Developmental

Question 1

What are the 3 developmental cardiovascular pathologies

Answer 1

Congestive heart failure
Nonbacterial thrombotic endocarditis
Cardiac arrhythmias

Question 2

Congestive heart failure is a __ (explain)

Answer 2

system complex not a disease
- inability of the heart to pump blood sufficiently
- volume overload as a result
- develops when the body cant compensate for volume overload or inadequate tissue perfusion

Question 3

4 causes of congestive heart failure

Answer 3

decreased myocardial function or cardiac valvular dysfunction
Increased vascular resistance
Increased blood volume
Excessive metabolic demand

Question 4

Systolic vs diastolic heart failure

Answer 4

systolic - reduced contractility
Diastolic - impaired relaxation + abnormal filling

Question 5

Which cause of congestive heart failure involves hypertension

Answer 5

increased vascular resistance

Question 6

What is the most common cause of congestive heart failure? Due to what ?

Answer 6

decreased myocardial function or cardiac valvular dysfunction
Previous MI

Question 7

aortic valve disease vs stenosis

Answer 7

Congenital heart defects / aortic valve disease = Decreased function
Aortic valve stenosis = increased vascular resistance

Question 8

Chronic renal failure/ kidney disease can lead to

Answer 8

increased blood volume

Question 9

anemia and thyrotoxicosis can lead to

Answer 9

excessive metabolic demand

Question 10

Most common cause of CHF

Answer 10

left ventricular systolic dysfunction (Previous MI most common cause)

Question 11

Left vs right sided heart failure

Answer 11

Left sided = failure of left ventricle or increased pressure in left atrium
Right sided = failure of right ventricle or increased pressure in right atrium

Question 12

S3 gallop can occur in

Answer 12

left sided heart failure

Question 13

Dyspnea, orthopnea, cough, hemoptysis –> pulmonary edema

Answer 13

Left sided heart failure

Question 14

Hemosiderin-laden alveolar macrophages

Answer 14

“heart failure cells”
causes what you cough up to be a rust color
Involved in L sided heart failure

Question 15

Cor pulmonale is also a cause of

Answer 15

right sided hart failure

Question 16

Pitting edema in extremities

Answer 16

Right sided heart failure

Question 17

Biventricular failure

Answer 17

usually not simultaneous but develops over time die to increased stress placed on remaining ventricle

Question 18

Backward vs forward failure

Answer 18

backward = venous congestion / “damming up” –> left sided
Forward = decreased cardiac output or failing ventricle = inadequate organ perfusion –> right sided

Question 19

Enlarged or tender liver and spleen

Answer 19

right sided / forward failure

Question 20

symptoms = anorexia, vomiting, decreased tissue mass

Answer 20

forward heart failure

Question 21

cardiac pump function =

Answer 21

ejection fraction
= 100 X SV / EDV

Question 22

EF is measured only in the

Answer 22

left ventricle

Question 23

Normal EF? Systolic dysfunction?

Answer 23

Normal = .5 (50%) to .7(70%)
Systolic dysfunction = less than or equal to .4(40%)

Question 24

Most CHF patients have EF below __ but you can have symptomatic CHF with __

Answer 24

50%
normal EF (heart failure with preserved EF)

Question 25

Cardiac abnormalities and lung abnormalities seen with left sided involvement

Answer 25

Left ventricle = hypertrophied or dilated (fibrosis microscopically)
Lungs = heavy and boggy due to pulmonary congestion and edema. Microscopically we see edema, RBC’s and heart failure cells