Cardiac Structure Flashcards by Alicen Honner

PRIMARY CARDIOMYOPATHY:
hypertrophic cardiomyopathy:
Patho: (1)
Cause: (4)
Complications: (3)
Manifestations: (5)

P: autosomal dominant disease caused by mutations in genes for encoding proteins of cardiac sarcomeres

C: LV hypertrophy and thickening of interventricular septum, abnormal diastolic filling, cardiac arrhythmias, intermittent LV outflow obstruction

comp: a fib, stroke, heart failure

m: dyspnea, chest pain w activity, exercise intolerance, syncope, arrhythmias

How well did you know this?

Not at all

Perfectly

in LV hypertrophy, walls get too thick and they can’t _______ which ________ CO and stroke vol

contract
decreases

How well did you know this?

Not at all

Perfectly

what is the common cause when athletes suddenly die?

intermittent LV outflow obstruction

How well did you know this?

Not at all

Perfectly

why is heart failure a complication of hypertrophic cardiomyopathy?

LV become enlarged and get tired, so they can’t pump out blood efficiently

How well did you know this?

Not at all

Perfectly

PRIMARY CARDIOMYOPATHY:
dilated cardiomyopathy:
Patho: (3)
Cause: (7)
Manifestations: (2)

C: genetic, acquired, toxins, alcohol, medications, disorders, idiopathic

P: 4 chambers and heart become “floppy” with thin walls due to dilation –> increased cardiac mass –> decrease in systolic function, increased cardiac workload

m: heart failure with dysrhythmia, thrombus formation

How well did you know this?

Not at all

Perfectly

stagnant blood flow = risk for

blood clots

How well did you know this?

Not at all

Perfectly

what heart disease?
big bucket with no strength that causes blood to pool in all chambers

dilated hypertrophy

How well did you know this?

Not at all

Perfectly

PRIMARY CARDIOMYOPATHY:
restricitve cardiomyopathy:
Patho: (2)
Cause: (1)
Manifestations: (7)

P: Ventricular filling is restricted by excess rigidity of ventricular walls

C: genetics or disease (amyloidosis, sarcoidosis, metastatic tumors)

M: dyspnea, orthopnea, hepatomegaly, peripheral edema, ascites, fatigue, weakness

How well did you know this?

Not at all

Perfectly

what heart condition?

ventricular walls are so stiff that they can’t squeeze and push blood out and blood gets backed up

ex) slow barista in starbs

Restrictive cardiomyopathy

How well did you know this?

Not at all

Perfectly

what are secondary cardiomyopathies?

heart muscle disease in the presence of multisystem disorder

How well did you know this?

Not at all

Perfectly

examples of secondary cardiomyopathy (4)

autoimmune (lupus)
Endocrine (DM)
neuromuscular (neurofibromatosis)
toxins (cancer chemo drugs)

How well did you know this?

Not at all

Perfectly

DISORDERS OF PERICARDIUM: Acute pericarditis
?: (1)
E: (4)
P: (4 aspects)
M: (3)

?: inflammatory process of pericardium

E: microorganisms, complications of disease, heart trauma, surgery

P: inflammation occurs on pericardial membrane –> inflammatory response (VD, cap perm, WBC) –> plasma proteins cross mem into pericardium –> exudate formation or pericardial effusion

M: Pericardial friction rub, chest discomfort, EKG changes

How well did you know this?

Not at all

Perfectly

DISORDERS OF PERICARDIUM: pericardial effusion
E: (6)
P: (1)
gradual manifestations: (5)
rapid manifestations: (8)

E: inflammatory process, trauma, neoplasma, cardiac surgeries, cardiac rupture d/t MI, dissecting aortic aneurysm

P: fluid accumulation in the pericardial cavity (rapid = cardiac tamponade)

gradual M: CP, SOB, inc RR, cough, fatigue

rapid M: CP, SOB, inc HR, hypotension, muffled heart sounds, systemic: dizzy, confused, fatigue

How well did you know this?

Not at all

Perfectly

DISORDERS of ENDOCARDIUM:
infective endocarditis
?:
E: (10)
P: (1)
Acute vs subacute-chronic

?: inflammation/infection of endocardium

E: bacterial (most common), mitral valve prolapse, congenital heart disease, prosthetic heart valves, implantable devices, neutropenia, immunodeficiency therapeutic immunosuppression, diabetes, IV drug use, ETOH

P: endocardial damage –> inflammatory response

How well did you know this?

Not at all

Perfectly

DISORDERS of ENDOCARDIUM:
ineffective endocarditis

Acute vs subacute-chronic

acute: rapid, no previous issues, IV drug users, sepsis, foley infection

subacute: months, worsens a pre-existing issues, surgery (dental!)

How well did you know this?

Not at all

Perfectly

what heart disease?

most often involves heart ______ causing bulky ________ to form = destruction of cardiac _______

ineffective endocarditis

valves
vegetations
tissues

How well did you know this?

Not at all

Perfectly

DISORDERS of ENDOCARDIUM: rheumatic fever
E: (1)
P: (6 aspects)
M: (4)

E: complication of the immune-mediated response to a group A strep throat infection

P: Delayed systematic autoimmune reaction to previous strep throat –> abnormal, exaggerated response to the infection by immune system –> ABx formation and inflammation –> autoimmune response –> may progress to rheumatic heart disease –> inflammation and scarring of myocardial tissue

M: signs of infection, polyarthritis/painful joints, acute rheumatic carditis, erythema imagination

How well did you know this?

Not at all

Perfectly

what heart disease?
overreaction to strep throat

rheumatic fever

How well did you know this?

Not at all

Perfectly

DISORDERS of ENDOCARDIUM: rheumatic fever PATHOphysiology:

Delayed systematic _________ reaction to previous strep throat –> abnormal, ________ response to the infection by immune system –> ______ formation and inflammation –> autoimmune response –> may progress to _______ heart disease –> inflammation and scarring of myocardial tissue

autoimmune
exaggerated
antibiotic
rheumatic

How well did you know this?

Not at all

Perfectly

what heart disease?

tell tale sign is erythema margination

rheumatic fever

How well did you know this?

Not at all

Perfectly

DISORDERS of ENDOCARDIUM: rheumatic fever

S/S of acute rheumatic carditis (5)

CP
tachycardia (comp mech)
muffled heart sounds
pericardial effusion (inflammatory response)

DISORDERS OF PERICARDIUM: Acute pericarditis PATHO

inflammation occurs on __________ membrane –> inflammatory response (___, ___ ____, ____) –> plasma ______ cross mem into pericardium –> _______ formation or pericardial effusion

pericardial
VD, cap perm, WBC
proteins
exudate

DISORDERS of ENDOCARDIUM:
kawasaki disease
?:
E:
P:
M:

?: acute vasulitis

E: kids under 5, acquired heart disease, immunologic in nature

P: inflammation of small vessels (can progress to larger)

M: conjunctivitis, lymphadenopathy, peripheral edema, rash, lethargy, high fever, red lips, aneurysm formation, dilated coronary a

CRASH and Burn for _______ diease

kawasaki

conjuctivits
rash
adenopathy
strawberry tongue
hands + feet swelling
burn (5 days of HIGH fever)

what are the 3 phases of Kawasaki and their time frame?

Acute: abrupt onset, 104 + fever for 5 days, lymphadenopathy, red swollen hands/feet, conjunctivitis, Subacute: after fever ends until all S/S disappear, sloughing of hands/feet Convalescent: subacute to resolution and inflammation disappears (8 wks)

2 examples of valvular heart disease

stenosis regurgitation

what is the most common etiology of valvular heart disease?

acquired

what is stenosis?

narrowing/constriction preventing proper opening

what is regurgitation?

insufficient valve closure

valular heart disease can happen with any valve but usually ... (2)

mitral aortic

MITRAL STENOSIS: Patho: (3 aspects) Effects: (3 aspects) Manifestations: (3)

P: mitral valve stiffens --> incomplete opening during diastole --> left arterial blood unable to flow to LV E: increased left arterial pressure --> left atrial dilation (as blood collects) --> pulmonary congestion M: signs of left heart failure, a fib --> thrombus formation

AORTIC STENOSIS Patho: (4 aspects) Effects: (3 aspects) Manifestations: (5)

P: stiff/narrow aortic valve --> resistance to blood flow from LV to aorta --> gradual, LV can adapt --> over time LV hypertrophy occurs E: increased systolic pressure --> LV hypertrophy --> dec CO eventually M: murmur, exertional dyspnea, angina, syncope, heart failure

MITRAL REGURGITATION Patho: (2 aspects) Effects: (4 aspects) Manifestations: (3)

P: incomplete valve closure --> blood moves in both directions in the left ventricle during systole E: mitral regurg gradually --> LA enlarges (comp mech) --> decreased filling to LV causing hypertrophy --> pulmonary congestion M: a fib, murmur, signs of pulmonary congestion

AORTIC REGURGITATION Patho: (3 aspects) Acute effects: (3 aspects) Chronic effects: (2) Manifestations: (2) late M: (2)

P: incompetent aortic valve --> during systole, blood flows back into LV --> LV vol inc Acute E: no time for LV to adapt --> increased LV pressure in LA and pulmonary veins --> pulmonary edema Chronic E: LV adapts by enlarging and increasing stroke vol M: Asymptomatic early, murmur Late M: signs of LV failure, wide pulse pressure (high systole d/t inc stroke vol and low diastole)

what is the most common valve disorder in the US?

mitral valve prolapse

S/S of left sided heart failure (14)

restlessness confusion orthopnea tachycardia external dyspnea fatigue cyanosis pulmonary congestion: cough, crackles, wheezes, blood-tinged sputum, tachypnea

MITRAL VALVE PROLAPSE Etiology: (1) Patho: (5 aspects)

E: genetics P: Degeneration of mitral valve leaflets --> ballooning of one or both into LA --> stress on chordae and papillary m --> rupture --> mitral regurg

what is CONGENITAL HEART DISEASE?

abnormality of structure of function of heart, circulatory system or both resulting in shunting, an obstructive defect or both

What is the genetic etiology of congenital heart disease?

1 in 125 infants if 1 kid has, next kids are 4-5x @ risk

what are environemntal causes of congenital heart disease? (5)

infections, drugs, alcohol, old, hptn

areas of concern for congenital heart disease (3)

anatomic defects hemodynamic alterations pulmonary blood flow and tissue oxygenation

Defects with increased pulmonary blood flow --> ________ defects

acyanotic

CONGENITAL HEART DISEASE: patent ductus arteriosus (PDA) opening between .... Failure of ______ ______ to close by 3 months after birth blood shunts from higher pressure ( _____ side/_____) to lower pressure (______ side/_________)

aorta and pulmonary ductus arteriosis left/aorta right/pulmonary

CONGENITAL HEART DISEASE: atrial septal defect (ASD) improper septal formation --> failure of _______ septum to close blood flows from high ( ___) to low (____) patent ____ ____ (PFO)

atrial LA --> RA foramen ovale

CONGENITAL HEART DISEASE: Ventricular septal defect (VSD) failure of _______ spetum to close small shunt --> blood flows from high/ ___ to low/ ____ large shunt --> R and L ventricular pressures _______ *amount of shunting is determined by the ratio of pulmonary to ________ vascular __________

ventiruclar LV --> RV equalize systemic, resistance

Defects with decreased pulmonary blood flow --> ________ defects

cyanotic

what are the 4 defects that make up tetralogy of fallot

Pulmonary outflow obstruction Hypertrophy of RV ventricular septal defect Displacement of aortic root to the right

CONGENITAL HEART DISEASE: mixing defect __________ of the great vessels ____ week of gestation: common truncus arteriosus divides into the pulmonary artery and ______ pulmonary artery arises from the ___ while the aorta branches off the ____ usually have ASD, VSD or ____ for blood mixing

transportation 4th, aorta PDA

what congenital heart defect is not compatible with life because the heart has 2 closed systems?

mixing defect

CONGENITAL HEART DISEASE: Obstructive congenital heart defect increased intra-chamber/ ___________ pressure __________ of the aorta (aorta develops improperly at 5th-__th week of gestation) localized _________ of the aorta --> restriction of blood flow _____ to the defect increased BP ________ to the defect (head and upper extremities) decreased BP ________ to the defect (torso and lower extremities) manifestations: (4)

intravascular coarctation, 7th proximal distal lower extremity cyanosis, cool/weak pulses, pain with activity, facial and upper extremity flushing