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D & D exam 4 > Ch. 19 Disorders of Cardiac Function > Flashcards

Ch. 19 Disorders of Cardiac Function Flashcards

1
Q

What is Pericardial Effusion?

A
  • build up of fluid in pericardial sac
  • threatens compression of the heart
  • sudden accumulation of fluid may compress the heart and cause it to stop (tamponade)
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2
Q

What is a cardiac Tamponade?

A

when the cardiac sac is way over stretched putting pressure on the heart

causes:

  • trauma
  • surgical (iatrogenic)-common after heart surgery
  • pericarditis
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3
Q

What is Pericarditis?

A
  • inflammation and fluid in the pericardium

- usually infectious exudate

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4
Q

what are the S/S associated with pericarditis?

A
  • chest pain
  • rub heard on auscultation
  • ECG changes
  • fatigue, shortness of breath, other vital symptoms
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5
Q

Pericarditis can lead to what?

A

Pericardial Effusion if the fluid builds up alot

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6
Q

what is the normal fluid volume in the pericardial sac?

A

2-3 tablespoons

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7
Q

a very large pericardial effusion can hold up to how much fluid?

A

1-2 liters

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8
Q

what happens with a very large pericardial effusion?

A

-the heart is pretty much suffocated and contraction does not perform well

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9
Q

what are the causes of Pericardial Effusion?

A

-inflammation (Pericarditis) because the pericardium gets inflamed and releases exudate

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10
Q

what causes pericarditis?

A
  • mainly viral infections: CMV, HIV
  • bacterial, fungal, parasitic
  • cancer
  • heart attack
  • injury to the mitochondria (surgical, trauma, car accident,)
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11
Q

What is the heart surrounded by?

A

the pericardium

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12
Q

what is the pericardium and what does it do?

A
  • thin 2 layered sac surrounding the heart
  • in-between the 2 layers there is a fluid that acts as padding from the beating
  • shields the heart from infection and malignancy
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13
Q

What are the S/S of a cardiac Tamponade?

A
  • 20mmHg drop in systolic blood pressure during respirations
  • harder to see with BP cuff so usually there is a line that is inserted in the artery that reaches the heart and monitors.
  • heart monitor will look normal but there will be no pulse
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14
Q

Why will the heart monitor look normal with a cardiac Tamponade even though there is no pulse?

A

-the heart is still sending the electrical signals but it is not beating because it has no room too

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15
Q

what is the treatment for a cardiac Tamponade?

A
  • stick a needle in the cardiac sac if there is a suspicion
  • if there is no fluid, oh well you were wrong
  • if there is fluid, drain it and then go immediately to OR to fix
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16
Q

What is angina?

A
  • a SYMPTOM
  • chest pain, discomfort in the area of the heart due to lack of O2
  • may radiate to the arm, neck, jaw
  • can feel like indigestion
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17
Q

What is CAD and what can it lead to?

A

-build up of plaque in the coronary arteries or atherosclerosis of the coronary arteries

  • angina
  • Myocardial infarction (MI)
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18
Q

What causes an MI?

A
  • occurs when a coronary artery is totally obstructed leading to prolonged ischemia and cell death or infarction, of the heart wall
  • most common cause is atherosclerosis usually with thrombus attached
  • common cause of disability and death
  • majority 65 years old and older
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19
Q

what may an MI ultimately lead to?

A

-heart failure, arrhythmia, or sudden death

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20
Q

how many deaths are caused by MIs?

A

1 in 5

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21
Q

what are some MAJOR risk factors for MI?

A
  • smoking
  • elevated blood pressure
  • elevated LDL cholesterol
  • low HDL cholesterol
  • diabetes mellitus
  • metabolic syndrome
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22
Q

What are some EMERGING risk factors for MI?

A
  • prothrombotic state (higher risk for throwing clots)
  • proinflammatory state
  • insulin resistance
23
Q

what are some UNDERLYING risk factors for MI?

A
  • high fat diet
  • obesity
  • physical inactivity
  • family history
24
Q

What are the 3 types of Acute Coronary Syndrome (ACS)?

A
  1. angina
  2. STEMI
  3. NONSTEMI
25
Q

When does Angina Pectoris occur?

A

occurs when there is a deficit of oxygen for the heart muscle. May occur when the heart is working more than usual or when supply of oxygen is impaired

26
Q

What is Chronic Stable Angina?

A
  • fixed coronary obstruction, seen with increased demands of myocardium, exercise induced and resolves with rest
  • emotional stress and cold can trigger episodes
27
Q

What is Acute Unstable Angina?

A
  • unexpected, emergency
  • sudden change in normal pattern of angina
  • something happened like a clot
  • can occur without knowledge of Stable Angina
28
Q

Which type of angina is a warning sign of MI?

A

acute Unstable angina

29
Q

what is given to people with Chronic Stable Angina?

A
  • a nitroglycerin supplement

- these are potent vasodilators

30
Q

What lifestyle changes we suggest for those who suffer from Angina?

A
  • get HDL up
  • get LDL down
  • stop smoking
  • exercise regularly/mall walkers
  • stop doing what whatever triggers the angina
31
Q

What are some medications that can be given to patients who suffer from angina?

A
  • nitroglycerin supplements to dilate blood vessels during an angina episode
  • different types to control the underlying problem
    ex: cholesterol medication that lowers cholesterol
32
Q

what are our goals for angina?

A
  • reduce pain

- prevent MI

33
Q

What is a STEMI?

A
  • a type of acute coronary syndrome (ACS)
  • “ST” wave is elevated during an MI, looks like a “RIP gravestone”
  • MORE SEVERE type of heart attack
  • large amount of heart muscle is being damaged
  • TOTAL BLOCKAGE
34
Q

What is a NONSTEMI?

A
  • a type of acute coronary syndrome(ACS)
  • “ST” wave is not elevated during an MI, normal
  • only partially blocked
  • still getting some profusion to the heart
35
Q

sudden death from an MI is most likely do to?

A

acute ventricular arrhythmia

  • monitor looks like fast zigzag
  • heart just gyrates and doesn’t actually pump
36
Q

What are the warning signs of a Heart Attack (MI)?

A
  • feeling of pressure, heaviness, or burning in chest, especially with increased activity
  • shortness of breath, sweating, weakness, fatigue
  • nausea, indigestion
  • anxiety and fear “Feeling of Doom”
37
Q

what are some diagnostic tests used to identify an MI?

A
  • EKG : can see if it’s STEMI v NONSTEMI
  • Serum enzymes & isoenzymes : heart muscle has specific enzymes so if cells die these will show up in the blood levels
  • cardiac catheterization: line in femoral artery that runs to the heart, dye is injected and images (xrays) are taken to locate the blockage
38
Q

What is a CABG?

A
  • coronary artery bypass graft
  • they get the graft from vessels in the leg; the heart cannot build collateral vessels but the leg can
  • graft a bypass around the block
39
Q

what is a Stent?

A
  • looks like a pen spring

- inserted into the affected coronary artery to keep it open

40
Q

2 to 3 days after an MI what might happen?

A
  • the necrosis in the area becomes inflamed and very irritable
  • might see dysrhythmias on the EKG
41
Q

What are the 3 types of Primary Cardiomyopathy?

A
  1. Genetic-HCM
  2. Mixed- DCM or RCM
  3. Aquired-Myocarditis or Takostubo
42
Q

Hypertrophic Cardiomyopathy (HCM)

A
  • Genetic form of ACS

- area of myocardium becomes thickened (hypertrophied) for no apparent reason

43
Q

Dilated Cardiomyopathy (DCM)

A
  • mixed form of ACS
  • increased left ventricular wall thinning
  • less contractility as heart gets bigger (its floppy)
  • may benefit from a pacemaker
44
Q

Restricted Cardiomyopathy (RCM)

A
  • mixed form of ACS
  • walls become rigid
  • heart is restricted from filling with blood
45
Q

Myocarditis

A
  • acquired form of ACS
  • inflammation of the heart muscle
  • usually caused by a VIRUS
  • often asymptomatic
  • may develop chest pain, fever, dyspnea or tachycardia
46
Q

Takotsubo

A

-broken heart syndrome

47
Q

Endocarditis

A
  • microbial infection that affects the ENDOTHELIUM and the VALVES
  • predisposing factors : rheumatic heart disease or valvular disease
  • murmur develops due to vegetative(abnormal growth inside the heart) valve destruction
48
Q

Endocarditis and Rheumatic Heart Disease (RHD) are both complications of what?

A

septicemia
why?
-vegetation (microbe growth) from infection will grow inside the heart as it passes through the heart in the blood

49
Q

Stenosis

A

narrowing of the orifice of valve

50
Q

Regurgitation

A

valves are not completely closing, so the blood will flow back into the chamber of which it just came

51
Q

What types of Mitral Valve Disorders are there?

A
  • stenosis
  • regurgitation
  • prolapse
52
Q

What types of Aortic Valve Disorders are there?

A
  • stenosis

- regurgitations: causes drop in diastolic blood pressure which can cause decreased coronary profusion

53
Q

Prolapse

A
  • heart valves leaflets are thickened sticking out into the other chamber
  • can cause: regurgitation, heart failure, cardiac arrest

D & D exam 4 (4 decks)

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