chap 8

Question 1

coronary circulation

Answer 1

main blood supply of the heart
- myocardium is too thick for the diffusion of nutrients
- venous blood collected by cardiac veins
- empties blood into the RA

Question 2

myocardial infarct

Answer 2

typically causes severe, persistent chest pain, often present atypically, may be asymptomatic

Question 3

congestive heart failure

Answer 3

• fluid buildup in the lungs and other tissue s
• shortness of breath due to pulmonary edema
• edema in extremities

Question 4

tests

Answer 4

chest x-ray, echocardiogram, electrocardiogram, serum enzyme levels, cardiac catheterization, stress test

Question 5

congenital heart disease

Answer 5

atrial and ventricular septal defects
- mainfestations
- murmur
- easily fatigued
- heart failure

Question 6

tetralogy of fallot

Answer 6

• rare: 5 in 10,000 infants
  four heart defects
  1) VSD
  2) pulmonary stenosis
  3) right ventricle hypertrophy
  4) overriding aorta
  
  • aorta is between left and right ventricles, over VSD
    manifestations
• cyanosis
• slow growth
• heart failure
• variable life expectancy
  treatment
• surgery soon after birth

Question 7

artherosclerosis

Answer 7

development begins early
- asymptomatic for many years

Question 8

myocardial infarction

Answer 8

leads to necrosis of heart muscle from severe ischemia
- basic mechanisms that trigger ischemia
- sudden blockage of coronary artery from thrombus, blockage from atherosclerotic plaque, sudden greatly increased myocardial oxygen requirements

Question 9

symptoms of acute myocardial infarction

Answer 9

• angina = severe, crushing, constrictive OR like heartburn
  sympathetic nervous system response
• GI distress, nausea, vomiting
• tachycardia and vasoconstriction
• anxiety, restlessness, feeling of impending doom
  hypotension and shock
• weakness in arms and legs
  men vs women
  may be asymptomatic

Question 10

features of MI

Answer 10

50% MI occur without warning
50% preceded by episodes of angina
80-90% MI pateints arrive alive
- die before - cardiac arrhythmia
- minority recover without complications
- most develop clinical complications

Question 11

myocardial infarction - diagnosis

Answer 11

medical history: inconclusive
- pain of severe angina may be similar to pain of MI
physical examination: usually not abnormal unless patient exhibits evidence of shock, heart failure, murmur

Question 12

laboratory data of MI

Answer 12

electrocardiogram, ECG, or EKG
- enzyme tests; enzyme leak out from necrotic cells after an infarct
- the larger the infarct, the longer for elevated levels to return to normal

Question 13

cardiac enzymes

Answer 13

creatine kinase, lactase dehydrogenase, troponin

Question 14

diagnosis of MI

Answer 14

coronary angiogram to locate and determine degree of obstruction

Question 15

treatment for CAD

Answer 15

treatment = destroy clot –> angioplasty
cardiac bypass
- stent

Question 16

stent

Answer 16

brace lumen open

Question 17

treatment for MI

Answer 17

control or eliminate risk factors
- cessation of smoking
- control of hypertension
- anti-coronary diet: low cholesterol and fat
- weight reduction
- exercise

Question 18

clinical features of coronary heart disease

Answer 18

arrythmia, angina, ischemia, plaques, congestive heart failure, scarring, heart failure, myocardial rupture, ventricular aneurysm, cardiac arrest all related

Question 19

long term complications of MI

Answer 19

arrhythmias, heart failure, cardiogenic shock, pericarditis, thromboemboli, cardiac rupture, ventricular aneurysm

Question 20

hypertensive heart disease

Answer 20

hypertension leads to increased workload for the heart which leads to structural and functional changes
- manifestations
- enlarged heart
- heart failure
- ischemia

Question 21

valvular heart disease

Answer 21

valvular dysfunctions:
valvular stenosis and valvular regurgitation

Question 22

valvular stenosis

Answer 22

aortic stenosis, mitral stenosis

Question 23

valvular regurgitation

Answer 23

aortic regurgitation, mitral regurgitation, tricuspid regurgitation

Question 24

aortic stenosis

Answer 24

leaflets undergo degenerative changes –> fibrotic, calcified rigid –> restricts valve mobility, stenosis
clinical outcomes : increase strain, left ventricular hypertrophy –> heart failure
more common with aging

Question 25

rheumatic fever (scarlet fever)

Answer 25

commonly encountered in children
- streptococcal bacterial
not due to bacterial infection per se but molecular mimicry
scarring of heart valves
- clinical outcome: valve stenosis –> increases strain on heart, eventually leads to heart failure

Question 26

cardiac arrhythmias

Answer 26

disturbance of the heart rhythm
- irregular heart beat
range from occasional “missed” or rapid beats to severe disturbances that affect the pumping ability of the heart
- can be caused by an abnormal rate of impulse generation or abnormal impulse condcution

Question 27

atrial fibrillation

Answer 27

disorganized electrical impulses, atria quiver instead of contract
- incomplete emptying
common with age
most common

Question 28

cardiomyopathy

Answer 28

caused by: genetic mutations, environment
types:
dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy

Question 29

dilated cardiomyopathy

Answer 29

weakened, enlarged (all chambers), poor pumping

Question 30

hypertrophic cardiomyopathy

Answer 30

can lead to sudden cardiac arrest, leading cause of death in young athletes, diminished outflow

Question 31

restrictive cardiomyopathy

Answer 31

heart is rigid, restricited from stretching

Question 32

complications of cardiomyopathy

Answer 32

heart failure, blood clots - pulmonary embolism, valve problems, cardiac arrest, sudden death

Question 33

organ failure

Answer 33

inadequacy of cardiac pump may cause:
cardiogenic shock
heart failure

Question 34

heart failure

Answer 34

• general term used to describe several types of cardiac dysfunction that result in inadequate perfusion of tissue with blood-borne nutrients