Chapter 18: Alterations of heart function

Question 1

what is cardiac output ?

Answer 1

amount of blood pumped out of the heart each minute

Question 2

what is stoke volume ?

Answer 2

amount of blood ejected from the ventricle each contraction

Question 3

what are the determinants of stroke volume?

Answer 3

preload
contractility
afterload

Question 4

true or false: coronary heart disease is responsible for approximately 50% of deaths by CVD

Answer 4

true

Question 5

what is CHD characterized by ?

Answer 5

insufficient delivery of oxygenated blood to the myocardium caused by atherosclerosis

Question 6

what are the known risk factors for CHD?

Answer 6

atherosclerosis : the source of all CHD

possible microcirculation abnormalities

Question 7

what is defined as good and bad cholesterol ?

Answer 7

LDL= bad
HDL= good

Question 8

what are lipids transported via?

Answer 8

apoproteins ( lipid+ protein = lipoprotein)

Question 9

what does HDL do?

Answer 9

circulates to the tissues and takes up excess free cholesterol to take back to the liver

Question 10

what does LDL do?

Answer 10

absorbed by tissues

70% returned to the liver

Question 11

what is atherosclerosis plaque formation initiated by?

Answer 11

injury to coronary endothelium

Question 12

what are the differences between vulnerable and stable plaques?

Answer 12

vulnerable: large lipid core, thin cap, high shear stress, and inflammation
stable: more collagen and fibrin, stable cap

Question 13

what can ischemia result in?

Answer 13

chronic or acute coronary syndromes

Question 14

true or false: ischemia results in oxygen supply insufficient to meet metabolic demands

Answer 14

true

Question 15

the rate of coronary perfusion can be altered by?

Answer 15

large, stable atherosclortic
acute platelet aggregation and thrombosis
vasospasm
failure of autoregulation by microcirculation
poor perfusion pressure

Question 16

describe the pathophysiology of chronic and acute ischemia

Answer 16

chronic: occlusion of a coronary vessel is associated with clinical syndrome of stable angina
acute: occlusion is associated with plaque disruption and thrombus formation and results in acute coronary syndrome

Question 17

true or false: acute coronary sydnrome is associated with acute changes in plaque morphology and thrombosis, which causes a sudden obstruction of coronary arteries

Answer 17

true

Question 18

true or false: chronic or acute coronary heart syndromes may precipitate sudden cardiac arrest and associated dysrhythmias

Answer 18

true

Question 19

true or false: stable angina cannot be relived by rest

Answer 19

false

Question 20

what factors of stable angina may upset the balance and lead to pain?

Answer 20

factors that decrease coronary supply or increase myocardial oxygen demand

Question 21

true or false: MI occlusion is complete and the thrombus lasts long enough to cause irreversible damage

Answer 21

true

Question 22

what is an accurate diagnosis of ACS?

Answer 22

signs/ symptoms
ECG changes
serum biomarkers

Question 23

what does chronic ischemic cardiomyopathy refer to?

Answer 23

disorder in which heart failure develops slowly because of progressive ischemic myocardial damage

Question 24

mitral valve is between which atrium and ventricle ?

Answer 24

left atrium and left ventricle

Question 25

what is the function of the aortic valve?

Answer 25

allows outflow from left ventricle to the aorta

Question 26

what is stenosis?

Answer 26

failure of the valve to open completely and results in extra volume work for the heart

Question 27

what is regurgitation?

Answer 27

the inability of a valve to close completely and results in extra volume work for the heart

Question 28

what defines rheumatic heart disease?

Answer 28

its an acute inflammatory disease that follows infection with group a B-hemolytic streptococci

Question 29

what defines infective endocarditis?

Answer 29

its an acute inflammatory disease that follows infection with group a B- hemolytic streptococci

Question 30

true or false: myocarditis is an inflammatory disorder of the heart muscle muscle characterized by necrosis and degeneration of myocytes

Answer 30

true

Question 31

true or false: right to left shunt is referred to as an acyanotic defect

Answer 31

false right to left: cyanotic defect left to right: acyanotic defect