CV System and Disorders: Week 4: Set 3 Flashcards
What is done to diagnose HF
- Coronary angiogram
- TSH-thyroid
- CBC
- Chemistry profile
- BMP (basic metabolic profile)
- Magnesium
- Check BNP (brain neutropenic protein)
- EKG
- Echocadiogram
- Chest Xray
Why is a coronary angio done for diagnosing HF? Who does it?
- Can’t figure out etiology
2. Cardiologist
Why is TSH levels read for diagnosing HF?
hyperthyroid > aFib> HF
Why is CBC read when diagnosing HF?
anemia
Why is magnesium read when diagnosing HF?
can cause cardiac arrhythmias
Why is BNP read when diagnosing HF?
Elevated in HF pts
Why is chest xray read when diagnosing HF?
- Visualize heart and lungs
2. See if pleural effusion or enlarged heart
what are AHA and ACC(1-4) AND NYHA (A-D)? What do they do?
- systems to classify HF
- so they know who can get heart transplants
- Higher is worse (4 and D)
Maintenance of Cardiac Reserve in HF: Compensatory and Adaptive Mechanisms
- Activation of SNS, RAAS
2. Activation of inflammatory mediators
What does activation of SNS, RAAS as a compensatory/adaptive mechanism for HF do to help?
- Maintain cardiac output through….
- increased retention of salt and water
- peripheral arterial vasoconstriction
What does activation of inflammatory mediators as a compensatory/adaptive mechanism for HF do to help?
involved in cardiac repair and remodelling
EF in systolic and diastolic HF
Systolic-Low EF
Diastolic-EF-60%
Which disorders start with right HF with progression to left HF?
COPD and cor pulmonale
Which disorders start with left HF with progression to right HF?
CAD
Acute vs chronic HF
Acute-occurs very suddenly, medical emergency
Chronic- develops gradually over time
- Paroxysmal Nocturnal Dyspnea
- Pulmonary congestion
- Restlessness
4, Confusion - Orthopnea
- Tachypnea
- Exertional dyspnea
- Fatigue
- Cyanosis
Left HF S&S
- Fatigue
- increased peripheral venous pressure
- Ascites
- Enlarged liver/spleen
- Secondary to pulmonary problems
- JVD
- Anorexia/GI distress
- Weight gain
- Edema
Right HF S&S
Systolic HF vs Diastolic HF
Systolic-left ventricle can’t contract completely
Diastolic- left ventricle can’t fill properly
Condition caused by excess fluid in the lungs. This fluid collects in the numerous air sacs in the lungs, making it difficult to breathe.
Pulmonary Edema
Types of Circulatory Shock
Hypovolemic Shock Cardiogenic Shock Obstructive Shock Distributive Shock Septic Anaphylactic Neurogenic
Circulatory Shock caused by insufficient circulating volume
Hypovolemic Shock
Circulatory Shock caused by a failure of the heart to pump correctly
Cardiogenic Shock
Circulatory Shock caused by an obstruction of blood flow outside of the heart (usually venous)
Obstructive Shock
Circulatory Shock caused by an abnormal distribution of blood to tissues and organs.
Distributive Shock
Distributive Shock is broken into 3 types of shock. what are they?
Septic
Anaphylactic
Neurogenic
How does Septic Shock occur?
- Systemic infection that cannot be cleared by the immune system
- Vasodilation and hypotension
How does Anaphylactic Shock occur?
- Reaction to allergen
- Release of histamine
- Vasodilation and hypotension
How does Neurogenic Shock occur?
- Damage to the CNS
- Impairs cardiac function by reducing HR and loosening the blood vessel tone
- Severe hypotension
- Cardiopulmonary arrest
- Dysrhythmia
- Renal failure
- Multisystem organ failure
- Ventricular aneurysm
- Thromboembolic sequelae
- Stroke
- Death
Complications of circulatory shock
Infants & Children with HF from what?
Heart damage
Rare self-limited vasculitis, most often affects kids younger than 5 years old.
Kawasaki Disease
Why is it best to be noticed ASAP?
can lead to all kinds of complications
Progression of Kawasaki Disease
Starts in small vessels and progresses to larger arteries
What virus causes Kawasaki Disease
Seen in children post corona virus
Etiology of Kawasaki Disease
Unknown
What can Kawasaki Disease cause?
Most common cause of acquired heart disease in children (if not picked up early)
Kawasaki Disease Diagnostics
- No specific diagnostics
2. Based on symptoms.
How soon should Kawasaki Disease be diagnosed to avoid long term damage?
within first 10 days
Phases of Kawasaki Disease
Acute
Subacute
Convalescent
How long for all symptoms and signs of inflammation disappear?
usually takes about 8 weeks
Most tell tale S&S of Acute phase of Kawasaki Disease
Fever
- bloodshot eyes
- pink rash on the back, belly, arms, legs, and genital area
- red, dry, cracked lips
- “strawberry” tongue
- sore throat
- swollen palms of the hands and soles of the feet 7. a purple-red color on hands and soles of the feet
- swollen lymph glands in the neck
Other S&S of Acute phase of Kawasaki Disease
How long does the Acute phase of Kawasaki Disease last?
About 5 days
Myocarditis
Myocardium is inflamed w/o evidence of a MI
Pericarditis
fluid build up in sac (pericardial sac)
Complication of Pericarditis
- compression of heart (Cardiac Tamponade)
Type of fluid in Pericarditis
can be fluid, blood, pus, ect
Is Pericarditis emergent?
Depending on the amount of fluid can be emergent
Treatment for Pericarditis
Pericardial window
How is Pericardial window performed
Open window> put in drain and collection bag to drain into
Where is Pericardial window performed?
cath lab
When is Pericardial window performed more than once for Pericarditis?
pts with certain cancers
Infective-Invasion on heart valves & endocardium by microbial agent
Endocarditis
What is usually effected by Endocarditis?
mitral and aortic valve
Diagnostics for Endocarditis
- Blood cultures
- Temperature
- EKG
- Echocardiogram
Criteria used to define endocarditis
Duke Criteria
What is Duke Criteria used for?
Treatment is based on that
Complication of Endocarditis
bulky, friable vegetations & destruction of underlying cardiac tissues
Who is at risk for Endocarditis
- Artificial heart valves
- certain heart birth defects
- Pts getting IV meds
- IV drug user
- Damage or defects to endocardial surface
What do pts at risk for Endocarditis need to do as a preventative measure?
take antibiotics to prevent endocarditis, before dental or surgical procedures
Most common organisms that cause Endocarditis?
- Staphylococci
- Streptococci
- Enterococci
Treatment of Endocarditis
Long IV treatment course
Abnormal murmurs are usually caused by congenital heart disease
Murmurs in children
inflammatory disease that can affect connective tissues-heart, joints, skin, or brain caused by Group A (Beta hemolytc) streptococcus
rheumatic fever
Who does rheumatic fever effect?
Children
Complication of rheumatic fever
- pyelonephritis and then kidney failure
2. myocarditis, pericarditis, endocarditis
Most effected valves in rheumatic fever
mitral & aortic
disease of the heart muscle that makes it harder for your heart to pump blood to the rest of your body
Cardiomyopathy (CMP)
What is a complication of CMP
HF
Cause of CMP
AFib (or tachy arrhythmias)
Who does CMP affect?
Can affect any age but most often older adults
Types of CMP
- Hypertrophic
- Dilated
- Restrictive
Hypertrophic CMP
- Diastolic
- athletes
- Thick left ven wall
Dilated CMP
- Systolic
- Common
- Enlarged all chambers
Restrictive CMP
- Diastolic
- Laast common
- Rigid vent walls
A circulatory condition in which narrowed blood vessels reduce blood flow to the limbs.
PV Disease
Systolic vs Diastolic Dysfunction: what is imparied?
Systolic- contractility
Diastolic- filling/relaxation
Systolic vs Diastolic Dysfunction- heart muscle
Systolic- thin weak
Diastolic- stiff/thick
Systolic vs Diastolic Dysfunction: heart sounds
Systolic- S3 gallop
Diastolic- S4 gallop
Systolic vs Diastolic Dysfunction: EJF
Systolic: low
Diastolic: normal