Heart disease/malformation/injury Flashcards
What are potential causes of valvular heart disease
- Stenosis or fusion of valve leaflets
- Regurgitations (insufficency)
What occurs if there is stenosis or fusion of valve leaflets
Valves fail to open completely impeding forward-flow
What occurs if there is regurgitations
Valves fail to close in systole which causes a reverse in blood flow
What occurs if there is dilated cardiomyopathy
increased mass of the heart results in difficulty pumping (can fill but can’t contract) this causes blood to back up into pulmonary circulation = stagnant blood
Stagnant blood increases risk of ____
clotting
What are 3 risk factors to dilated cardiomyopathy
- increased volume with pregnancy (third trimester)
- chronic alcohol use (~10 yrs)
- chemotherapy drugs
What is hypertrophic cardiomyopathy
Increased mass of heart with thickening of the ventricular wall - leads to abnormalities in filling (limited due to stiff tissues)
hypertrophic cardiomyopathy is ____ determined
genetically
hypertrophic cardiomyopathy Can lead to what fatal condition in young athletes
Sudden cardiac death
S&S of hypertrophic cardiomyopathy
Many asymptomatic
Angina
Dyspnea
Sudden death
What is cardiac tamponade
compression of the heart due to blood or fluid accumulation in the pericardial sac
Cardiac tamponade is sometimes the result of what?
Puncture wound through the heart during a procedure
Cardiac tamponade S&S
- small decrease in systolic BP on inspiration - pulse paradoxus (>10mL decrease)
- low cardiac output (limited capacity to fill) causing hypotension, shock, death
- jugular vein distension
- muffled heart sounds
What is arteriosclerosis
Hardening of the arteries caused by thickening and decreased elasticity
Why do artery walls thicken in atherosclerosis
Due to accumulation of atheroma’s (WBCs + cholesterol + triglycerides) in lumen
What is the effect of atherosclerosis
weakened underlying artery
People with atherosclerosis are at risk for…
Heart attack
Stroke
Aortic aneurism
What is aortic stenosis? What is it caused by?
narrowing of the aortic valve opening
Calcification due to age or lipid accumulation
What are the consequences of aortic stenosis
- heart murmur
- hypertrophy
- angina
- syncope -> transient loss of consciousness
What is an aneurism
Localized abnormal dilation of the wall of a blood vessel - may rupture
Causes of aneurism
Atherosclerosis
Trauma
Congenital defects
Infection
Most common site of aneurism
Abdominal aortic aneurism
What is the result of an aneurism
Tear in inner wall of aorta causing blood to flow btw layers of aorta wall forcing the layers apart (aortic dissection)
Aneurism S&S
Chest or abdominal pain Dissecting aneurism (tear in wall of blood vessel)
What is flail chest? What is it normally accompanied by?
Multiple rib fractures result in free floating rib section that move independently. Chest wall is no longer rigid which results in less ventilation on that side
Accompanied with pulmonary contusion (bruising of the lung sections)
What is usually the main cause of respiratory failure
Pulmonary contusion
What type of breathing is seen in flail chest
Paradoxical breathing
What occurs during inspiration in flail chest
flail segment sucks in - lung, heart, mediastinum shift away, reducing air entry into the unaffected lung
What occurs during expiration in flail chest
flail segment pushes outward - Lung, heart, mediastinum are pushed toward flail segment
Flail chest Rx
- pain control
- intubation/ventilation if necessary
- O2, airway clearance
What is pneumothorax ? what is it caused by?
- collapse of lung due to air in pleural space
* due to: puncture of chest wall or lung spontaneously bursts (ie. tall, skinny males)
What do you hear upon percussions in someone with pneumothorax
Hyperresonant percussion
Pneumothorax Rx
Chest tube to release pressure
Pneumothorax Types
- open – stab wound, air into pleural space
- tension – critical emergency - “flap” opens on inspiration but seals on expiration, air trapped in pleural space. Increases pressure on heart and heart can stop beating!
- spontaneous : spontaneous rupture of air-containing space of lungs
- hemothorax: collapse of lung due to blood in pleural space, AX: decreased breath sounds
