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Cardiovascular Diseases 1 Flashcards

1
Q

Name the three types of primary cardiomyopathy

A

dilated, hypertrophic and restrictive

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2
Q

What is the most common CM and accounts for 25% of heart failure?

A

dilated cardiomyopathy

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3
Q

Describe hearts of dilated CM

A

big heart with thin walls

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4
Q

Describe hearts of hypertrophic CM

A

big heart with thick walls

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5
Q

Which CM is mostly inherited and involves mutations for genes encoding sarcomere proteins?

A

hypertrophic CM

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6
Q

All CM may have – origins

A

familial

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7
Q

What happens to heart tissue during restrictive CM

A

replace cardiac tissue = lose contractile ability

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8
Q

What does functional classification focus on?

A

systolic and diastolic functions change

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9
Q

What is dilated CM associated with?

A

bi-ventricular dilation (or dilated L and squished R) and contractile dysfunction

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10
Q

Name three possible results of dilated CM

A

enlarged heart (cardiomegaly), systolic dysfunction and signs of congestive heart failure

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11
Q

describe the wall thickness of dilated CM

A

normal (but enlarged chambers)

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12
Q

What is systolic failure?

A

bad CO (pumping out blood)

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13
Q

What is hypertrophic CM associated with?

A

L ventricle hypertrophy and thickened interventricular septum

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14
Q

Describe the wall thickness of hypertrophic CM

A

thick walls (but similar chamber size)

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15
Q

Why is hypertrophic CM asymptomatic for many years?

A

late contractile (diastole) dysfunction

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16
Q

What are potential consequences of hypertrophic CM?

A

arrhythmia (irregular heart beat), myocardial ischemia (chest pain), or sudden death

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17
Q

Which CM is least common in western countries?

A

restrictive CM

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18
Q

What is associated with restrictive CM?

A

diastolic dysfunction and sometimes endocardial scarring of ventricles

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19
Q

Where does dilation occur in restrictive CM?

A

bi-atrial then left ventricle

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20
Q

Describe walls in restrictive CM

A

very rigid ventricular walls –> bad diastolic filling (atria can’t empty)

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21
Q

in Amyloidosis: the atria are markedly dilated and the – , normally smooth, has yellow-brown amyloid deposits that give texture to the surface

A

left atrial endocardium

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22
Q

inflammation of myocardium

A

myocarditis

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23
Q

What causes myocarditis?

A

infections, autoimmunity or toxins

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24
Q

Consequences of myocarditis

A

arrhythmia, chest pain and sudden death (similar to hypertrophic CM) + fever

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25
How is myocarditis classified?
by type of inflammatory response
26
What is the most common myocarditis?
lymphocytic
27
What is the origin of lymphocytic myocarditis?
infectious
28
What is the most common mode of lymphocytic myocarditis?
viruses
29
example of bacterial lymphocytic myocarditis
Lyme disease
30
example of parasitic lymphocytic myocarditis
Chagas diseases
31
What kind of treatment could you give a person infected with lymphocytic myocarditis?
antiviral or antibacterial
32
Which myocarditis affects young adults with congestive heart failure and arrhythmias?
giant cell
33
What kind of treatment would you give a person infected with giant cell myocarditis?
immunosuppressant and/or transplantation
34
Which myocarditis is associated with allergy?
eosinophilic
35
The inability of the heart to supply adequate oxygenated blood to meet body’s metabolic needs
congestive heart failure
36
What are causes of abnormal myocardial structure and function?
increase in hemodynamic burden or reduction in myocardial oxygen
37
Describe dysfunction of congestive heart failure
usually both systolic and diastolic
38
Define systolic dysfunction
dilated ventricles and decreased contractility
39
define diastolic dysfunction
normal contractility but decreased myocardial compliance (can't relax)
40
What are consequences of systolic dysfunction?
reduced CO and ejection fraction
41
What are consequences of diastolic dysfunction?
increased diastolic pressure but CO can be normal
42
What is the purpose of adaptive mechanisms?
maintain adequate pumping functions, CO, and adequate perfusion of vital organs
43
Which adaptive mechanism is activated rapidly but continues over a long period of time?
peripheral mechanisms
44
Describe the Frank-Starling relationship
stretch cardiac tissue --> stronger contractions
45
How can you expand volume/stretch cardiac tissue/increase resting muscle length?
retain sodium = retain water = increase preload
46
What kind of adaptive mechanism is the Frank-Starling relationship?
short term
47
What kind of adaptive mechanism is the activation of neurohumoral system?
short term
48
name the two neurohumoral systems
adrenergic | renin-angiotensin-aldosterone
49
What's the function of the adrenergic system?
increases contractility or contraction velocity and heart rate (maintain/improve CO)
50
What's the function of renin-angiotensin-aldosterone system?
helps maintain arterial pressure and tissue perfusion and increases preload
51
give examples of long term adaptive mechanisms
heart chamber dilation | myocardial remodeling/hypertrophy
52
increased radius of (L) ventricle requires -- to generate the same pressure which increases the demand of the heart
greater wall tension
53
What does chronic volume overload lead to?
dilated LV
54
What does chronic pressure overload and high wall tension lead to?
pathological myocardial remodeling (fibrosis in damaged areas)
55
According to the Law of Laplace, in order to reduce wall tension -- increases
wall thickness
56
How do you increase wall thickness?
increase size of individual myocytes and increase overall muscle mass
57
Give examples of hemodynamic consequences of adaptive changes
decreased ejection fraction and CO increased EDV and EDP blood redistribution edema
58
In moderate LV dysfunction compare CO during rest and exercise
normal and unable to increase CO
59
In severe heart failure how is CO affected?
decreased
60
less blood to skeletal muscles -->
anaerobic metabolism and fatigue
61
less blood to kidneys -->
Na and nitrogen retention
62
less blood to liver
liver dysfunction
63
Left sided edema show symptoms --
secondary to pulmonary congestion
64
generalized fluid accumulation characterizes --
right sided edema
65
ischemic heart disease is a --
cause of left sided heart failure
66
valvular heart disease is a --
cause of left sided heart failure
67
cardiomyopathy causes --
left sided heart failure
68
myocarditis causes --
left sided heart failure
69
left sided heart failure causes --
right sided heart disease
70
pulmonary hypertension is a --
cause of right sided heart disease
71
pulmonary emboli is a --
cause of right sided heart disease
72
Precipitating factors that led the progression of congestive heart disease to heart failure
``` myocarditis myocardial ischemia arrhythmias pulmonary embolism inappropriate reduction of therapy stress ```
73
pulmonary edema is a symptom of --
left heart failure
74
a subjective feeling of not enough air or choking
dyspnea
75
difficulty in breathing while lying flat
orthopnea
76
sudden inability to breathe, awakening patient during night
paroxysmal nocturnal dyspnea
77
increased rate of respiration
tachypnea
78
indicating fluid in alveolar spaces
rales
79
gallop rhythm is a sign of --
left heart failure
80
congestion of organs like liver is a sign of --
right heart failure
81
edema of lower extremities is a sign of --
right heart failure
82
clubbing of fingers and cyanosis is a sign of --
right heart failure
83
jugular venous distention is a sign of --
right heart failure
84
increased jugular vein pressure (JVP) is a sign of --
right heart failure
85
what is pulmonary edema?
fluid moving into interstitial and alveolar spaces
86
Treat congestive heart failure: decrease preload by --
diuretics and angiotensin converting enzyme inhibitors
87
Treat congestive heart failure: improve contractility by --
cardiac glycosides and beta-blockers
88
Treat congestive heart failure: reduce afterload by --
vasodilators
89
Treat congestive heart failure: correct complicating causes like anemia by --
transfusion
90
Treat congestive heart failure: correct complicating causes like rhythm problems by --
medications
91
Treat congestive heart failure: correct complicating causes like heart block with --
pacemaker
92
Treat congestive heart failure: correct complicating causes like coronary heart disease by --
dilate or graft vessels
93
Treat congestive heart failure: diet by --
reduce sodium and caloric intake
94
Treat congestive heart failure: severe cardiomyopathies require --
heart transplant

Systems 1 (22 decks)

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