Chapter 28 Flashcards
Mitral valve prolapse- one or both _______ of the mitral valve ______ _______ (prolapse) into the ______ ________ during systole. Most common valve disorder in the U.S. Many cases are completely __________. Characterized by a ________ ________ upon auscultation.
Cusps Billow upward Left atrium Asymptomatic Mid systolic click
If a pt with mitral valve prolapse is symptomatic you may note palpitations r/r ________, ________, light headedness, _______, fatigue (especially in the _______), lethargy, ______, dyspnea, ______ _______, anxiety, hyperventilation, depression, panic attacks, and _________ _______ _____.
Dysthymia Tachycardia Syncope Morning Weakness Chest tightness Atypical chest pain
_______ ________ may be needed to alleviate syncope, severe chest pain, or palpitations.
Beta blockers
Mitral regurgitation permits ______ of blood from the _____ ventricle into the ___ atrium during ventricular systole, producing a ______ best heard at the _____.
Back flow Left Left Murmur Apex
Because of mitral regurgitation the increased volume from LA, the LV gradually becomes ______ and _____ in order to maintain adequate _____ ____ and will eventually cause atrial ______ and atrial _______ and ultimately _____ ________.
Dilated Hypertrophy Cardiac output Dilation Fibrillation Heart failure
Mitral stenosis impairs the flow of blood from the ____ to the ____. Most common in ______ and occurs in ____ of people with a history of _______ heart disease.
LA
LV
Women
Rheumatic diseases
Autoimmunity in response to streptococcal antigens leads to _______ and ______ of the valvular leaflets to become _______ and _____, and the chordae tendineae become _______.
Inflammation Scarring Fibrous Infused Shortened
As mitral stenosis progresses, symptoms of decreased _____ ______ occur, esp. During ______. If untreated, chronic mitral stenosis develops into pulmonary _______, pulmonary edema, and right _____ ______.
Cardiac output Exertion Hypertension Edema Ventricular failure
Aortic regurgitation results from inability of the aortic valve _____ to close properly during _____ due to _____ or ______ abnormalities.
Leaflets
Diastole
Congenital
Acquired
______ _______ occurs in the ventricle because it receives blood from both the left atrium and from the ______ during diastole.
Volume overload
Aorta
As the ____-________ _______ of the LV increases, myocardial fibers stretch to accommodate the extra fluid and the LV will increase its ______ ______ and maintain cardiac output.
End-diastolic volume
Stroke volume
______ _______ occurs due to increased volume and increased __________. Overtime, ______ ______ and ________ eventually cannot compensate for aortic incompetence and _______ _________ develops.
Ventricular hypertrophy Afterload Ventricular dilation Hypertrophy Heart failure
Aortic stenosis has 3 common causes: 1) ______ ______ ______ 2) degeneration with _______, and 3) _____ damage caused by rheumatic heart disease. Usually develops ______ and Classic s/sx include ______, syncope, and _____.
Congenital bicuspid valve Aging Inflammatory Gradually Angina Dyspnea
Clinical manifestations include _____ stroke volume, and ______ pulse pressure, ________, and delayed pulses.
Decreased
Narrowed
Bradycardia
Once pts become _______ from aortic stenosis, the ______ is poor. Develops from thickening, ______, calcification, vegetation, or _____ of the flaps of the valve.
Asymptomatic
Prognosis
Scarring
Refusing
Left ventricular hypertrophy occurs as the _______ nervous system is activated to compensate for ___ _______ _______. When compensatory mechanisms fail, _____ ______ results.
Sympathetic
Low cardiac output
Heart failure
Cardiomyopathy- enlargement of the heart _______ or _______ of the heart that causes ______ _______. Causes: heredity, ____, chronic alcohol or cocaine use, ___, thiamine or zinc deficiencies, infections, or autoimmune disease.
Muscle Chambers Heart failure Myocardisis HIV
Diagnostic finding in cardiomyopathy
Angina, Arrhymias, dyspnea, fatigue, syncope, and s3 gallop rhythm.
Echo shows abnormal _______ _______ or large ________ _________. EKG shows arrhythmias.
Myocardial thickness
Chamber signs
Pt with cardiomyopathy needs ______ _____ to visualize chamber size and _______. Cardiac ____ to visualize heart _____ and chamber size.
Cardiac cath
Contractility
MRI
Wall
Cardiomyopathy complications
CHF, enlargement of the septum that blocks aortic valve resulting in abnormal heart rhythms and sudden death, thromboemboli.
Rheumatic endocarditis-> beta-hemolytic streptococci that caused ______ _______ or _______ cause bacteremia. The BHS infect the heart ___________ after the initial infection.
Throat infections
Impetigo
2-3 weeks
Rheumatic endocarditis may occur in childhood and _______ and all ______ of the heart are affected, with ________ ________ of all heart structures.
Reoccur
Layers
Generalized inflammation.
Pericarditis- inflammation of pericardial sac. Sac normally contains _______ mL of serous fluid. In pericarditis volume may increase to _______ mLs.
25-50
1500
Pericarditis s/sx
Radiating substernal CP that increases with deep inspiration or lying flat and some what relieved by sitting upright and leaning forward; dyspnea; low grade fever; cough and pericardial friction rub.
Pericarditis complications
Pericardial effusion and can lead to heart failure.
Myocarditis- the myocardium is _______ by inflammatory cells leading to ______ of muscle cells and _______.
Infiltrated
Necrosis
Fibrosis
Myocarditis causes include ______, _____ _______ and ________ infections; inflammatory or ________ causes; exposure to chemical or ______ and ________ therapy. Pregnant women have an ________ _______.
Viral Bacterial Protozoan Fungal Autoimmune Toxins Radiation Increased risk
Myocarditis complications: _______, arrhythmias, chronic dilated cardiomyopathy and ______ _______.
Pericarditis
Heart failure
