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Med Path Fall 2020 > CVDII > Flashcards

CVDII Flashcards

1
Q

What is heart failure

A

Inadequate cardiac output. Cannot meet the metabolic demands of the body.

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2
Q

Major causes of heart failure

A

***MI
HTN
Vascular disease/valve damage
Cardiomyopathy- muscle heart disease

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3
Q

HF risk factors

A 
Coronary heart disease
HTN
Cigarette
obesity 
Diabetes
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4
Q

Heart failure causes

A

Congestion of blood flow, inability to increase cardiac output as needed.

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5
Q

What happens if left side of heart fails first?

A

Rt side keeps pumping fluid into lungs, but the left side of the heart can’t get rid of it. Causes back up in the pulmonary system

Pulmonary edema 
Causes tachypnea (rapid breathing) and cyanosis (body is hypoxic and turns blue)
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6
Q

What happens if the right side of heart fails first?

A

Blood backs up in systemic circulation.
Systemic circulation flows into right side. If right side can’t move blood, it stops there.

Causes peripheral edema. Hepatomegaly (enlargement of liver) and ascites (fluid problems. Excess venous pressure causes blood to leak into abdomen)

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7
Q

Common symptoms of heart failure

A

Fatigue, shortness of breath

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8
Q

Right side failure is most commonly caused by

A

Left side failure

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9
Q

3 compensatory mechanisms for HF

A
  1. Sympathetic nervous system activation (by baroreceptors in carotid)
  2. Compensatory vasoconstriction
  3. Myocardial hypertrophy
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10
Q

Cardiac arrhythmia

A

Irregularity in the hearts beating pattern due to pacemaker/SA node. Electrical conductivity problem in the heart.

Inefficient heart contractions, decreases CO, can be fatal.

Most common side effect of MI, but can also occur on its own and lead to heart failure.

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11
Q

What causes cardiac arrhythmia

A 
Myocardial ischemia or MI **
Electrolyte imbalance (K+)
Stress due to cortisol release
Drugs (stimulants) 
Congenital defects in the myocardial electrical network
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12
Q

4 types of cardiac arrhythmia

A
  1. Tachycardia. Abnormally fast heart rate.
  2. Bradycardia. Abnormally slow heart rate.
  3. Flutter. Irregular or regular. Elevated rate.
  4. Fibrillation of atria or ventricles. Sporadic, quivering pattern. Inefficient pumping.
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13
Q

Atria vs ventricle fibrillation

A

Atria: too many p waves. Tx with meds, surgeries. No tx may lead to stroke.
Ventricle: Can quickly be fatal. Cause incomplete contraction and inefficient pumping.

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14
Q

Ischemic and non-ischemic forms of cardiomyopathy

A

Ischemic: Thrombus causes coronary heart disease.

Non-Ischemic:

  • Toxic (alcohol abuse)
  • Metabolic (Thyroid disease: elevated HR and hypertrophy. Amyloidosis: Amyloid accumulation in heart muscles due to autoimmune disease)
  • Infectious (Post viral myocarditis. HIV, COVID)
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15
Q

3 types of cardiomyopathy

A
  1. Dilated
  2. Restrictive
  3. Hypertrophic
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16
Q

Dilated cardiomyopathy

  • What is it
  • Usually caused by what
A

Heart is enlarged due to heart trying to maintain CO.

  • Walls are normal thickness
  • Ventricular chamber is increased
  • Contractility is decreased

More common out of the three types
Predominantly caused by ischemic damage to the heart due to MI. Results in myocardial degeneration bc ischemia.

17
Q

What is cardiomyopathy

A

Myocardial degeneration that leads to heart failure.

18
Q

Restrictive cardiomyopathy

  • What is it?
  • Primary causes
A

Normal sized heart that becomes more rigid. Results in reduced filling capacity because heart cannot initially expand to let more blood enter.

Amyloidosis- autoimmune disease that causes amyloid accumulation in heart muscles.
or idiopathic.

19
Q

Hypertrophic cardiomyopathy

-What is it?

A

Larger than normal heart due to muscles getting larger.

  • IV septum thicker than 1.5cm
  • Reduced filling capacity because there is less space for blood due to increasing muscle size
  • Normal capacity

Primarily an autosomal dominant genetic defect.
-AA men most affected

Most common cause of sudden cardiac death in young adults

20
Q

Most common cause of sudden cardiac death in young adults

A

Hypertrophic cardiomyopathy

21
Q

Difference between Hypertrophic and dilated cardiomyopathy

A

Dilated:

  • Heart is enlarged due to trying to maintain CO.
  • Walls are normal thickness.
  • Decreased contractility. *
  • Ventricular chamber is increased *

Hypertrophic:

  • Larger than normal heart due to muscles getting larger.
  • IV septum thicker than 1.5 cm.
  • Normal contractility. *
  • Reduced filling capacity. *
22
Q

Two types of endocardial/valvular disease and what causes this

A
  1. Stenosis: Associated with narrowing of valve. It cannot completely open.
  2. Regurgitation: Valve cannot close completely.

Cause: Inflammation, scarring, calcification/ageing, congenital malformations.

23
Q

Mitral valve regurgitation

A

Valve that is between left atrium and left ventricle. Instead of going from left ventricle to circulation, blood flows back into left atria.

24
Q

Aortic valve stenosis

A

Aortic valve that doesn’t open or close completely. This increases the workload of the left ventricle. may lead to left ventricular hypertrophy and eventually HF.

25
Q

Mitral valve prolapse

  • What is it
  • ocular associations
A

Degeneration of connective tissue (chordae/leaflets) in the valve.

  • Valve leaflets balloon into left atrium during systole.
  • May lead to mitral valve regurgitation.

Risk factor for bacterial endocarditis (infection) or thrombosis (clot)

Ocular associations: CRAO, BRAO, choroidal occlusion due to clot traveling.

26
Q

Infective endocarditis

  • What is it
  • most common bacteria
  • Predisposing risk factors
A

Colonization of endocardial structures due to pre-existing damage to the heart.

Strep, Staph

Rheumatic endocarditis/heart disease
Congenital valve defects

27
Q

Rheumatic endocarditis/heart disease

A

Occurs in younger ppl: 5-15 years
Develops 1-5 weeks after infection. Must be exposed twice.

Type II hypersensitivity. Antibodies cross react with connective tissue antigens in the heart.

28
Q

Pericardium

A

Sack that surrounds the heart. Outer covering. Holds the heart in place and assists with the regulation of blood pressure and HR. First line of defense against infection and inflammation.

29
Q

Pericardial fluid

A

Cushion and lubricant

30
Q

Acute pericarditis

A

Lasts less than 6 weeks
May be confused with MI
Leading cause: Neoplasm*

31
Q

Chronic pericarditis

A

Lasts more than 6 months
Constrictive pericarditis. Increased scarring reduces movement and normal function of heart.
leading cause: Idiopathic* or TB

32
Q

Systemic associations to pericarditis

A

Uremia* excess ammonia in the blood
Rheumatic fever
SLE

33
Q

Ocular manifestation of infective endocarditis

A

Roth’s spot: red dot with white center.
Choroiditis
Endophthalmitis

34
Q

Ocular manifestation of mitral valve prolapse

A

Mitral valve prolapse causes turbulence –> Coagulation –> Platelet emboli that travels to eye

35
Q

Ocular manifestations of aortic stenosis

A

Associated with calcification of aortic valve. May break off and cause calcium emboli.

Med Path Fall 2020 (20 decks)

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