HS2-17 Clinical Relevance of Heart Anatomy

Question 1

What is the effect of pericardial tamponade on the heart?

Answer 1

impaired cardiac filling leading to decreased cardiac output

Question 2

What is the clinical presentation of a patient with pericarditis?

Answer 2

chest pain worse with laying down, made better by sitting forward

Question 3

What are some of the clinical symptoms of pericardial tamponade?

Answer 3

hypotension

tachycardia

tachypnea

Question 4

What is pericardiocentesis?

Answer 4

procedure done to remove fluid that has built up in the pericardium

Question 5

What is the pericardium?

Answer 5

the bag that surrounds the heart

Question 6

What is cardiac tamponade?

Answer 6

fluid buildup inside the pericardium

Question 7

What is constrictive pericarditis?

Answer 7

calcified pericardium leading to a fixed space, rather than a fluid-filled pericardium

Question 8

What is the Rx for pericarditis? (2)

Answer 8

steroids

colchicine

Question 9

How do you treat constrictive pericarditis?

Answer 9

pericardial stripping, an open-heart procedure in which parts of the pericardium are removed

Question 10

Inflammation of the pericardium causes

Answer 10

pericarditis

Question 11

Fluid in the pericardium causes

Answer 11

cardiac tamponade

Question 12

Calcification and scarring of the pericardium causes

Answer 12

constrictive pericarditis

Question 13

What artery supplies the anterior wall of the left ventricle?

Answer 13

left anterior descending coronary artery

Question 14

The left main coronary artery branches into

Answer 14

left anterior descending + left circumflex coronary arteries

Question 15

The left anterior descending coronary artery supplies (2)

Answer 15

anterior wall

interventricular septum

Question 16

The left circumflex coronary artery supplies (2)

Answer 16

anterolateral wall

lateral wall

inferior/posterior wall (if dominant)

Question 17

The right coronary artery supplies (3)

Answer 17

the inferior/posterior wall

right ventricle

papillary muscles of mitral valve

Question 18

What is the treatment for an acute myocardial infarction?

Answer 18

cardiac catheterization, in which stents (balloons) are placed to make artery open up to flow

Question 19

What is systolic murmur?

Answer 19

turbulent or abnormal blood flow from high pressure chamber to low pressure chamber

Question 20

What happens in mitral regurgitation?

Answer 20

blood goes from left atrium to left ventricle, but then leaks back into left atrium

Question 21

What two processes can contribute to a new/abnormal systolic murmur?

Answer 21

mitral regurgitation

ventricular septal defect

Question 22

What is a ventricular septal defect?

Answer 22

hole in the ventricular septum

Question 23

What are the long term effects of a ventricular septal defect?

Answer 23

volume overload to right ventricle

Question 24

A right ventricle infarction would lead to

Answer 24

low BP w/ clear lungs

Question 25

How is a right ventricle infarction treated?

Answer 25

treated with fluid rescucitation and revascularization

Question 26

Ischemia to the SA or AV nodes can cause

Answer 26

various heart blocks

Question 27

Ischemia to the atria can cause

Answer 27

atrial arrhythmias

Question 28

If you were to cut off blood flow to the papillary muscles of the heart, what would happen?

Answer 28

papillary muscles are responsible for anchoring the mitral valve, so without blood flow, they would wither and rupture

Question 29

List the chain of events that occurs if you have a right coronary artery occlusion. (4)

Answer 29

right coronary artery occlusion

infarct of inferior/posterior wall + posterior papillary muscle

rupture of damaged posterior papillary muscle

blood flows back through mitral valve into left atrium, pulmonary veins, and lungs

Question 30

What are the anatomical features of dilated cardiomyopathy?

Answer 30

enlarged right ventricle or enlarged left ventricle or enlarged both ventricles

Question 31

What is a common clinical finding with dilated cardiomyopathy?

Answer 31

left bundle branch block, which in essence means electrical signals aren’t travelling as fast as they should be

Question 32

What is a common procedure used to treat cardiomyopathy?

Answer 32

pacemaker placement

Question 33

Describe how pacemaker is placed in the context of heart anatomy.

Answer 33

one lead placed going down into right ventricle

one lead placed going into the coronary sinus that eventually follows the lateral cardiac vein

Question 34

What is the function of a pacemaker?

Answer 34

restores concordant contraction of the right and left ventricles