ch28 structural, infectious, and inflammatory Cardiac disorders

Question 1

is pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle (myocardium) and the outer covering sac of the heart (pericardium).

Answer 1

Cardiac tamponade

Question 2

sometimes referred to as “fluid around the heart,” is the abnormal build-up of excess fluid that develops between the pericardium, the lining of the heart, and the heart itself.

Answer 2

Pericardial Effusion

Question 3

Patients who present with either unstable angina or an acute myocardial infarction.

Develops when ischemia is prolonged and not immediately reversible.

Answer 3

Acute coronary syndrome

Question 4

Complete occlusion of the artery causing irreversible myocardial cell death

Answer 4

Myocardial infarction

Question 5

is a series of progressive events associated with cardiac dysfunction
Can lead to heart failure, dysrhythmias, or sudden death

In other words ……. The heart loses its ability to pump the blood

Answer 5

Cardiomyopathy

Question 6

• increased atrial chamber size
• increased ventricular chamber size
• decreased muscle size

Answer 6

dilated cardiomyopathy

Question 7

• thickened interventricular septum
• decreased ventricular chamber size
• left ventricular hypertrophy

Answer 7

hypertrophic cardiomyopathy

Question 8

-left ventricular hypertrophy

Answer 8

restrictive cardiomyopathy

Question 9

3 cardinal signs of cardiac tamponade: hypotension, muffled heart sounds, JVD

Answer 9

Beck’s triad

Question 10

Inflammation of the inner lining of the heart and valves
Occurs primarily in patients who have prosthetic heart valves, structural cardiac defects, abuse IV drugs
Possible ports of entry—oral cavity, surgery
Hospital acquired -

Answer 10

endocarditis

Question 11

Inflammation of the pericardium, the membranous sac that encloses the heart.

• Primary symptom is pain
• Most characteristic sign is a creaky or scratchy friction rub heard most clearly at the left sternal border. also fever, high WBC’s, anemia, elevated ESR or C-reactive protein, nonproductive cough or hiccough.

Answer 11

pericarditis

Question 12

When valves do not close completely causing blood to flow backwards

Answer 12

regurgitation

Question 13

when valves do not open completely and bloodflow through the valve is reduced

Answer 13

stenosis

Question 14

stretching of the valve leaflet into the atrium during systole. It is a deformity that usually produces no symptoms.

• More frequent in women than men.
• These patients are at risk for endocarditis so teach pt. to practice good oral hygiene for prevention.
• should avoid alcohol and caffeine(cough syrup)

Answer 14

mitral valve prolapse

Question 15

predictable and consistent pain that occurs on exertion and is relieved by rest and/ or NTG

Answer 15

stable angina

Question 16

also called pre infarction or crescendo angina: symptoms increase in freq. and severity may NOT be relieved with rest and NTG

Answer 16

unstable angina

Question 17

severe incapacitating chest pain

Answer 17

intractable or refractory angina

Question 18

also called prinzmetal’s angina: pain at rest with reversible ST-segment elevation; thought to be caused by coronary artery vasospasm

Answer 18

variant angina

Question 19

objective evidence of ischemia such as ekg changes with a stress test, but patient reports no pain

Answer 19

silent ischemia

Question 20

involves blood flowing back from the left ventricle into the left atrium during systole.

Answer 20

Mitral regurgitation

Question 21

the flow of blood back into the left ventricle from the aorta during diastole.

• These pts. are usually on CCB’s and ACE inhibitors
• Need to advise to avoid physical exertion, sports, and isometric exercise.

Answer 21

Aortic regurgitation

Question 22

the narrowing of the office between the left ventricle and the aorta. Often a result of degenerative calcifications.

• A systolic crescendo-decresendo murmor is heard, it low-pitched rough and rasping.
• If you rest your hand over the base of the heart a vibration may be felt

Answer 22

aortic stenosis

Question 23

A microbial infection of the endothelial surface of the heart.

• fever and heart murmur are primary symptoms.(may be present)
• other symptoms include petichiae, Osler nodes, Janeway lesions, Roth spots, Splinter hemorrhages, cardiomegaly, HF, tachycardia, or splenomegaly.

Answer 23

infective endocarditis

Question 24

an inflammatory process involving the myocardium, can cause hurt dilation, thrombi on the heart wall(mural thrombi), infiltration of circulating blood cells around the coronary vessels and between muscle fibers themselves.
CAUTION- these pt’s are sensitive to digoxin

Answer 24

myocarditis

Question 25

pericarditis that occurs 10 days to 2 months after acute MI

Answer 25

Dressler syndrome

Question 26

a decrease of 10mm Hg or more in the systolic BP during inspiration( can be a sign of cardiac tamponade)

Answer 26

pulses paradoxus

Question 27

procedure that punctures the pericardial sac to aspirate pericardial fluid.

• The patient is on continuous ECG and frequent vital signs.
• Head elevated 45-60 degrees.
• Ultrasound used to guide placement of needle.
• Patient will feel immediate relief.

Answer 27

pericardiocentesis

Question 28

Electrical activity is present but there is ineffective cardiac contraction or circulating volume.
-Can be caused by hypovolemia, hypoxia, hypothermia, hyperkalemia, massive pulmonary embolism, MI, med overdose (BB’s,CCB’s)

Answer 28

PEA pulseless electrical activity

Question 29

3 meds to avoid for a patient with myocarditis

Answer 29

NSAID’s, Dig, BB’s