cardio p 296 - 300 Flashcards
what path is associated with systolic regurgitation murmur, balloon appearance of heart on CXR?
dilated cardiomyopahty
what is the path that is associated with hypertrophic cardiomyopathy, muscle weakness, loss of DTR, vibratory sense, and proprioception?
Friedreich ataxia
define kussmaul sign
inc JVP on inspiration instead of a normal dec
explain the mech of kussmaul sign
during inspiration –> negative intrathoracic pressure is not transmitted to the heart –> impaired filling of the Rt. ventricle –> blood backs up into vena cava and inc JVD during inspriation
name 3 paths associated with kusmmaul sign
- constrictive pericarditis
- restrictive cardiomyopathies
- Rt atrial/ventricular tumors
what is the most common cardiac tumor in child?
rhabdomyomas (associated with tuberous sclerosis)
what path is associated with “multiple tumor plop” sound?
myxomas
90% of the myxoma takes place in
Lt. atrium
what kind of obstruction is seen in myxoma?
ball valve obstruction (pedunculated mass) in the Lt. atrium
what is the most common heart tumor?
metastasis
what particular structure is disrupted in 3’ syphilis?
vasa vasorum
what mutation is associated with hypertrophic cardiomyopathy?
beta myosin heavy-chain mutation
what is the main cause of death in hypertrophic cardiomyopathy?
ventricular arrhythmia
in hypertrophic cardiomyopathy, what leads to the outflow obstruction?
asymmetric septal hypertrophy and systolic motion of mitral valve
symptoms of hypertrophic cardiomyopathy?
syncope, dyspnea
what type of hypertrophy do you see in dilated cardiomyopathy?
eccentric
name all the etiologies for dilated cardiomyopathy?
alcohol wet beriberi coxsackie B virus myocarditis cocaine chagas doxorubicin hemochromatosis sarcoidosis peripartum cardiomyopathy
what is the name of the path associated with endomyocardial fibrosis with a prominent eosinophilic infiltrate in restrictive cardiomyopathy?
Loffler syndrome
what is the characteristic of ECG for restrictive/infiltrative cardiomyopathy?
low voltage ECG despite thick myocardium
name 4 causes for restrictive/infiltrative cardiomyopathy
- sarcoidosis
- amyloidosis
- postradiation fibrosis
- endocardial fibroelastosis (thick fibroelastic tissue in endocardium of young children)
what treatment of HF improves both symptoms and mortality?
hydralazine with nitrate
what treatment of HF is used for symptomatic relief?
thiazide/loop diuretics
the diff btw systolic vs diastolic dysfunction?
EF is reduced in sysotlic (normal is diastolic)
EDV is inc in systolic (normal in diastolic)
what is the 1st sign of shock?
tachycardia
symptoms of systemic inflammatory response syndrome?
fever/hypothermia, tachycardia, tachypnea, leukocytosis/leukopenia
most likely culture neg bacterial endocarditis?
Coxiella burnetii, Bartonella spp and HACEK
name examples of nonbacterial endocarditis
marantic/thrombotic secondary to malignancy, hypercoagulable state, lupus
what is the early/late lesion of rheumatic fever?
early: mitral valve regurge
late: mitral stenosis
treatment/prophylaxis for rheumatic fever?
penicillin
explain anitschkow cells
“activated histiocyte” enlarged macrophages with ovoid, wavy, rod-like nucleus
what is the order of the most affected valve to the least affected valve in rheumatic fever?
mitral > aortic»_space; tricuspid (high pressure valve is affected most)
what are the ECG changes in acute pericarditis?
widespread ST segment, T wave inversion, ST elevation, PR depression
name all the causes for acute pericarditis?
- idiopathic (most common, presumed viral)
- confirmed infection (coxsackievirus)
- neoplasia
- autoimmune (SLE, rheumatoid arthritis)
- uremia
- cardiovascular (acute STEMI, Dressler)
- radiation therapy
what is the characteristics of pain in acute pericarditis?
sharp pain, aggravated by inspiration, relieved by sitting up
