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Systems Pathology Final > Heart Pt. 1 > Flashcards

Heart Pt. 1 Flashcards

1
Q

What is the function of the circulatory system?

A

Provide nutrients, remove waste

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2
Q

What is the most common mechanism of heart disease?

A

Contractile (pump) failure

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3
Q

What are the mechanisms of heart disease?

A

Pump failure, obstruction of flow, regurgitant flow, shunted flow, dysfunction cardiac conduction, ruptured vessels or heart walls

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4
Q

What is the most common cause of congestive heart failure?

A

Decreased cardiac output

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5
Q

How many Americans are affected by heart failure?

A

5 million

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6
Q

What conditions are associated with increased tissue demands which can lead to heart failure?

A

Hyperthyroidism, severe anemia, fistula, “high-output failure”

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7
Q

What are the causes of decreased cardiac output?

A

Systolic dysfunction, diastolic dysfunction, valvular dysfunction

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8
Q

What are the risks for systolic dysfunction?

A

CAD, systemic hypertension, decreased pH (shock)

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9
Q

What causes systolic dysfunction?

A

Weak contraction

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10
Q

What causes diastolic dysfunction?

A

Failure to relax which inhibits filling

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11
Q

What gender is more likely to develop diastolic dysfunction?

A

Females

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12
Q

What conditions are associated with diastolic dysfunction?

A

Myocardial fibrosis, amyloidosis, left-sided hypertrophy, pericardial tamponade

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13
Q

What conditions are associated valvular dysfunction?

A

Stenosis, endocarditis

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14
Q

What occurs due to insufficient output of the heart resulting in forward failure?

A

Hypoxia

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15
Q

What is backward failure of the heart?

A

Venous congestion, increased venous volume and pressure

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16
Q

Forward and backward failure of the heart affects what organs?

A

Virtually every one

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17
Q

Do forward and backward heart failure tend to occur independently?

A

No, usually together

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18
Q

How do forward and backward heart failure change the heart?

A

Lead to myocardial adaptations

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19
Q

What is the Frank-Starling mechanism of compensated heart failure?

A

Increased stretch leading to stronger contraction

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20
Q

What is the benefit of Frank-Starling mechanism of compensated heart failure?

A

Increased cardiac output

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21
Q

What is the cost of Frank-Starling mechanism of compensated heart failure?

A

Increased oxygen and tension

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22
Q

How does norepinephrine affect the heart?

A

Increased heart rate and contractility

Stimulation of renin-angiotension system therefore increasing blood pressure

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23
Q

How does ANP affect the heart?

A

Vasodilation (balances NE and leads to diuresis)

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24
Q

What two substances make up the neurohumoral mechanisms of compensated heart failure?

A

Norepinephrine and ANP

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25
What are the three mechanisms of compensated heart failure?
Frank-Starling mechanism, neurohumoral mechanisms, cardiac hypertrophy
26
Physiologic cardiac hypertrophy is seen among what type of individuals?
Top athletes
27
Which kind of cardiac hypertrophy is the "good kind"?
Physiological
28
What changes to the size of the heart can result from overload and increased oxygen consumption?
Cardiac hypertrophy
29
What occurs with transposition of the great arteries?
Arteries connect to the wrong ventricles
30
In transposition of the great arteries, the aorta connects to what ventricle?
Right
31
In transposition of the great arteries, the pulmonary artery connects to which ventricle?
Left
32
What is a visual sign of transposition of the great arteries that is seen after birth in 1:4,000 births?
Postnatal cyanosis
33
What is the prognosis for transposition of the great arteries?
Poor, lethal in less than one month
34
What treatment can be used for transposition of the great arteries to increase the life expectancy slightly?
Shunting
35
What usually abnormal defects can actually benefit patients with transposition of the great arteries by enabling more blood movement?
Patent ductus arteriosus, ventricular septal defect
36
What gender is more likely to suffer from aortic coarctation?
Males
37
Those with what genetic condition are more likely to have aortic coarctation?
Turner syndrome
38
How is the aortic valve changed with aortic coarctation?
>50% have bicuspid aortic valve instead of the usual three cusps
39
Where do we seen aortic coarctation in infants (pre-ductal)?
Proximal to a patent ductus arteriosus
40
What is common with an adult form of aortic coarctation?
Infolding near the ligamentum arteriosum (asymptomatic)
41
What are some of the features of aortic coarctation?
Upper extremity hypertension, weak lower extremity pulses, lower extremity vascular claudication and cyanosis, systolic murmurs/thrills
42
What is a coarctation?
Congenital narrowing
43
Increased consumption of what gas can lead to cardiac hypertrophy?
O2
44
What conditions can result from chronic increased cardiac pressure?
Hypertension, valvular stenosis
45
Physiologic cardiac hypertrophy can lead to the formation of what vascular structures?
Capillary beds
46
What is the most common cause of left-side heart failure?
Ischemic heart disease (CAD)
47
What are all the causes for left-sided heart failure?
IHD/CAD, hypertension, valve disorders (mitral and aortic), primary myocardial disease (amyloidosis)
48
How are the heart chambers affected in left-sided heart failure?
Left ventricular hypertrophy, possible dilation of left atria, atrial fibrillation, atrial thrombi (stroke)
49
How can left-sided heart failure affect the pulmonary system?
Decreased cardiac output leads to pulmonary edema
50
What are signs and symptoms of left-sided heart failure?
Dyspnea, rales, orthopnea, cough
51
How is heart rate affected by left-sided heart failure?
Tachycardia (Over 100bpm)
52
Right-sided heart failure most commonly results from what prior condition?
Left-sided heart failure (backward failure)
53
What is the condition involved with pulmonary hypertension and isolated right-sided heart failure?
Cor pulmonale
54
What valves can be impaired in right-sided heart failure?
Pulmonary or tricuspid
55
Peripheral congestion and edema are seen in what vascular structures during right-sided heart failure?
Systemic and portal veins
56
During heart failure of which side do we see more pulmonary congestion and involvement?
Left-sided (minimal involved with right-sided)
57
What are some clinical features seen with right-sided heart failure?
Ascites and hepatosplenomegaly
58
What is a big risk for congenital heart disease?
Prematurtity
59
What vessels and structures are primarily affected by congenital heart disease?
Cardiac walls and great vessels: superior and inferior vena cavae, pulmonary artery, pulmonary vein, and aorta
60
What condition makes up 30% of birth defects?
Congenital heart disease
61
How frequent is congenital heart disease?
8:1,000
62
What is the genetic component to congenital heart disease?
Trisomy involvement (13, 18, and 21), polygenic
63
What environmental factors can increase risk for congenital heart disease?
Teratogens, maternal diabetes, infection
64
What is the cause of 90% of congenital heart disease cases?
Idiopathic in nature
65
Over half of congenital heart disease cases involve which septal defects?
Ventricular and atrial septal defects
66
What other less common defects can be associated with congenital heart disease?
Pulmonary valve stenosis, patent ductus arteriosus, tetralogy of fallot, coarctation of aorta
67
What is the most common shunting path of congenital heart disease?
Left-to-right
68
What occurs with right-to-left shunts in congenital heart disease?
Blood bypasses lungs
69
What defects can result from right-to-left shunts in congenital heart disease?
Tetralogy of Fallot, transposition of great arteries
70
What visible sign can be seen in a baby with right-to-left shunts in congenital heart disease?
Cyanosis ("dusky blue")
71
What condition is associated with left-to-right shunts in congenital heart disease?
Pulmonary hypertension
72
What defects are seen with left-to-right shunts in congenital heart disease?
Atrial septal defects (patent foramen ovale) Ventricular septal defects Patent ductus arteriosus
73
What defects are seen with obstruction of flow in congenital heart disease?
Valvular stenosis, aortic coarctation
74
What type of septal defects is most commonly asymptomatic until adulthood?
Atrial septal defect
75
Is which septal defects is spontaneous closure rare?
Atrial septal defect
76
What is the most common structural abnormality of septal defects?
Ventricular septal defect
77
What type of septal defect may spontaneously close?
Ventricular septal defect
78
A patent ductus arteriosus is associated with what type of shunt?
Left-to-right
79
What is the most common type of congenital heart disease to cause cyanosis?
Tetralogy of Fallot
80
What are the four features of tetralogy of Fallot?
Large ventricular septal defect Valve stenosis with right ventricular outflow obstruction Overriding aorta between ventricles Right ventricular hypertrophy
81
A "boot-shaped" heart seen on X-ray is associated with what cardiac condition?
Tetralogy of Fallot
82
Tetralogy of Fallot presents risk of what type of blockage?
Systemic emboli
83
What is the treatment for aortic coarctation?
Balloon dilation, surgical resection, vascular graft
84
How long does it take for dysfunction to arise in ischemic heart disease? Necrosis?
Dysfunction: 1-2 minutes Necrosis: 20-40 minutes
85
What condition mkaes up 90% of all ischemic heart disease cases?
Coronary artery disease (CAD)
86
What is the leading cause of death in the U.S.?
IHD
87
CAD, pneumonia, CO poisoning, and A-V fistula can all lead to what cardiac disease?
IHD
88
What condition is a result of myocardial ischemia that involves the occlusion of coronary arteries?
Acute coronary syndrome (ACS)
89
Is acute coronary syndrome a serious matter?
Yes, medical emergency
90
What is angina pectoris?
Chest pain of cardiac origin involving ischemia of the heart but no cellular death
91
Is angina pectoris the same as a myocardial infarction?
NO; angina pectoris does not involve necrosis
92
Chronic IHD can lead to what condition?
Congestive heart failure
93
What is SCD?
Sudden cardiac death
94
What are the features of coronary atherosclerosis?
Inflammation, thrombosis, vasoconstriction
95
What happens to the diameter of the coronary arteries during coronary atherosclerosis?
Decreased diameter
96
How much vessel occlusion does it take to present angina pectoris?
Over 70%
97
Where do we see referred pain in angina pectoris?
Jaw, left arm, back shoulders
98
What is the most common type of angina pectoris?
Stable angina (typical angina)
99
How can stable angina be relieved?
With rest and vasodilators
100
What vasodilator can be used to relieve typical angina pectoris?
Nitroglycerin
101
What is the unique type of angina pectoris?
Variant angina (Prinzmetal angina)
102
What occurs at rest with variant angina pectoris?
Vasospasms
103
Which forms of angina pectoris respond to vasodilators?
Both
104
What are the other names for unstable angina?
Crescendo angina or pre-infarction angina
105
What provokes unstable angina?
Decreased exertion
106
How much coronary artery occlusion do we see when unstable angina is presented?
90%
107
What is the cause of unstable angina?
Plaque disruption, thrombosis, embolization, vasospasm
108
What is different with angina pectoris in females?
Less predicable symptoms that tend to resemble menstrual symptoms like nausea, dizziness, and back pain

Systems Pathology Final (2 decks)

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