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Systems Path 1 > Exam 3: Heart > Flashcards

Exam 3: Heart Flashcards

1
Q

1 cause of death in US

A

Heart disease

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2
Q

Heart disease MC due to

A

Contractile failure

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3
Q

CHF MC due to

A

Low cardiac output

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4
Q

Systolic dysfunction

A

Weak contraction

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5
Q

Diastolic dysfunction

A

Failed relaxation

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6
Q

Valvular dysfunction

A

Failure to effectively seal

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7
Q

Forward failure

A

Insufficient output

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8
Q

Backward failure

A

Congestion

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9
Q

Forward failure is almost always accompanied by

A

Backward failure

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10
Q

Forward failure impacts

A

Virtually every organ

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11
Q

3 adaptations to heart failure

A

Frank-starling law mechanism

Neurohumoral mechanisms

Structural changes

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12
Q

Frank-starling law

A

Increase stretch = stronger contraction

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13
Q

Benefit and cost of frank-starling law

A

Benefit: increase output

Cost: increase O2 and tension

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14
Q

Neurohumoral mechanisms

A

NE = increase HR and increase contractility

ANP = diuresis and vasodilation

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15
Q

Structural changes

A

Cardiac hypertrophy

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16
Q

Cost of structural changes

A

Increase O2 consumption

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17
Q

Pathological cardiac hypertrophy

A

Concentric hypertrophy

Increase pressure

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18
Q

Physiologic cardiac hypertrophy

A

Eccentric hypertrophy
Increase volume
Increase capillary density

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19
Q

Athlete’s heart can be used to describe

A

Sarah

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20
Q

Orthopnea

A

Dyspnea when lying down

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21
Q

L side heart failure causes L ventricle to

A

Hypertrophy

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22
Q

L side heart failure causes gradual decrease in ____ and therefore ____

A

cardiac output

Pulmonary edema

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23
Q

Signs of L side heart failure

A

Cough
Rales
Orthopnea
Tachycardia

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24
Q

R side heart failure MC from

A

L sided failure

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25
R side heart failure causes minimal
Pulmonary congestion
26
R side heart failure causes peripheral congestion, including
Pitting edema Ascites Hepatosplenomegaly
27
30% of all birth defects
Congenital heart disease
28
As embryo...R atrium communicates with L atrium via
Foramen ovale
29
As embryo... L pulmonary artery joins aorta at
Ductus arteriosus
30
___ closes at birth and ____ closes 1-2 days after birth
FO DA
31
Risks for congenital heart disease
``` Prematurity Trisomies Teratogens Maternal diabetes Fetal infection ```
32
90% of congenital heart disease are
Idiopathic
33
Isolated R side heart failure is from
Pulmonary HTN
34
Pulmonary HTN can be due to
Lung pathology Valve disorder Left to right shunt
35
R side heart failure coming from something in lungs causing pulmonary HTN
Cor pulmonale
36
Over half of congenital heart disease is due to
Septal defects VSD or ASD
37
R to L shunt
Blood bypass lungs —> cyanosis
38
R to L shunt can be due to
Tetralogy of fallot Transposition of great arteries
39
MC shunt
L to R
40
42% of malformations and 30% isolated
VSD
41
10% malformations
ASD
42
MC asymptomatic and spontaneous closure is rare
ASD
43
7% malformations and 90% isolated
PDA
44
VSD may spontaneously
Close
45
#1 cause of congenital heart disease
VSD
46
Obstructed flow can be due to
Valve stenosis | Aortic coarctation
47
4 malformations of tetralogy of fallot
VSD RV outflow obstruction Overriding aorta RV Hypertrophy
48
MC congenital heart disease to cause cyanosis
Tetralogy of fallot
49
“Boot shaped” heart and polycythemia describe
Tetralogy of fallot
50
Irregular connections in transposition of great arteries
RV -> aorta | LV -> pulmonary A
51
Transposition of great arteries separates ___ and is incompatible with postnatal life
Pulmonary and systemic circulation
52
Aortic coarctation MC in
Males | Turner syndrome
53
Types of aortic coarctation
Infantile Adult
54
Infantile aortic coarctation
Pre-ductal Proximal to PDA
55
Adult aortic coarctation
Post-ductal Near ligamentum arteriosum MC asymptomatic
56
Variable features of aortic coarctation
Upper extremity HTN HA Low blood to LE Systolic murmurs
57
More than half of aortic coarctation have
Bicuspid aortic valve
58
More severe aortic coarctation
Infantile
59
Ischemia causes ___ in 1-2 min and ___ in 20-40 min
Dysfunction Infarction
60
90% of IHD cases
CAD
61
Left anterior descending artery aka
Anterior interventricular Artery “Widow maker”
62
MC artery involved in IHD
Left anterior descending Artery
63
Progression of IHD
Fatty streaks Atheroma Significant luminal stenosis Thrombosis
64
4 types of cardiac syndromes
1. Angina pectoris 2. Acute MI 3. Sudden cardiac death (SCD) 4. Chronic IHD
65
Angina Pectoris occurs due to myocardial ischemia (____ occlusion)
70%
66
Angina pectoris causes pain in
Substernal pain Jaw Let arm Back Shoulders
67
Stable angina
Episodic and exertional Relieved with rest and vasodilators
68
Variant angina
Vasospasm at rest Responds to vasodilators
69
Unstable angina
``` Increase intensity Increase frequency Increase duration Provoked by less exertion >90% occlusion ```
70
>70% occlusion aka
Critical stenosis
71
>70% occlusion observed in
Stable angina
72
>90% occlusion observed in
Unstable angina
73
Angina pectoris in females is less ____ and many have no ____
Predictable Angina
74
Symptoms of angina in females
``` Nausea Dizziness Back pain Lower chest or epigastric pain Dyspnea Fatigue ```
75
MI causes
Myocardial necrosis
76
____ of MIs are lethal
1/3
77
90% of MI cases are due to
Acute coronary thrombosis
78
Risks for MI
``` HTN Smoking CHF DM Males Age 40-60 Postmenopausal females Sickle cell Stress ```
79
Reperfusion injures due to MI can cause
Endothelial swelling -> block capillaries
80
Treatment for MI
``` CPR Defibrillation Vasodilator meds Angioplasty Stent CABG ```
81
Symptoms of MI
Crushing pain with intense pressure -unrelieved by “nitro” Thready pulse Nausea Sweaty Dyspnea
82
In community, MI’s __ lethal, in hospital, ___ lethal
30% 7%
83
Diagnosis for MI
Troponins CK-MB Myoglobin
84
Most sensitive and specific cardiac marker
Troponin
85
Progressive failure secondary to ischemia damage, including past MI and long term CAD
Chronic ischemic heart disease
86
Chronic ischemia HD has a ___ prognosis
Poor
87
Order of cardiac conduction system
SA node AV node Bundle of His Purkinje Fibers
88
___ begins electrical impulse
SA node
89
Sudden cardiac death MC from
Ischemic injury (CAD)
90
Sustained arrhythmia causing death that is unexpected and sudden
Sudden cardiac death
91
Commotio cordis
SCD from precordial trauma
92
Commotio cordis causes no
Tissue damage
93
Commotio cordis MC in
Adolescent males | 15 yo
94
Commotio cordis has a ___ prognosis
Poor

Systems Path 1 (12 decks)

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