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Systems 1 > Cardiovascular Diseases 1 > Flashcards

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
Q

How is myocarditis classified?

A

by type of inflammatory response

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26
Q

What is the most common myocarditis?

A

lymphocytic

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27
Q

What is the origin of lymphocytic myocarditis?

A

infectious

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28
Q

What is the most common mode of lymphocytic myocarditis?

A

viruses

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29
Q

example of bacterial lymphocytic myocarditis

A

Lyme disease

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30
Q

example of parasitic lymphocytic myocarditis

A

Chagas diseases

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31
Q

What kind of treatment could you give a person infected with lymphocytic myocarditis?

A

antiviral or antibacterial

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32
Q

Which myocarditis affects young adults with congestive heart failure and arrhythmias?

A

giant cell

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33
Q

What kind of treatment would you give a person infected with giant cell myocarditis?

A

immunosuppressant and/or transplantation

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34
Q

Which myocarditis is associated with allergy?

A

eosinophilic

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35
Q

The inability of the heart to supply adequate oxygenated blood to meet body’s metabolic needs

A

congestive heart failure

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36
Q

What are causes of abnormal myocardial structure and function?

A

increase in hemodynamic burden or reduction in myocardial oxygen

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37
Q

Describe dysfunction of congestive heart failure

A

usually both systolic and diastolic

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38
Q

Define systolic dysfunction

A

dilated ventricles and decreased contractility

39
Q

define diastolic dysfunction

A

normal contractility but decreased myocardial compliance (can’t relax)

40
Q

What are consequences of systolic dysfunction?

A

reduced CO and ejection fraction

41
Q

What are consequences of diastolic dysfunction?

A

increased diastolic pressure but CO can be normal

42
Q

What is the purpose of adaptive mechanisms?

A

maintain adequate pumping functions, CO, and adequate perfusion of vital organs

43
Q

Which adaptive mechanism is activated rapidly but continues over a long period of time?

A

peripheral mechanisms

44
Q

Describe the Frank-Starling relationship

A

stretch cardiac tissue –> stronger contractions

45
Q

How can you expand volume/stretch cardiac tissue/increase resting muscle length?

A

retain sodium = retain water = increase preload

46
Q

What kind of adaptive mechanism is the Frank-Starling relationship?

A

short term

47
Q

What kind of adaptive mechanism is the activation of neurohumoral system?

A

short term

48
Q

name the two neurohumoral systems

A

adrenergic

renin-angiotensin-aldosterone

49
Q

What’s the function of the adrenergic system?

A

increases contractility or contraction velocity and heart rate (maintain/improve CO)

50
Q

What’s the function of renin-angiotensin-aldosterone system?

A

helps maintain arterial pressure and tissue perfusion and increases preload

51
Q

give examples of long term adaptive mechanisms

A

heart chamber dilation

myocardial remodeling/hypertrophy

52
Q

increased radius of (L) ventricle requires – to generate the same pressure which increases the demand of the heart

A

greater wall tension

53
Q

What does chronic volume overload lead to?

A

dilated LV

54
Q

What does chronic pressure overload and high wall tension lead to?

A

pathological myocardial remodeling (fibrosis in damaged areas)

55
Q

According to the Law of Laplace, in order to reduce wall tension – increases

A

wall thickness

56
Q

How do you increase wall thickness?

A

increase size of individual myocytes and increase overall muscle mass

57
Q

Give examples of hemodynamic consequences of adaptive changes

A

decreased ejection fraction and CO
increased EDV and EDP
blood redistribution
edema

58
Q

In moderate LV dysfunction compare CO during rest and exercise

A

normal and unable to increase CO

59
Q

In severe heart failure how is CO affected?

A

decreased

60
Q

less blood to skeletal muscles –>

A

anaerobic metabolism and fatigue

61
Q

less blood to kidneys –>

A

Na and nitrogen retention

62
Q

less blood to liver

A

liver dysfunction

63
Q

Left sided edema show symptoms –

A

secondary to pulmonary congestion

64
Q

generalized fluid accumulation characterizes –

A

right sided edema

65
Q

ischemic heart disease is a –

A

cause of left sided heart failure

66
Q

valvular heart disease is a –

A

cause of left sided heart failure

67
Q

cardiomyopathy causes –

A

left sided heart failure

68
Q

myocarditis causes –

A

left sided heart failure

69
Q

left sided heart failure causes –

A

right sided heart disease

70
Q

pulmonary hypertension is a –

A

cause of right sided heart disease

71
Q

pulmonary emboli is a –

A

cause of right sided heart disease

72
Q

Precipitating factors that led the progression of congestive heart disease to heart failure

A 
myocarditis
myocardial ischemia
arrhythmias
pulmonary embolism
inappropriate reduction of therapy
stress
73
Q

pulmonary edema is a symptom of –

A

left heart failure

74
Q

a subjective feeling of not enough air or choking

A

dyspnea

75
Q

difficulty in breathing while lying flat

A

orthopnea

76
Q

sudden inability to breathe, awakening patient during night

A

paroxysmal nocturnal dyspnea

77
Q

increased rate of respiration

A

tachypnea

78
Q

indicating fluid in alveolar spaces

A

rales

79
Q

gallop rhythm is a sign of –

A

left heart failure

80
Q

congestion of organs like liver is a sign of –

A

right heart failure

81
Q

edema of lower extremities is a sign of –

A

right heart failure

82
Q

clubbing of fingers and cyanosis is a sign of –

A

right heart failure

83
Q

jugular venous distention is a sign of –

A

right heart failure

84
Q

increased jugular vein pressure (JVP) is a sign of –

A

right heart failure

85
Q

what is pulmonary edema?

A

fluid moving into interstitial and alveolar spaces

86
Q

Treat congestive heart failure: decrease preload by –

A

diuretics and angiotensin converting enzyme inhibitors

87
Q

Treat congestive heart failure: improve contractility by –

A

cardiac glycosides and beta-blockers

88
Q

Treat congestive heart failure: reduce afterload by –

A

vasodilators

89
Q

Treat congestive heart failure: correct complicating causes like anemia by –

A

transfusion

90
Q

Treat congestive heart failure: correct complicating causes like rhythm problems by –

A

medications

91
Q

Treat congestive heart failure: correct complicating causes like heart block with –

A

pacemaker

92
Q

Treat congestive heart failure: correct complicating causes like coronary heart disease by –

A

dilate or graft vessels

93
Q

Treat congestive heart failure: diet by –

A

reduce sodium and caloric intake

94
Q

Treat congestive heart failure: severe cardiomyopathies require –

A

heart transplant

Systems 1 (22 decks)

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