Cardiac Pathologies Flashcards
causes of valve abnormalities
rheumatic fever viral infn calcification weak papillary muscles or chordea tendineae for AV valves ischemic heart disease
mitral stenosis
what happens to BPs?
narrowing of mitral valve LA= increase LV sys= decrease LV dia= decrease Aorta= decrease
mitral regurgitation
what happens to BPs?
blood flows back into LA LA= increase LV sys= decrease LV dia= increase aorta= decrease
aortic stenosis
what happens to BPs?
narrowing of the aortic valve LA= increase LV sys= increase LV dia= increase Aorta= decrease
TAVR
transcatheter aortic valve replacement
treatment for aortic stenosis
aortic regurg
what happens to BPs?
regurg back into LV from aorta LA= increase LV sys= increase LV dia= increase aorta sys= increase aorta dia= decrease
what happens to the pulse pressure with aortic regurg?
wide pulse pressure
possible symptoms of valvular abnormalities (8)
decrease exercise tolerance dizziness/ short of breath ventricular hypertrophy ventricular dilation atrial and ventricular arrhythmias decreased CO pulmonary edema HF
what causes ventricular hypertrophy
high afterload
what causes ventricular dilation
high preload
when would you hear the aortic stenosis murmur?
ventricular systole
when would you hear the aortic regurg murmur?
ventricular diastole
when would you hear mitral valve regurg murmur?
ventricular systole
when would you hear mitral valve stenosis murmur?
ventricular diastole
dilated cardiomyopathy cause
virus pericarditis toxins MI volume overload cocaine autoimmune
why is dilated cardiomyopathy bad?
weaked portion of heart
low EF
increased diastolic and systolic volumes
leads to HF and arrhythmias
cardiac hypertrophy
concentric hypertrophy (growing inward)
lower filling volume
weaker muscle per cross sectional area
what are the two ways that hypertrophy muscles are weaker?
decreased ability to handle calcium
shift in myosin isoform type
physiological hypertrophy
heart chamber can grow outward
exercise is cause
increases CO
MI
myocardial infarction
heart attack
damage or death of heart muscle
3 MI causes
blood clots in coronary circulation
LDL/cholesterol/plaques
coronary artery dissection
can myocardium regenerate well?
no
just leaves scar tissue
what labs can you run to tell someone had an MI?
troponin T and troponin I the cardiac ones
coronary artery dissection
when the endothelium cracks and then blood fills between endo and muscle and occludes the vessel
what happens immediately after MI on EKG?
Vfib
causes of HF
severe valve disease
pathological hypertrophy
dilated cardiomyopathy
MI
2 problems of HF
CO decreases
cant supply organs with blood
systolic HF (HFrEF)
HF with reduced EF
SV is low
dilation “volume overload”
diastolic HF (HFpEF)
HF with preserved EF
SV and EDV is low
pathological hypertrophy “pressure overload”
aortic regurg
dilation or hypertrophy?
dilation
aortic stenosis
dilation or hypertrophy?
hypertrophy
mitral regurg
dilation or hypertrophy?
dilation
mitral stenosis
dilation or hypertrophy?
neither
changes in cardiac myocytes with HF
release BNP/ANP lower contractility Calcium channels dont work right anymore decreased SERCA increased Na/Ca exchanger decreased RyR2
what can HF do to action potential
longer AP
altered refractory periods
bodys compensation during mild HF
sympathetics to increase CO
RAAS to increase BP
what to treat mild HF?
beta block and antihypertensive
chronic (decompensated) HF
blood backs up in circulation
fluid build up
cardiogenic shock
what are the 4 things that fluid build up in HF can do?
pulmonary edma
systemic edema
dyspnea
fatigue
what would be a good treatment for HF?
dobutamine
are the treatments for HFrEF and HFpEF the same?
yes
circulatory shock
severe circulatory failure
inadequate BF through body
cant supply tissues with oxygen
what are the 4 types of circulatory shock?
hypovolemic
cardiogenic
vasogenic (septic, anaphylactic)
neurogenic
hypovolemic shock
low blood volume
decrease preload
decrease CO
what are the compensatory mechanism for hypovolemic shock?
baroreceptor reflex
chemoreceptor reflex
increase in RAAS
cardiogenic shock
reduction of CO caused by inability of heart to pump blood
3 causes of cardiogenic shock
mI
cardiomyopathy
arrhythmias
symptom of cardiogenic shock
pulmonary edema
what are the 4 common drugs used for short term treatment of HF?
digoxin
dobutamine
milrinone
levosimendan
septic shock
whole body inflammatory response due to system wide infxn
limited treatment
what is septic shock commonly spread from?
GI rupture
UTI
skin strep or staph infxn
pulmonary infxn
what is the treatment for septic shock?
Ang II
anaphylactic shock
MABP drops
histamine release
vadodilation
increased capillary permeability
neurogenic shock
loss of vasomotor tone (massive dilation)
lose pressure and reduces preload
what are the causes of neurogenic shock
general anesthesia
spinal anesthesia
spinal cord damange
brain damage
which two types of shock effect the CO?
hypovolemic
cardiogenic
what two types of shock effect the vascular resistance?
vasogenic (septic, anaphylactic)
neuorgenic
what type of loop is shock?
postive feedback loop
until tissue death
