Cardio17

Question 1

What are the clinical symptoms and signs of Congestive Heart Failure?

Answer 1

Dyspnea
Fatigue
Edema
Rales

Question 2

What is the most common cause of Right-sided heart failure?

Answer 2

Left-sided heart failure

Question 3

What is Isolated Right-sided heart failure usually caused by?

Answer 3

Cor Pulmonale

Question 4

What is the cause of cardiac dilation?

Answer 4

Greater Ventricular End-Diastolic volume

Question 5

What is the cause of Dyspnea on Exertion?

Answer 5

Failure of Cardiac Output to INcrease during exercise

Question 6

WHat causes Pulmonary edema & paroxysmal dyspnea (left-heart failure)?

Answer 6

1-INcreased pulmonary venous pressure

2-Pulmonary venous distention and transudation of fluid

Question 7

What is found in the lungs in pulmonary edema and paroxysmal nocturnal dyspnea?

Answer 7

Hemosiderin-laden macrophages

*“heart-failure” cells

Question 8

What is Orthopnea?

Answer 8

Shortness of breath when supine

Question 9

What causes orthopnea?

Answer 9

INcreased venous return in supine position exacerbates pulmonary vascular congestion

Question 10

Hepatomegaly, peripheral edema, and jugular venous distention are all associated with what?

Answer 10

Right-sided Heart Failure

Question 11

What causes hepatosplenomegaly?

Answer 11

1-INcreased venous pressure
2-INcreased Resistance to Portal Flow

*rarely leads to “cardiac cirrhosis”

Question 12

How does acute pericarditis commonly present?

Answer 12

Sharp pain - aggravated by INSPIRATION
RELIEVED by Sitting Up and Leaning Forward

*Friction rub

Question 13

What are the ECG changes seen on acute pericarditis?

Answer 13

Widespread ST Elevation and/or PR Depression

Question 14

What are the 3 types of acute pericarditis?

Answer 14

Fibrinous
Serous
Suppurative/purulent

Question 15

What causes fibrinous pericarditis?

Answer 15

Dressler’s syndrome
Uremia
Radiation

*presents with LOUD friction fub

Question 16

What causes serous pericarditis?

Answer 16

Viral (often resolves spontaneously)

Noninfectious inflammatory diseases (e.g., RA, SLE)

Question 17

What causes Cardiac Tamponade?

Answer 17

Compression of heart by fluid (e.g., blood, effusions) in pericardium
-leads to DEcreased CO

*Equilibration of diastolic pressures in all 4 chambers

Question 18

What are the findings in Cardiac Tamponade?

Answer 18

Hypotension
INcreased Venous pressure
Distant heart sounds
INcreased HR
Pulsus paradoxus

Question 19

What is Pulsus Paradoxus?

Answer 19

-DEcreased amplitude of systolic blood pressure by ≥ 10 mmHg during Inspiration

Question 20

What conditions do you Pulsus Paradoxus?

Answer 20

• Severe cardiac tamponade
• Asthma
• Obstructive Sleep apnea
• Pericarditis
• Croup

Question 21

What is syphilitic heart disease?

Answer 21

3˚ syphilis disrupts the Vasa Vasorum of the AORTA

• Atrophy of the vessel wall
• Dilation of Aorta and Valve ring

Question 22

What are the pathologic findings of syphilitic heart disease?

Answer 22

Calcifications of the Aortic Root & Ascending Aortic Arch

-Leads to “TREE BARK” appearance of the Aorta

Question 23

What is the most common primary cardiac tumor in adults?

Answer 23

Myxoma (amorphous extracellular matrix)

Question 24

What is the most frequent primary cardiac tumor in children?

Answer 24

Rhabdomyomas

Question 25

Where are myxomas typically found?

Answer 25

Left atrium

Question 26

What are myxomas typically associated with?

Answer 26

Multiple syncopal episodes

Question 27

What are Rhabdomyomas associated with?

Answer 27

Tuberous Sclerosis

Question 28

What is the most common heart tumor?

Answer 28

Metastasis

Question 29

Where do heart tumors Mets from?

Answer 29

Melanoma

Lymphoma

Question 30

What happens to Jugular Venous Pressure normally during Inspiration?

Answer 30

DEcreases

Question 31

What is it called when you see an INcrease in JVP on inspiration instead of the normal DEcrease?

Answer 31

Kussmaul’s sign

Question 32

What is the pathophysiology of Kussmaul’s sign?

Answer 32

1-Inspiration 
2-Negative Intrathoracic pressure not transmitted to heart
3-Impaired filling of Right Ventricle
4-Blood backs up into Venae Cavae
5-Jugular Venous Distention (JVD)

Question 33

What conditions can you see Kussmaul’s sign?

Answer 33

Constrictive pericarditis
Restrictive cardiomyopathies
Right Atrial or Ventricular tumors
Cardiac tamponade