and beginning of ventricular repolarization

ST segment

Represents ventricular depolarization to repolarization in the ECG

QT interval

How many boxes does the QRS complex usually take up?

< 3 squares

3 types of ECG leads

Standard limb Augmented limb Precordial Limb