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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
Q

R side heart failure causes minimal

A

Pulmonary congestion

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26
Q

R side heart failure causes peripheral congestion, including

A

Pitting edema
Ascites
Hepatosplenomegaly

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27
Q

30% of all birth defects

A

Congenital heart disease

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28
Q

As embryo…R atrium communicates with L atrium via

A

Foramen ovale

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29
Q

As embryo… L pulmonary artery joins aorta at

A

Ductus arteriosus

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30
Q

___ closes at birth and ____ closes 1-2 days after birth

A

FO

DA

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31
Q

Risks for congenital heart disease

A 
Prematurity 
Trisomies 
Teratogens
Maternal diabetes 
Fetal infection
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32
Q

90% of congenital heart disease are

A

Idiopathic

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33
Q

Isolated R side heart failure is from

A

Pulmonary HTN

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34
Q

Pulmonary HTN can be due to

A

Lung pathology
Valve disorder
Left to right shunt

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35
Q

R side heart failure coming from something in lungs causing pulmonary HTN

A

Cor pulmonale

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36
Q

Over half of congenital heart disease is due to

A

Septal defects

VSD or ASD

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37
Q

R to L shunt

A

Blood bypass lungs —> cyanosis

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38
Q

R to L shunt can be due to

A

Tetralogy of fallot

Transposition of great arteries

39
Q

MC shunt

A

L to R

40
Q

42% of malformations and 30% isolated

A

VSD

41
Q

10% malformations

A

ASD

42
Q

MC asymptomatic and spontaneous closure is rare

A

ASD

43
Q

7% malformations and 90% isolated

A

PDA

44
Q

VSD may spontaneously

A

Close

45
Q

1 cause of congenital heart disease

A

VSD

46
Q

Obstructed flow can be due to

A

Valve stenosis

Aortic coarctation

47
Q

4 malformations of tetralogy of fallot

A

VSD
RV outflow obstruction
Overriding aorta
RV Hypertrophy

48
Q

MC congenital heart disease to cause cyanosis

A

Tetralogy of fallot

49
Q

“Boot shaped” heart and polycythemia describe

A

Tetralogy of fallot

50
Q

Irregular connections in transposition of great arteries

A

RV -> aorta

LV -> pulmonary A

51
Q

Transposition of great arteries separates ___ and is incompatible with postnatal life

A

Pulmonary and systemic circulation

52
Q

Aortic coarctation MC in

A

Males

Turner syndrome

53
Q

Types of aortic coarctation

A

Infantile

Adult

54
Q

Infantile aortic coarctation

A

Pre-ductal

Proximal to PDA

55
Q

Adult aortic coarctation

A

Post-ductal

Near ligamentum arteriosum

MC asymptomatic

56
Q

Variable features of aortic coarctation

A

Upper extremity HTN
HA
Low blood to LE
Systolic murmurs

57
Q

More than half of aortic coarctation have

A

Bicuspid aortic valve

58
Q

More severe aortic coarctation

A

Infantile

59
Q

Ischemia causes ___ in 1-2 min and ___ in 20-40 min

A

Dysfunction

Infarction

60
Q

90% of IHD cases

A

CAD

61
Q

Left anterior descending artery aka

A

Anterior interventricular Artery

“Widow maker”

62
Q

MC artery involved in IHD

A

Left anterior descending Artery

63
Q

Progression of IHD

A

Fatty streaks

Atheroma

Significant luminal stenosis

Thrombosis

64
Q

4 types of cardiac syndromes

A
  1. Angina pectoris
  2. Acute MI
  3. Sudden cardiac death (SCD)
  4. Chronic IHD
65
Q

Angina Pectoris occurs due to myocardial ischemia (____ occlusion)

A

70%

66
Q

Angina pectoris causes pain in

A

Substernal pain

Jaw
Let arm
Back
Shoulders

67
Q

Stable angina

A

Episodic and exertional

Relieved with rest and vasodilators

68
Q

Variant angina

A

Vasospasm at rest

Responds to vasodilators

69
Q

Unstable angina

A 
Increase intensity 
Increase frequency 
Increase duration 
Provoked by less exertion 
>90% occlusion
70
Q

> 70% occlusion aka

A

Critical stenosis

71
Q

> 70% occlusion observed in

A

Stable angina

72
Q

> 90% occlusion observed in

A

Unstable angina

73
Q

Angina pectoris in females is less ____ and many have no ____

A

Predictable

Angina

74
Q

Symptoms of angina in females

A 
Nausea 
Dizziness
Back pain 
Lower chest or epigastric pain 
Dyspnea 
Fatigue
75
Q

MI causes

A

Myocardial necrosis

76
Q

____ of MIs are lethal

A

1/3

77
Q

90% of MI cases are due to

A

Acute coronary thrombosis

78
Q

Risks for MI

A 
HTN
Smoking 
CHF
DM
Males 
Age 40-60
Postmenopausal females
Sickle cell 
Stress
79
Q

Reperfusion injures due to MI can cause

A

Endothelial swelling -> block capillaries

80
Q

Treatment for MI

A 
CPR
Defibrillation 
Vasodilator meds
Angioplasty 
Stent 
CABG
81
Q

Symptoms of MI

A

Crushing pain with intense pressure
-unrelieved by “nitro”

Thready pulse
Nausea
Sweaty
Dyspnea

82
Q

In community, MI’s __ lethal, in hospital, ___ lethal

A

30%

7%

83
Q

Diagnosis for MI

A

Troponins

CK-MB

Myoglobin

84
Q

Most sensitive and specific cardiac marker

A

Troponin

85
Q

Progressive failure secondary to ischemia damage, including past MI and long term CAD

A

Chronic ischemic heart disease

86
Q

Chronic ischemia HD has a ___ prognosis

A

Poor

87
Q

Order of cardiac conduction system

A

SA node
AV node
Bundle of His
Purkinje Fibers

88
Q

___ begins electrical impulse

A

SA node

89
Q

Sudden cardiac death MC from

A

Ischemic injury (CAD)

90
Q

Sustained arrhythmia causing death that is unexpected and sudden

A

Sudden cardiac death

91
Q

Commotio cordis

A

SCD from precordial trauma

92
Q

Commotio cordis causes no

A

Tissue damage

93
Q

Commotio cordis MC in

A

Adolescent males

15 yo

94
Q

Commotio cordis has a ___ prognosis

A

Poor

Systems Path 1 (12 decks)

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