Class 1 - Heart Pathologies Flashcards
What is the best known cause of congenital heart defects?
rubella infection during organogenesis (first 3 months of pregnancy)
What are the 3 most common types of causes of types of heart defects?
viral infections, toxic substances, and chromosomal abnormalities
What is the most common form of congenital heart disease? What percentage of clinical cases do these make up?
septal defects - 30-40%
The heart murmur in the case of an interatrial septal defect is caused by…
the passage of blood from the left to right atrium during systole
What is the most common congenital heart defect recognized in clinical practice?
interventricular septal defects (most common cause of heart murmurs in newborns)
What are the signs/symptoms of left-to-right shunt of blood with an interventricular septal defect?
shortness of breath/dyspnea, hypertrophy of the right ventricle, pulmonary hypertension
What are the 4 heart defects seen in tetralogy of fallot?
ventricular septal defect
overriding aorta
pulmonary stenosis
hypertrophy of the right ventricle
What is seen in a ‘tet spell’?
bluish skin - especially fingers, fingernails (and same of feet) and lips after crying, feeding, or feeling agitated
What are atheromas?
fatty deposits in the inner lining (tunica interna) of an artery - the central part is soft, of lipids and cell debris, and this is covered by fibrous tissue
What causes atheromas?
endothelial cell injury of the tunica interna, hypertension, metabolic disease (DM)
What is the most important question to ask a client with diabetes?
Is your diabetes stable/well-managed/well-regulated?
What are some risk factors of atherosclerosis?
cigarette smoking (nicotine tar damages endothelial cells), hypertension, hyper LDL, diabetes mellitus, stress (cortisol)
What are three possible fates for atheromas?
become larger + more numerous
rupture
calcification
Peripheral vascular disease affects what parts of the body? And more frequently?
the extremities and abdominal organs - more especially the legs, kidneys, and intestines
What are the consequences of an atherosclerotic aorta?
less elasticity: cannot adapt to BP changes or expand during systole –> hypertension, aortic aneurysm
Sudden occlusion of peripheral arteries leads to…
gangrene
Why does intermittent claudication occur?
the lack of oxygen means muscles must gather energy from anaerobic respiration, leading to a build up of lactic acid which causes muscle cramps
What cascade occurs when blood flow to the kidneys is limited by an aortic atheroscelerosis?
not enough blood to kidneys –> kidneys release renin to increase BP –> kidneys excrete less NaCL to increase BP –> anasarca (edema)
What is cor pulmonale?
right-sided heart failure
What are the signs/symptoms of cor pulmonale?
swollen legs at the end of the day, ascites, distended jugular veins (venous return stagnancy)
hepatomegaly and pain in R hypochondriac region (blood gets backed up in hepatic veins)
fatigue
weight gain
Atherosclerosis is also called ____ and is implicated in which CVS diseases?
Ischemic Vascular Disease of the Arteries
shows up in: aortic aneurysms peripheral vascular disease coronary artery/heart disease (CAD) myocardial infarction sometimes, cor pulmonale
Right-side heart failure is usually caused by…
chronic lung disease (pulmonary hypertension)
What are some prodromal symptoms of a heart attack?
sudden onset of severe/progressive angina shortness of breath fatigue excessive sweating pain in epigastric region
What enzyme levels are elevated
3-6 hours after occlusion of a coronary artery?
cardiac troponin I or T
What enzyme levels are elevated 1-2 hours after a heart attack?
creatinine kinase (a sign of muscle damage)
50% of heart attacks occur due to…
occlusion of the left descending coronary artery
30-40% of heart attacks occur due to…
occlusion of the right coronary artery
15-20% of heart attacks occur due to…
occlusion of the left circumflex artery
What is the most common cause of death in Western societies?
myocardial infarction
Sudden death occurs in what percentage of heart attacks? Why?
25% due to ventricular fibrillation
The two most common complications in the first week after a heart attack are…
arrhythmia (90%)
congestive heart failure (60%)
The most common complication in the first year after a heart attack is…
congestive heart failure (70%)
What percentage of people will die during the year following a heart attack?
30-40%
What are possible treatment options following a heart attack to try to resolve the issue?
bypass surgery
stent
heart transplant
Left ventricular failure will result in…
pulmonary congestion/edema and dyspnea
Nocturnal angina is associated with…
tachycardia from dreams or underlying CHF
What is the most common cause of angina?
coronary artery disease (90% of cases)
What is Prinzmetal’s angina?
angina due to abnormal coronary artery spasm rather than directly as a result of atherosclerosis
What is strange about decubitus angina?
it occurs at rest and is reduced by sitting/standing, normally
How could you tell the difference between heartburn and angina pectoris?
heartburn pain will usually change when you change the position of your torso, whereas angina will not
What is hypercarbia?
high carbon dioxide in the blood
90% of cases of angina are caused by…
coronary artery disease
Compare and contrast coronary artery disease vs. coronary heart disease
Coronary artery disease is a form of coronary heart disease, but they are often used interchangeably
