Cardiac Pathologies Flashcards
Hypertrophic Cardiomyopathy (HCM)
Characterized as an abnormally hypertrophied left ventricle (over 15 mm) that causes physical obstruction of blood flow and diastolic dysfunctions
Hypertrophic Cardiomyopathy (HCM) S&S
- fatigue
- exertional dyspnea
- chest pain
- syncope or near-syncope
- increased left ventricle impulses
Hypertrophic Cardiomyopathy (HCM) Treatment
- referral
- 12-lead ECG & chest x-ray
- echocardiogram
- blood work for genetic markers
- discontinue athletic participation for at least 1 month to confirm diagnosis
- restrict participation from contact sports
Athlete Heart Syndrome
- normal adaptation to training
- long term aerobic and anaerobic exercise can lead to cardiac hypertrophy of the left ventricle
Athlete Heart Syndrome S&S
- can have ECG similar to HCM
- possible heart murmur due to increased volume and faster flow (louder with squatting / quieter with standing)
- fatigue
- exertional dyspnea
- chest pain
- syncope or near-syncope
Athlete Heart Syndrome Treatment
Decondition for 3 months and repeat ECG and echocardiogram to compare results
Sudden Cardiac Death
unexpected death due to cardiac issued
Commotio Cordis
Sudden blunt force trauma to the chest often causing sudden cardiac death in absence of cardiac damage (impact occurs during repolarization)
Commotio Cordis S&S
sudden collapse
Commotio Cordis Treatment
CPR and AED
Marfan Syndrome
A hereditable disorder that affects connective tissue (heart, lungs, eyes, arms)
Marfan Syndrome S&S
CV:
- ascending aortic dilation
- aortic dissection
- aortic regurgitation
- mitral regurgitation
- mitral valve prolapse
- abdominal aortic aneurysm
Ocular:
- superior lens discoloration
- flat cornea
- elongated globe
- retinal detachment
- myopia
- bulging eyes
Skeletal:
- anterior chest deformity (pectus excurvatum)
- scoliosis
- thoracic lordosis
- tall skinny stature
- hypermobile joints
- high-arched palate
Marfan Syndrome Screening Criteria
- wingspan greater than height
- moderate kyphoscoliosis
- heart murmur of mild systolic click
- fam hx of Marfan syndrome or sudden cardiac death before 40 y/o
Myocarditis
Inflammation of the myocardium (often due to enteroviral infections)
Myocarditis S&S
- generalized viral illness
- fever
- constitutional symptoms
- nausea
- diarrhea
- vomitting
- dyspnea
- palpitations
- syncope
- exercise intolerance
Myocarditis Treatment
immediate referral
Myocarditis Athletic Participation
- 30% are able to return to activity if there are no diagnostic issues after 6 months of removal from sport
- physical activity can trigger cardiac arrest
- should never participate with fever
- ill athletes should be discouraged from participation
Mitral Valve Prolapse
Mitral valve (between the left atrium and left ventricle) does not close properly resulting in regurgitation of blood back into the left atrium
Mitral Valve Prolapse S&S
- chest pain
- heart palpitations
- dyspnea
- syncope
- click murmur (Barlow’s)
Mitral Valve Prolapse Treatment
- immediate referral
- holt monitor
- anti-arrhythmic treatments may be needed in symptomatic patients
Mitral Valve Prolapse RTP
sport participation is allowed if asymptomatic and cleared by cardiologist
Acute Myocardial Infarction
“Heart Attack”
- diminished blood supply to the heart causing irreversible cell damage or death
Acute Myocardial Infarction S&S
- angina
- dyspnea
- syncope
- pale/clammy skin
- epigastric discomfort
Acute Myocardial Infarction Treatment
Activate EMS
Wolf-Parkinson-White Syndrome
Rare arrhythmic condition caused by ventricular pre-excitation from an accessory pathway
Wolf-Parkinson-White Syndrome S&S
- Chest Pain
- difficulty breathing
- tachycardia
- atrial fibrillation
Wolf-Parkinson-White Syndrome Treatment
- slow accessory pathway with medicine (beta blockers of calcium channel blockers)
- cardiac catheterization with ablation (surgical removal) of accessory pathway
Hypertension
high blood pressure
Hypertension S&S
- typically asymptomatic
- headaches
- vision issues
- exercise intolerance
Hypertension Treatment
- stop smoking
- diet control
- alcohol moderations
- exercise prescription
- ACE inhibitors for active patients
Blood Pressure Categories
Normal = less than 120/less than 80
Elevated = 120-129/less than 80
Stage 1 Hypertension = 130-139/80-89
Stage 2 Hypertension = 140+/90+
Hypertensive crisis = 180+/120+
Exertional Rhabdomyolysis
Catabolic destruction and degeneration of skeletal muscle accompanied by leakage of myoglobin and muscle enzymes into the vascular system
- due to acute or chronic muscle breakdown
Exertional Rhabdomyolysis S&S
- muscle weakness
- muscle pain
- hematuria
- myoglobinuria
Exertional Rhabdomyolysis Treatment
Immediate Referral
Sickle Cell Trait
Genetic defect of hemoglobin resulting in sickle-shaped red blood cells
Exertional Sickling
most common when exercise is high intensity and has short or small amounts of recovery between drills
Sickle Cell Trait S&S
- muscle weakness
- intense muscle pain/cramping
- rapid breathing, but normal pulmonary exam
- athlete “slumps” to ground
Sickle Cell Trait Treatment
- Stop activity and activate EMS
- check vitals
- administer high flow oxygen (non-rebreather)
- cool athlete
- inform HCP at hospital of sickle cell status
Deep Vein Thrombosis
occurs when a blood clot becomes lodged in a vein (leading to venous block)
Deep Vein Thrombosis S&S
- throbbing/cramping pain
- limb swelling and edema
- limb redness/discoloration
- hard or “cauliflower veins”
- veins TTP
- (+) homan’s sign
Deep Vein Thrombosis Treatment
- Immediate Referral
- avoid applying pressure
- no activity or treatment
- watch for S&S of pulmonary embolism
Pulmonary Embolism
Blood clots block the pulmonary blood vessels
Pulmonary Embolism S&S Red Flags
- dyspnea
- chest pain
- history of symptoms
- recent travel/prolonged sitting
- fatigue
- exercise intolerance
- hemoptysis (coughing blood)
Pulmonary Embolism Treatment
- immediate referral
- 3 months of anticoagulation meds
- temporary removal from activity while being treated
Anemia
Decreased RBC or hemoglobin
Anemia S&S
- fatigue
- dizziness
- headache
- decreased performance
- tachycardia
- dyspnea
- tachypnea
- pallor
- craving crunchy foods
- bruise easily
Anemia Treatment
- refer
- participate as tolerated
- lifestyle adjustments
