Cardiomyopathy to valvular disease

Question 1

Cardiomyopathy is _____ (what kind of problem)

how is it divided

Answer 1

is a heart muscle disorder

there are primary and secondary forms

Question 2

cardiomyopathy types

Answer 2

hypertrophic
dilated/congestive
restrictive

Question 3

what is hypertrophic cardiomyopathy
what happens
primary or secondary

Answer 3

primary
excessive hypertrophy of ventricle
thick IV septum

Question 4

etiology of hypertrophic cardiomyopathy

Answer 4

genetic (50% of cases) transmission is autosomal dominant

• idiopathic (50%)
• systolic fx is usually normal and therefore it can be asymptomatic (CO is normal)

Question 5

from Fig 24-15 what can hypertrophic cardiomyopathy do to blood flow in heart

Answer 5

a thickened IV causes intermittent L ventricular outflow obstruction

Question 6

mfts of hypertrophic cardiomyopathy

Answer 6

-dyspnea, angina, syncope (fainting d/t lack of blood flow to brain), palpitations
sudden death?

Question 7

tx of hypertrophic cardiomyopathy

Answer 7

negative inotrope
(the IV is often so thck that drugs may not help. May use sx to thin IV septum)
a negative inotrope is a drug that dec myocardial activity eg beta blocker, calcium channel blocker)

Question 8

Dilated/congestive cardiomyopathy

Answer 8

• cardiac enlargement especially ventricles
• weak contractions-> decreased ejection fraction (ejection fraction is expressed n percent and it describes the amount of the blood in the heart that is being pumped out with each beat?)
• alcohol abuse is implicated

Question 9

restrictive cardiomyopathy

Answer 9

least common type

• very rigid V walls
• incomplete V filling-> dec CO
• usually leads to CHF

think its like the elastic band is now made of wire

Question 10

electrical signal through heart

Answer 10

SA node->Av node->bundle of His->L and R bundle branches and L nterior fascicle for mitral

Question 11

which part of heart is pacemaker

Answer 11

SA node

Question 12

what type of cells are transmit the elctricity int he heart

Answer 12

specialized cardiac muscle cells

Question 13

Arrythmias

• what are they
• what do they change/affect

Answer 13

• abnormal heart rate and or rhythm
• alters cardiac cycle (filling/emptying)
  
  • CO and perfusion are affected

Question 14

do arrythmias take place in diseased hearts only

Answer 14

no. can be in normal heart too

Question 15

et of arrythmias

Answer 15

• heart defects (congenital)
• myocardial ischemia
• myocardial infarction
• drugs (particularly stimulants)
• fluid-electrolyte imbalances

Question 16

atrial fibrillation vs flutter which is more problematic

what is worse than either of these

Answer 16

atrial fibrillation
worse=heart block
worst=ventricular fibrillation

Question 17

atrial flutter

Answer 17

• regular, atrial tachycardia (~300BPM)
• regular, ventricular tachycardia (~150BPM)
• usually 2:1 ratio (A:V)

Question 18

atrial fibrillation

Answer 18

• irreg, chaotic contractions (400-600BPM)

- irreg, rapid Ventricular rate (~80-180BPM it ould be the normal rate but will be irreg)

Question 19

Heart block

Answer 19

(not the flow of blood)

-abnormal or no impulse conduction for atrium to ventricles

Question 20

1st, 2nd, 3rd degree heart block

Answer 20

1st degree=delayed conduction, reg rhythms

2nd degree hert block=intermittent failure of conduction

3rd degree-no conduction, independent Atria rate & Ventricular rate (they are still contracting despite lack of rhythm)

Question 21

Ventricular fibrillation

Answer 21

quivering, no contraction
can cause death in minutes
(neither filing nor empyting)

Question 22

Tx of arrythmias

Answer 22

based on type

• drugs eg beta blockers and calcium channel blockers
• defibrillation-(apply electrical current to chest wall which terminates all electrical activity in heart then, stop shocking and wait for SA to resume pacemaking)
• pacemakers
• ablation (not always indicated

Question 23

Valvular disease refers to which valves

Answer 23

the cardiac valves

Question 24

valvular disease

what hapens and why?

Answer 24

(either the valve opens when it shouldnt or doesnt open adequately)

damaged valves->impeded flow or regurgitation
-aortic and mitral valves are more susceptible WHY?
(mitral valve must work hardest and L semilunar to push blood into systemic circuit.)

Question 25

Et of valvular disease

Answer 25

• valve trauma
• degenerative change
• ischemic damage
• congenital defects

Question 26

what is stenosis?

Answer 26

the abnormal narrowing of a passage in the body.

Question 27

stenosis in r/t valvular disease

Answer 27

the valve will either have stenosis and be too narrow or it will be incompetent and not close well enough

• stenosis
  
  • stiff valve, narrow orifice->impeded flow

Question 28

incompetent valve

Answer 28

-distorted valves->improper closure->regurgitation

Question 29

which valve is most commonly affected by stenosis or incompetence?

Answer 29

mitral

Question 30

Tx of valvular disease

Answer 30

maintain/improve fx using drugs

-sx? (in many cases its nec. damaged valve is replaced)

Question 31

how can hypertrophic cardiomyopathy be asymptomatic

Answer 31

systolic fx is usually normal

Question 32

how are atrial flutter and fibrillation different other than the inc heart BPM

Answer 32

flutter has regular beat