heart part 2 Flashcards
disorders of pericardium
pericarditis
pericardial effusion (fluid accumulation in pericardial space)
cardiac tamponade (special form of pericardial effusion)
*fluid applys pressure on heart preventing effective contraction and ejection (causing OBSTRUCTIVE SHOCK)
endocardial disorders
endocarditis: inflammation of endocardium
subacute bacterial endocarditis (SBE) (bacterial infection)
*valvular vegetations form and damage valve function
prevention: pre-procedural antibiotic prophylaxis
Rheumatic heart disease
inflammation of the endocarial structure due to immune reaction to group A Beta hemolytic streptococcal pharyngeal infection (strep throat).
due to molecular mimicry (cells look similar and get destroyed)
valvular damage and valvular vegetative growth
prevention: antibiotics
valular disorders
valvular stenosis (narrowing)
valvular insufficiency (failure to close completely)
*aka regurgitation or incometent
aortic valve disorders
aortic stenosis
aortic insufficiency (regurgitation)
mitral valve disorder
mitral stenosis
mitral insufficiency (regurgitation)
mitral valve prolapse syndrome
*”ballons backward” into the atria
*if it is pure prolapse it will only muve backward but valve stays closed
*can also have incompetent mitral valve too with prolapse
heart disease in infants and children
congenital cardiac defects
kawasami syndrome
Covid-19 related “multisystem inflammatory disorder in children” (MIS-C)
congenital cardiac defects
higher to lower pressure and thru path of least resistance
1)defects with increased pulmonary blood flow
2)defects with decreased pulmonary blood flow
3)defecrs with miced effects on blood flow
4)defects with decreased systemic blood flow
3 fetal shunts
Ductus arteriosus:
*connects aorta and pulmonary artery
Foramen ovale:
*connects right and left atria
Ductus venosus:
*shunts blood across the liver
congenital cardiac defects
1)defects with increased pulmonary blood flow
intro
cause a left-to-right shunting of blood
oxygenated blood in left side of heart or aorta is redurected to right side or pulmonary artery then back to lungs again
*this increased pulmonary blood flow
remain acyanotic unless increased blood flow causes secondary pulmonary edema
if pulmonary edema develops patient becomes cyantic due to the pulmonary edma not the cardiac defect
congenital cardiac defects
1)defects with increased pulmonary blood flow
Patent ductus arteriosus (PDA)
left-to-right shunt from aorta to PA thru ductus arteriosus
(ex of oxygenated blood being pushed into right side increasing pulmonary blood flow)
congenital cardiac defects
1)defects with increased pulmonary blood flow
atrial septal defect (ASD)
ventricular septal defect (VSD)
left-to-right shunt thru the ASD
left-to-right shunt thru the VSD
(both examples of oxygentated blood going to right side of heart increasing pulmonary blood flow)
congenital cardiac defects
2)defects with decreased pulmonary blood flow
intro
blood flow from right side of heart to lungs is diminished or obstructed
the actual cardiac defect is what causes cuyanosis
congenital cardiac defects
2)defects with decreased pulmonary blood flow
examples
pulmonic stenosis (narrowing of pulmonary valve)
pulmonic atresia (the valve has no opening)
tetralogy of fallot (explained later)
congenital cardiac defects
2)defects with decreased pulmonary blood flow
Tetralogy of fallot (explained)
caused by comination of 4 defects:
*pulmonic stenosis (PS) (blockes PA)
*right ventricular hypertrophy (addes pressure)
*ventricular septal defect (VSD) (gives blood a place to go)
*overriding aorta
(opening of the aort overrides the VSD and taked its deoxygenated blood with the oxygenagted blood)
children have hypercyanotic “Tet Spells”
congenital cardiac defects
3) defects with mixed effects on blood flow
transposition of the greart vessels:
cyanotic:
*2 completely seperate circulatory systems
usually has PDA, ASD, VSD that allows some mixed of oxygenated and deoxygenated blood
congenital cardiac defects
4) defects with decreased systemic blood flow
intro
interference with outflow of blood from the left heart, which decreases systemic perfusion
will have cyanosis if the outflow is decreased enough
congenital cardiac defects
4) defects with decreased systemic blood flow
Coarctation of the Aorta
narrowing of the aorta-obstructs left ventricular outflow
*raisies pressure above level of obstruction but still reduces systemic perfusion below point of of aortic narrowing
above the obstruction is the branches of aorta so you have
increased pulses/BP in arms
decreased pulses /BP in legs (bc their below obstruction)
congenital cardiac defects
4) defects with decreased systemic blood flow
Aortic stenosis
narrowing at the aortic valve
due to congentially bicuspid aortic valve
no shunting of blood (obstructed outflow)