cardiovascular adult

Question 1

Acute Coronary Syndrome

Answer 1

• Sudden coronary obstruction because of thrombosis formation over a ruptured atherosclerotic plaque

Question 2

Atherosclerosis

Answer 2

• Thickening and hardening caused by the accumulation of lipid-laden macrophages in the arterial wall
• Plaque development

• Symptoms and signs are the result of inadequate perfusion of tissues.

Question 3

Cardiomyopathy

Answer 3

• Any vascular disorder that narrows or occludes the coronary arteries
• Results in an imbalance between coronary supply of blood and myocardial demand for oxygen and nutrients
•

Question 4

Aortic Stenosis

Answer 4

valve narrows, causing diminished blood flow from the left ventricle into the aorta

Clinical manifestations: angina, syncope, and heart failure

Question 5

Mitral Stenosis

Answer 5

Impairment of blood flow from the left atrium to the left ventricle
Most common cause: acute rheumatic fever
Clinical manifestation: opening snap

Question 6

aortic regurgitation

Answer 6

 Inability of aortic valve to close properly during diastole
Clinical manifestations: widened pulse pressure as a result of increased stroke volume and diastolic backflow

Question 7

mitral regurgitation

Answer 7

causes: mitral valve prolapse, rheumatic heart disease, infective endocarditis, MI, connective tissue disease, dilated cardiomyopathy
 Permits backflow of blood from the left ventricle into the left atrium

Question 8

tricuspid regurgitation

Answer 8

 Leads to volume overload in the right atrium and ventricle,
increased systemic venous blood pressure, and right heart failure

Question 9

Mitral valve prolapse syndrome

Answer 9

o Anterior and posterior cusps of the mitral valve billow upward (prolapse) into the atrium during systole

Clinical manifestations: asymptomatic

Question 10

heart failure

Answer 10

• Is a pathophysiologic condition in which the heart is unable to generate adequate cardiac output, resulting in an inadequate perfusion of tissues or an increased diastolic filling pressure of the left ventricle, or both

Question 11

Systolic heart failure

Answer 11

• Inability of the heart to generate adequate cardiac output to perfuse tissues

Clinical manifestations
• Dyspnea, orthopnea, cough of frothy sputum
• Fatigue
• Decreased urine output and edema

Question 12

diastolic heart failure

Answer 12

8• Heart failure with preserved ejection fraction
• Decreased compliance of the left ventricle and abnormal diastolic relaxation (lusitropy)
• Clinical manifestations: dyspnea on exertion and fatigue

Question 13

cardiac output

Answer 13

depends on the heart rate and stroke volume•

Question 14

stroke volume

Answer 14

contractility
preload and
afterload

Question 15

increased Preload

Answer 15

increased when decreased contractility or excess plasma volume is present

Question 16

increased Afterload

Answer 16

Increased afterload is most commonly from increased peripheral vascular resistance

Question 17

right heart failure

Answer 17

• Is the inability of the right ventricle to provide adequate blood flow into the pulmonary circulation

Clinical manifestations
• Jugular venous distension, peripheral edema, hepatosplenomegaly

Question 18

High output failure

Answer 18

• Is the inability of the heart to supply the body with bloodborne nutrients, despite adequate blood volume and normal or elevated myocardial contractility

Common causes
• Anemia, septicemia, hyperthyroidism, and beriberi

Question 19

Infective Endocarditis

Answer 19

• Inflammation of the endocardium from infectious agents
• Most common: bacteria, especially streptococci, staphylococci, and enterococci
Clinical manifestations
• Fever
• New cardiac murmur
• Petechia
• Osler nodes/ Janeway lesions
Weight loss, back pain, night sweats, heart failure, emboli

Question 20

Myocardial Infarction

Answer 20

• Prolonged ischemia causes irreversible damage to the heart muscle (myocyte necrosis).
o Subendocardial infarction
o Transmural infarction
clinical manifestations

Sudden severe chest pain
ECG changes
Troponin I: most specific
(CPK-MB), LDH
Hyperglycemia

Question 21

Myocardial Ischemia

Answer 21

• Develops if the supply of coronary blood cannot meet the demand of the myocardium for oxygen and nutrients

Question 22

stable angina

Answer 22

causes predictable chest pain

Question 23

prinzmetal angina
(varient)

Answer 23

causes unpredictable chest pain

Question 24

Angina pectoris

Answer 24

causes transient substernal chest discomfort