Cardiac Function Flashcards
heart anatomy
2 atriums & 2 ventricles
tricuspid valve & mitral valve
3 layers of fibrous membrane
tricuspid valve
separates right atrium from right ventricle
mitral valve
separates left atrium from left ventricle
visceral pericardium
inner layer of pericardium
perietal percardium
outer layer of pericardium
pericardium fluid
fluid between layers
3 layers of heart wall
epicardium, myocardium, endocardium
epicardium
outer layer of heart wall
myocardium
middle layer, striated muscle fibers, has actin, myosin & troponin as well as myoglobin in this layer
enzymes CK-MB & LD isoenzymes LD1 & LD2 are found here
damage to the myocardium results in what?
troponin
CK-MB
LD isoenzymes into serum
Dyspnea
shortness of breath
symptom of heart disease
Chest pain
gamete from angina to crushing pain
symptom of heart disease
Palpitations
thumping to flip-flops, heart to catch these for evaluations
symptom of heart disease
Syncope
fainting, loss of consciousness
symptom of heart disease
Edema
swelling of tissues, legs, eyes, abdomen, chest wall (especially for congestive heart failure)
symptom of heart disease
Cyanosis
bluish color of fingernails, lips, non-02 blood
symptom of heart disease
symptoms of heart disease
Dyspnea chest pain palpitations syncope edema cyanosis
5 categories of cardiac diseases
Congenital cardiovascular diseases heart failure acute coronary syndrome hypertensive heart disease infective heart disease
Congenital heart disease
congenital cardiovascular defects= CCVD
defects range from heart walls, valves, artery & veins crisscrossing etc
symptoms of congenital heart disease
cyanosis, pulmonary hypertension, clubbing of fingers, embolisms, reduced growth, & syncope (fainting)
development of congenital heart defects
most defects are multi-factorial & include some environmental factors
infants develop heart w/in first 10 weeks of pregnancy & pick up on infants a few weeks after birth
CCVDs
Tetralogy of Fallot
VSD
Tetralogy of Fallot
transposition of arteries, atrio ventricular septa defects, coartction of the aorta, hypoplastic left heart syndrome
ventricular septa defects (most common)
VSD
hole between 2 ventricles, leads to hypertrophy, increased pulmonary pressure, blood shunted away from aorta
decreased output
tests for CCVD
increased catecholamines & salt
water retention
do FISH tests for DNA mutations
Heart failure
when any structural or functional cardiac disorder impairs the ability of the ventricle to fill & eject blood
common causes of HF
coronary artery disease (CAD) cardiomyopathies (thickening of ventricle walls) inflammatory heart diseases valvular disease cardiac arrhythmias
Acute Coronary Syndrome (ACS)
events:
angina-> reversible tissue injury -> unstable angina -> MI -> extensive heart tissue necrosis
Acute coronary syndrome symptoms
chest pain, referred pain, nausea, vomiting, dyspnea, diaphoresis, light headed
typical ‘heart attack’ symptoms
major causes of acute coronary syndrome
atherosclerosis or inflammation involving cholesterol, bacteria, hyperlipidemia, glycosylated products from diabetes &/or inflammatory cytokines
ischemia
tissue gets destroyed via 02 deprivation
Factors predisposing to atherosclerosis
age gender = women have increased HDL & decreased risk until menopause family history dyslipidemia smoking hypertension sedentary lifestyles diabetes mellitus
3 possible aliments w/ ischemia
congestive heart failure
angina pectoris
myocardial infarction
Angina pectoris
pain due to ischemia, not all chest pain is angina pectoris though
stable angina
reversible if addressed early, stops when activity stops
unstable angina
progressive; pain at rest & unpredictable, can lead to AMI, plague ruptures, throw clots
Hypertension statistics
1 in 3 US citizens has high blood pressure
@ 60 >50%
@ 70 >75%
Hypertension
systolic > 140 mmHg
diastolic > 90 mmHg
Hypertension contributing factors
obesity
lack of physical activity
unhealthy nutritional habits
genetic predisposition
Hypertensive heart disease includes:
left ventricular hypertrophy
coronary artery disease (CAD)
congestive heart disease (CHF) - due to increased blood pressure
Hypertensive heart disease & optic nerve
blood pressure change can squeeze the optic nerve & can cause blindness
Blood pressure & cardiovascular disease
Hypertension can cause cardiac disease even if you have no other heart issues or risk factors if it is not addressed
mechanism of hypertension & heart disease
peripheral resistance to blood flow determines blood pressure. when resistance increases, it leads to hypertrophy of ventricle & dilation
affects mitral value & get blood regurgitation into left atrium
overtimem atrium becomes enlarged & dilated as well
Infective heart disease
Rheumatic heart disease - complications of group A beta-hemolytic strep, the autoimmune response
infective endocarditis
pericarditis
Laboratory diagnosis of heart disease
measure heart affect on other organs (liver, kidney, lungs)
blood gases for acid-base status
electrolytes & osmolality - for edema, cardiac output & monitoring diuretic
enzymes: AST, ALT, ALP for increases in chronic ventricular failure
GGT (2x in CHF)
lipids -Lp(a), LDL, HDL
2nd heart failure to thyroid
CBC, WBC
troponin
Cardiac Markers of Inflammation
high-sensitivity C-reactive protein - generally nonspecific; predictive for CAD
PAPP-A
lipoprotein associated w/ phospholipase A2
PAPP-A
pregnancy associated plasma protein A
zinc-binding protein in pregnancy, found in unstable atherosclerosis plagues, ACS conditions
Marker for congestive heart disease
BNP(!!), ANP, CNP
NT-proBNP
