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Clin Med III > Cardiac Pathologies > Flashcards

Cardiac Pathologies Flashcards

1
Q

What is a myocardial infarction (MI)?

A

ischemic event that might result in injury or irreversible tissue death of myocardium

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2
Q

What are the definitive signs and symptoms of MI?

A
  • initial ECG changes of S-T segment elevation, inverted T-wave, & significant Q wave
  • signs of cardiac insufficiency
  • elevation of cardiac enzymes
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3
Q

How is MI diagnosed or what is called ruled in (R/I) or ruled out (R/O)?

A

must have 2/3 signs of MI

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4
Q

What is the zone of ischemia?

A

Tissue is viable & may not have any damage if infant doesn’t extend

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5
Q

what is zone of injury?

A

viable as long as O2 delivery stays intact. increasing O2 delivery can save this tissue

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6
Q

what is zone of infarct?

A

tissue is O2 deprived & has irreversible damage

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7
Q

what are the cardiac enzymes that will elevate in instance of MI?

A
  • CPK - MB
  • Troponin
  • LDH-1
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8
Q

when will the cardiac enzyme CPK-MB elevate?

A

0-24 hours

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9
Q

when will the cardiac enzyme Troponin elevate?

A

12 hrs - 4 days

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10
Q

What should be examined in regards to the cardiac enzyme LDH-1?

A

Ratio LDH-1:LDH-2 greater than 1 suggest MI

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11
Q

When an MI is transmural what deficits are seen?

A

most wall motion deficits

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12
Q

A transmural MI can be either:
- Hypokinetic
- Dyskinetic
- Akinetic
What is the definition of all 3?

A
  • Hypokinetic: decreased wall motion
  • Dyskinetic: unorganized wall motion
  • Akinetic: absent wall motion
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13
Q

what is a subendocardial MI?

A

partial thickness infarct

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14
Q

What is the wall motion and EKG changes with a subendocardial MI?

A
  • Wall motion: may appear normal
  • EKG: less changes than transmural
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15
Q

What is cardiomyopathy?

A

disease where contraction & relaxation of cardiac muscles are impaired

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16
Q

Cardiomyopathy may be the result of what 3 things?

A
  • a progression of fibrous invasion of the cardiac tissue as a result of MI or systemic collagen disorder
  • immune dysfunction or unknown (idiopathic) etiology
  • secondary to problems in neurotransmission
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17
Q

What are the 3 basic types of cardiomyopathy?

A
  • dilated cardiomyopathy
  • hypertrophy
  • restrictive
18
Q

What is dilated cardiomyopathy?

A
  • similar to an aneurysm
  • heart wall motion is floppy therefore decreased EF
19
Q

What hypertrophy cardiomyopathy?

A
  • hyper- contractile left ventricle meaning an increased myocardial O2 demand so rapid ventricular emptying
  • decreased EF
20
Q

What is restrictive cardiomyopathy?

A

endocardial scarring which restricts heart wall dissension which decreases EF

21
Q

what can right sided CHF be caused by?

A
  • pulmonary HTN
  • right vent infarct
22
Q

what is right sided CHF initially seen as?

A
  • systemic edema with fluid accumulation in the abdomen (ascitis)
  • liver
  • legs
23
Q

what are the sings and symptoms of right CHF?

A
  • primary sign is LE edema
  • watch for weight gain (3-5 lbs in 1-2 days)
  • JVD (jugular vein distension)
24
Q

What can left sided CHF be caused by?

A

resistance from systemic HTN, MV, or LV dysfunction secondary to cardiomyopathy or infarct

25
Q

what is left sided CHF initially seen as?

A

pulmonary edema

26
Q

what are the signs/ symptoms of left CHF?

A
  • primary symptom is dyspnea
  • Others: tachypnea, lung or mouth crackles, orthopnea
27
Q

T/F: Eventually both sides of the heart will become involved with CHF

A

True by a retrograde progression

28
Q

What are the signs that may indicate right or left CHF?

A
  • pulmonary edema
  • weight gain
  • S3 heart sound
  • tachycardia
  • decreased activity tolerance
29
Q

describe NYHA I classification

A
  • no limitation of physical activity
  • ordinary physical activity does not undue fatigue, palpation or shortness of breath
30
Q

describe NYHA II classification

A
  • slight limitation of physical activity
  • comfortable at rest
  • ordinary physical activity results in fatigue, palpitation, SOB or chest pain
31
Q

describe NYHA III classification

A
  • marked limitation of physical activity
  • comfortable at rest
  • less than ordinary activity causes fatigue, palpitation, SOB or chest pain
32
Q

describe NYHA IV classification

A
  • symptoms of heart failure at rest
  • any physical activity causes further discomfort
33
Q

what is the concern of cardiac output in regards to CHF?

A

low CO is primary concern of R & L CHF

34
Q

How does the cardiopulmonary system respond to low cardiac output?

A
  • retain fluid
  • vasoconstriction to maintain BP
  • increase stroke force
  • increase HR
  • Results is that increased demands, which are counter-productive are placed on an already failing system
35
Q

medical intervention for CHF is needed to control and reduce what?

A
  • Control: stroke force
  • Reduce: vascular pressure & excess fluid to decrease workload on heart
36
Q

what is the pulmonary impact of CHF?

A
  • heart & lungs are intimately involved in the process of O2 transfer & CO2 elimination
  • any significant chronic or acute pulmonary problem would eventually put a strain on the heart
37
Q

why is hypertrophy of the left ventricular wall a concern when chronic left-sided heart failure is present?

A

the left ventricle has the largest cardiac muscle mass with subsequently high Os consumption needs, making it increasingly vulnerable to ischemic attack

38
Q

what are the peripheral changes with CHF in regards to:
- muscle fiber change:
- Skeletal muscle

A
  • muscle fiber change: decreased type I fibers so decrease endurance
  • skeletal muscle atrophy
  • decrease skeletal muscle blood flow so decreased ability to work
  • impaired skeletal muscle metabolism especially decreased ability to break down O2 for use
39
Q

how does pulmonary edema occur?

A

factors cause fluid to leak from pulmonary & lymphatic systems interstitially and into the alveoli creating a barrier making gas exchange between capillaries & alveoli difficult

40
Q

What happens to the heart with pulmonary edema?

A
  • heart has to work much harder to gain sufficient levels of oxygen
  • O2 levels are affected most because CO2 is more soluble than O2

Clin Med III (5 decks)

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