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Systems Path I Final > Chapter 10: The Heart (Part 1) > Flashcards

Chapter 10: The Heart (Part 1) Flashcards

1
Q

What is the number one cause of death in the U.S.?

A

Heart Disease

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2
Q

What is the number two cause of death in the U.S.?

A

Cancer

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3
Q

What is the most common type of heart disease?

A

Contractile failure (or systolic dysfunction or pump failure)

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4
Q 
All of the following are examples of heart disease EXCEPT:
A) Contractile Failure
B) Obstruction of flow
C) Shunted Flow
D) Stroke
A

D) Stroke

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5
Q

Define: Heart Failure

A

heart fails to meet tissue demands

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6
Q

What is two causes of heart failure and which is most common?

A

Decreased cardiac demand (MC)

Increased tissue demands

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7
Q

What are some examples of increased tissue demands that can lead to heart failure?

A

hyperthyroidism, severe anemia, AV fistula

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8
Q

What is the name of the condition where increased tissue demands leads to heart failure

A

High-Output (Heart) Failure

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9
Q

What is the prognosis for patients diagnosed with Heart Failure?

A

poor prognosis (disease is progressive)

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10
Q

What other condition is associated with Congestive Heart Failure?

A

Pitting edema (non-inflammatory edema)

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11
Q

Systolic Dysfunction is most closely associated with:

A) Failed relaxation
B) decreased filling of the heart
C) weak contraction
D) Failure to effectively seal

A

C) Weak contraction

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12
Q

What three conditions are associated with Systolic dysfunction?

A

CAD, systemic HTN, and shock

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13
Q

Diastolic Dysfunction is most closely associated with (pick all that apply):

A) Failed relaxation
B) decreased filling of the heart
C) weak contraction
D) Failure to effectively seal

A

A) Failed Relaxation

B) Decreased filling of the heart

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14
Q

What three conditions are associated with Diastolic Dysfunction?

A

1) Myocardial fibrosis/amyloidosis
2) left-sided hypertrophy
3) pericardial tamponade

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15
Q

Valvular Dysfunction is most closely associated with (pick all that apply):

A) Failed relaxation
B) decreased filling of the heart
C) weak contraction
D) Failure to effectively seal

A

D) failure to effectively seal

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16
Q

Define “Forward Heart Failure”

A

insufficient output due to hypoxia

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17
Q

Define “Backward Heart Failure”

A

Venous congestion (dude to increased venous blood volume and pressure)

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18
Q

True or False: Forward failure is almost always accompanied by backward failure.

A

True

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19
Q

Which of the following stimulates cardiac adaptations:

a) Forward Failure
b) Backward Failure
c) all of the above

A

C) All of the above

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20
Q

What are the three explanations of cardiovascular adaptations to heart failure?

A

1) Frank-Starling (law) mechanism
2) Neurohumoral mechanism
3) Structural Changes

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21
Q

The cardiovascular adaptation of increasing stretch to create a stronger contraction is best explained by:

A

Frank-Starling Law

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22
Q

What are the benefits and the cost of the Frank-Starling Mechanism?

A

Benefit: Increased Output
Cost: Increased O2 and Increased Tension

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23
Q

How does the neurohumoral mechanism explain cardiovascular adaptation via the release of norepinephrine?

A

It increases Heart Rate and increases contractility; engages the R-A-A system

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24
Q

How does the neurohumoral mechanism explain cardiovascular adapatation via the release of atrial natriuretic peptide (ANP) hormone?

A

It causes diuresis and vasodilation

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25
Q

What is the structural change that can occur in the heart as as result of cardiovascular adaptation to heart failure? What is the cost?

A

cardiac hypertrophy

Cost: Increased O2 consumption

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26
Q

Are you more likely to see an increase in pressure or an increase in volume with Cardiac Hypertrophy?

A

Increase in pressure

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27
Q

Are you more likely to see an increase in pressure or an increase in volume with Dilated Cardiac Myopathy?

A

Increase in volume

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28
Q

Which type of Cardiac Hypertrophy is associated with increased pressure, HTN, and valvular stenosis? (pick all that apply)

a) Pathologic hypertrophy
b) Physiologic hypertrophy
c) Eccentric hypertrophy
d) Concentric hypertrophy

A

a) Pathologic hypertrophy

d) Concentric hypertrophy

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29
Q

Which type of Cardiac Hypertrophy is associated with increased blood volume, bradycardia, and increased capillary density? (pick all that apply)

a) Pathologic hypertrophy
b) Physiologic hypertrophy
c) Eccentric hypertrophy
d) Concentric hypertrophy

A

b) Physiologic hypertrophy

c) Eccentric hypertrophy

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30
Q

Left-sided heart failure is seen following what conditions?

A

HTN, CAD, valve disorders, cardiomyopathies

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31
Q

Which part of the heart undergoes hypertrophy during left-sided heart failure?

A

Left ventricle hypertrophies

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32
Q

What happens to cardiac output during left-sided heart failure?

A

It decreases; causes the activation of the R-A-A system

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33
Q

What condition results from the activation of the R-A-A system during left-sided heart failure?

A

Pulmonary edema

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34
Q

What signs and symptoms are associated with left-sided heart failure?

A

cough, dyspnea, rales, orthopnea and tachycardia

35
Q

What is orthopnea?

A

Shortness of breath that occurs when lying down

36
Q

How can orthopnea be relieved?

A

sleep at an angle or sit in a chair

37
Q

What is the most common cause of developing right-sided heart failure

A

left sided heart failure

38
Q

What are the possible causes of right-sided heart failure?

A

pulmonary HTN, lung pathology, valve disorder, left-to-right shunt

39
Q

What pathologies are seen with right-sided heart failure?

A

ascites, hepatosplenomegaly

40
Q

Why are pathologies such as ascites and hepatosplenomegaly seen in right-sided heart failure?

A

congestion and edema of peripheral tissues due to back up in systemic and portal veins.

41
Q

True or False: There is significant pulmonary congestion in right-sided heart failure.

A

False; there is minimal pulmonary congestion

42
Q

Can congential heart disease be genetic, developmental or both?

A

Both

43
Q

Which structural malformation in congenital heart disease is the most mild? Most lethal?

A

Most Mild- Cardiac Walls

Most Lethal- Aorta

44
Q

What are the risks for congenital heart disease?

A

prematurity, trisomies, teratogens, maternal diabetes, fetal infection

45
Q

Which septal defects make up over half of congenital heart disease?

A

ventricular septal Defects (VSD) = 42%

Atrial Septal Defects (ASD0 = 10%

46
Q

If the blood bypasses the lungs this is known as:

A) Right-to-left shunt
B) Left-to-right shunt
C) Obstructed Flow

A

Right to left shunts

47
Q

The characteristic feature of cyanosis in the face and lips is seen in which congential heart disease?

A

Right-to-left shunts

48
Q

What are two examples where Right-to-left shunts are seen?

A

1) Tetralogy of Fallot

2) Transposition of Great Arteries

49
Q

Which is more common: Left-to- Right shunts or Right-to-Left shunts?

A

Left-to-right shunts

50
Q

Pulmonary hypertension is seen in:

A) Right-to-left shunt
B) Left-to-right shunt
C) Obstructed Flow

A

B) left-to-right shunts

51
Q

ASDs, VSDs, and PDA are all congenital heart disease examples of:

A

Left-to-right shunts

52
Q

Valvular stenosis is seen in:

A) Right-to-left shunt
B) Left-to-right shunt
C) Obstructed Flow

A

C) Obstructed flow

53
Q

Obstructed flow can lead to:

A

aortic coarctation

54
Q

Which is the most common heart structural abnormality:

VSD or ASD

A

VSD

55
Q

Which is most commonly asymptomatic?

VSD or ASD

A

ASD

56
Q

Which may spontaneously close?

VSD or ASD

A

VSD

57
Q

Which may be diagnosed in adulthood?

VSD or ASD

A

ASD

58
Q

What four diagnostic abnormalities must be present to have Tetralogy of Fallot?

A

1) VSD
2) Right Ventricular Outflow Obstruction (ie Pulmonary Stenosis)
3) Overriding Aorta
4) Right Ventricular Hypertrophy

59
Q

In Tetralogy of Fallot, an overriding aorta is an example of which kind of shunt?

A

Right-to-left shunt

Rt. Ventricle to Aorta

60
Q

What is the most common congenital heart disease to cause cyanosis?

A

Tetralogy of Fallot

61
Q

What is the prognosis for Tetralogy of Fallot?

A

variable severity, may worsen with age

62
Q

What is characteristic about the x-ray of the heart in patients with tetralogy of fallot?

A

boot shaped heart

63
Q

The disease where arteries connect to wrong locations is known as?

A

Transposition of the Great Arteries

64
Q

In Transposition of the Great Arteries, the right ventricle connects to:

A

the aorta

65
Q

In Transposition of the Great Arteries, the left ventricle connects to:

A

pulmonary artery

66
Q

Why is transposition of the great arteries a life threatening condition?

A

It separates pulmonary and systemic circulation

67
Q

Is transposition of the great arteries compatible with postnatal life?

A

No (postnatal cyanosis)

68
Q

If transposition of the great arteries were to be treated, what is required?

A

shunting

PDA, VSD, or surgical repositioning

69
Q

Who is more likely to have an aortic coarctation, males or females?

A

males (2x)

70
Q

What genetic condition increases the likelihood of developing an aortic coarctation?

A

Turner Syndrome (45, X)

71
Q

Which type of aortic coarctation is pre-ductal and is proximal to a PDA?

A

Infantile

72
Q

Which type of aortic coarctation is post-ductal and is near the ligamentum arteriosum?

A

Adult

73
Q

Which type of aortic coarctation is usually discovered early and more severe?

A

Infantile

74
Q

Which type of aortic coarctation is more commonly asymptomatic?

A

Adult

75
Q

What are some of the features of aortic coarctation?

A

Upper extremity HTN, decreased blood flow to lower extremities and systolic murmurs/thrills

76
Q

What signs and symptoms are present on a patient with aortic coarctation that might indicate a reduction in blood flow to the lower extremities?

A

cyanosis and claudicator

77
Q

What physical abnormality is present in over half of patients diagnosed with aortic coarctation?

A

Bicuspid Aortic Valve

78
Q

A group of conditions involving myocardial ischemia is known as:

A

Ischemic Heart Disease

79
Q

How does the heart receive energy?

A

via oxidative phosphorylation

80
Q

Within 1-2 minutes, what happens to an ischemic heart?

A

dysfunction

81
Q

Within 20-40 minutes, what happens to an ischemic heart?

A

infarction

82
Q

What disease makes up about 90% of Ischemic Heart Diseases?

A

Coronary Artery Disease

83
Q

Which coronary artery is most commonly affected by heart disease?

A

Anterior Interventricular Artery

84
Q

What are the four stages of CAD progression?

A

Fatty streaks, atheromas, significant luminal stenosis, thrombosis

Systems Path I Final (4 decks)

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