Chapter 10 Final Flashcards
The #1 cause of death in the US is:
Heart disease
The most common mechanism of cardiac pathology.
Pump failure
Mechanisms of cardiac pathology.
Pump failure, obstruction of flow, regurgitant flow, shunted flow, dysfunctional cardiac conduction and rupture of heart wall/vessels
The common end-point for many cardiac diagnoses is that:
Heart cannot supply tissue demand
3 types of dysfunction in CHF.
Systolic, diastolic and valvular dysfunction
Systolic dysfunction is characterized by _____, and its risks are:
Loss of myocardial contractility; IHD and HTN
Diastolic dysfunction is characterized by ____ and its risks are:
Normal contraction but abnormal relaxation/filling; Female/older adults, left ventricular hypertrophy and fibrosis
Risks for valvular dysfunction.
Endocarditis, stenosis and HTN
Forward failure results in _____, while backward failure results in _____.
Hypoxia/insufficient output; Venous congestion
Adaptation that uses stronger contraction at the cost of oxygen.
Frank-Starling mechanism
Neurohumoral mechanisms use _____ to increase HR and _____ to cause vasodilation (balance).
Norepinephrine; ANP
Which mechanism results in overload and an increase in oxygen?
Cardiac hypertrophy
Left-sided heart failure is characterized by ______ and may cause ______.
Left ventricular hypertrophy and dilation; Pulmonary edema
What commonly results from left-sided heart failure?
Right-sided heart failure
Left-sided HF causes _____, while right-sided HF causes _____.
Pulmonary edema; peripheral edema
What percentage of congenital heart disease cases are idiopathic?
90%
CHD can be genetic and result from trisomies of which chromosomes?
13, 15, 18 and 21
What is the most common defect in CHD cases?
Ventricular septal defect (42%)
The second most common defect in CHD cases is:
Atrial septal defect (10%)
The most common shunt of CHD is:
Left-to-right shunts
Which shunt is characterized by cyanosis and tetralogy of Fallot?
Right-to-left shunt
What are the four characteristics of Tetralogy of Fallot?
VSD, right ventricular outflow obstruction, overriding of VSD by aorta and right ventricular hypertrophy
The most common CHD to cause cyanosis is:
Tetralogy of Fallot
In transposition of vessels, the right ventricle will connect to the:
Aorta
In transposition of vessels, the left ventricle will connect to the:
Pulmonary artery
Aortic coarctation is most common in _____ and those with which disease?
Males; Turner syndrome
Infantile aortic coarctation occurs where?
Proximal to PDA
Adult aortic coarctation occurs where?
Ligamentum arteriosum
90% of IHD cases result from:
Atherosclerosis (CAD)
Occlusion of the coronary arteries that may result in catastrophic consequences is termed:
Acute coronary syndrome
What percentage of occlusion is classified as critical stenosis?
> 70% occlusion
What percentage occlusion is likely to cause unstable angina?
90%
Sub-sternal chest pain, “crushing” or “squeezing” pain is the result of:
Angina pectoris
Characteristics of stable angina.
Episodic, exertional and relieved with rest and nitroglycerin
Characteristics of variant angina.
Vasospasm at rest and is relieved by vasodilators
Which type of angina is termed “crescendo angina?”
Unstable angina
Characteristics of unstable angina.
Increased frequency and intensity, longer duration and provoked by decreased exertion (compared to stable angina)
The most common (90%) way MI occurs is via:
Acute ischemia from thrombosis
How do patients usually die from MI?
Arrhythmia (V Fib)
Why isn’t reperfusion the best way to overcome MI?
Production of ROS and residual “stunned” myocardium
Which lab value is associated with angina?
CK-MB
What is the difference between angina pectoris and angina caused by an MI?
Angina pectoris is relieved by nitroglycerin, whereas MI angina isn’t
Myocardium acts “deconditioned” in which disorder?
Chronic IHD
The most common stimulus for sudden cardiac death (SCD) is:
CAD
What can be done to dramatically improve the prognosis of SCD?
Defibrillation
A blow to the sternal region that disrupts heart rhythm (arrhythmia) is called:
Commotio cordis
Commotio cordis is most common in:
Adolescent males (athletes)
What type of hypertrophy occurs in hypertensive HD?
Concentric
Type of systemic hypertensive HD characterized most commonly as the “silent killer.”
Left ventricular hypertrophy
Left ventricular hypertrophy occurs most commonly where?
Brain and kidneys
Pulmonary HTN and right-sided heart failure are characteristics of this type of pulmonary hypertensive HD.
Cor pulmonale
Acute cor pulmonale is characterized by:
Large pulmonary emboli and permanent dilation
Chronic cor pulmonale is characterized by:
Prolonged COPD or pulmonary fibrosis and permanent hypertrophy
What is stenosis and which valve does it most commonly involve?
Failure to completely open; Mitral valve
What is insufficiency and what is it also called?
Failure to completely close; Regurgitation
Turbulent flow through a diseased valve describes what condition?
Heart murmur
Heart murmurs commonly involve which valve?
Bicuspid aortic valve
The most common cause of aortic valve stenosis is:
Calcific AVS
The most common degenerative valvular disease is ____ and is most common in patients aged _____.
Aortic stenosis; 60-80 years
Rheumatic valvular disease is caused by:
Group A beta-hemolytic streptococcal pharyngitis
In rheumatic valvular disease, which hypersensitivity is most common in children?
Carditis
In RVD, which hypersensitivity is most common in adults?
Migratory polyarthritis
Which valve is most commonly attacked in RVD?
Mitral valve
What causes Scarlet Fever?
Group A b-hemolytic strep. (same as RVD)
Scarlet fever is characterized by:
Pink punctate skin rash (dots), may transition to RF
Which fever occurs sooner after a strep infection?
Scarlet fever (1-4 days as opposed to 2-3 weeks for RF)
Infective endocarditis is most commonly caused by:
Bacteremia
Which type of infective endocarditis is more difficult to treat?
Acute
Which type of infective endocarditis is easier to treat?
Subacute
What are the two types of prosthetic cardiac valves?
Mechanical (MC) and bioprosthetic
Dilated cardiomyopathy is most common in which patient population?
20-50 year olds (alcohol is the main risk)
What percentage of all cardiomyopathy diagnoses are dilated cardiomyopathy?
90%
Which type of cardiomyopathy is caused by contractile gene mutations?
Hypertrophic cardiomyopathy
“Asymmetrical septal hypertrophy” is characteristic of:
Hypertrophic cardiomyopathy
The most common form of restrictive cardiomyopathy is:
Endomyocardial fibrosis
Endomyocardial fibrosis is most common in what patient population?
African descent, kids/young adults
Myocarditis results most commonly secondary to:
Viral infections
The most common cardiac neoplasm is:
Metastasis to the heart
The most common primary cardiac neoplasm in adults is:
Myxoma
Which primary cardiac neoplasm is common in children?
Rhabdomyomas
The most common malignant primary cardiac neoplasm is:
Angiosarcoma
90% of myxomas develop near where?
Fossa ovalis
What complications arise from cardiac transplantation?
Rejection, allograft arteriopathy (MC long-term limitation)