Ischemic Heart Disease Flashcards

0
Q

Some etiology for ischemic heart disease?

A

Coronary artery disease (artherosclerosis)
Congenital coronary anomalies
Coronary artery spasm

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1
Q

The size of aneurysms during systole?

A

Increase

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2
Q

Name some complications associated w ischemic heart disease?

A
Arrhythmias 90 percent 
Aneurysm 8-15 percent 
Mural thrombus 20-40 percent of amis
Death
Pseudo aneurysm 
Pericardial effusion papillary muscle dysfunction 
Pap rupture 
Vsf 2percent of mi
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3
Q

The most common (mechanical) complication of an MI?

A

Aneurysm formation

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4
Q

Pathophysiology for ischemic heart disease?

A

Risk factors: sex, age, smoking, htn, diabetis and hyperlipidemia
Artherosclerotic plaque causes stenotic lesions in the coronary arteries
Obstruction to blood flow leads to deprivation of myocardial oxygen resulting in ischemia
Total blockage of flow causes muscle death (infarction)

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5
Q

Physical signs for ischemic heart disease?

A

Angina (stable or unstable) although some mi’s 25 percent are silent
Presence of a new murmur post mi could be from mr papillary muscle dysfunction papillary rupture or ischemic vsd

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6
Q

What would you expect to see with patient myocarditis?

A

Ventricular dysfunction, global or regional in nature.

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7
Q

Cardiac tamponade is rapid filling of fluid?

A

Restrictive diastolic filling

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8
Q

Pericardial fluid drains into what normally?

A

Lymphatic system

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9
Q

A medium size pericardial effusion is defined as?

A

Less than 1cm but seen anterior and posterior

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10
Q

In patient with possible cardiac tamponade echo helps to determine all the following except?

A

Degree of diastolic dysfunction(but is not clinically relevant)

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11
Q

Which of the following cardiomyopathies is characterized by ventricular dilation and poor overall contrActile function?

A

Congestive

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12
Q

The size of left ventricular aneurysms during systole?

A

Increase. Yes true aneurysms of the LV usually increase during systole. Commonly referred to as “systolic bulging”

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13
Q

In the majority of human hearts the posterior descending artery is a branch of which coronary artery?

A

Right. This means they are “right dominant”

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14
Q

Filling of the main coronary arteries occurs during which part of the cardiac cycle?

A

Ventricular diastole

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15
Q

The most common cardiac valvular tumor is a? (Primary)

A

Fibroelastoma

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16
Q

Children w tuberous sclerosis complex TSC develop what type of cardiac tumors?

A

Rhabdomyomas

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17
Q

A pericardial effusion can often be seen I pts w?

A

Renal failure

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18
Q

Constrictive pericarditis involves which of the following?

A

Pericardial thickening and scarring, this restricts right side filling

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19
Q

The majority of human hearts the posterior descending artery is a branch of which coronary artery?

A

Right

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20
Q

Which of the following best describes unstable angina?

A

Chest pain at rest

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21
Q

The most sensitive way to diagnose cardiac tamponade?

A

Respiratory variation of mitral inflow

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22
Q

What might be the first indication of metastatic cardiac disease?

A

Pericardial effusion

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23
Q

Which cardiac chamber is most likely to be involved with metastatic tumors?

A

Right Atriumu

24
Q

During a treadmill stress echo, the most common stages captured on screen?

A

Rest and Impost

25
Q

Which of the following is considered a risk factor for ischemic heart disease?

A

Systematic hypertension, a risk factor for ischemic

26
Q

Myocardial infarction means what?

A

Actual tissue death

27
Q

True aneurysms of the left ventricle have which of the following features?

A

Wide base, walls containing myocardium & low risk of rupture

28
Q

The diastolic function of hypertrophic CM is most commonly characterized by:?

A

Delayed relaxation with E<A mitral inflow pattern.

29
Q

All of the following are components of Beck’s Triad Except:?

A

Systematic hypertension

30
Q

Decreased myocardial contractility can be caused by all of the following Except:?

A

Marantic endocarditis, (non-bacterial)

31
Q

Myocardial ischemia means what?

A

Lack of oxygen to myocardium, means lack of H20 to tissue.

32
Q

Which of the following pathologies would most likely affect coronary artery circulation?

A

Aortic regurgitation

33
Q

Disease process which could cause infiltrative CM do not include:?

A

Carcinoid

34
Q

All of the following are risk factors for ischemic heart disease Except:?

A

Pulmonary hypertension

35
Q

The sac that surrounds the heart is the:?

A

Fibrous pericardium

36
Q

PT’s with constrictive pericarditis and those in cardiac tamponade will have all of the following Except:?

A

Left ventricular hypertrophy

37
Q

Blood supply of the inferior wall of the left ventricle is by which coronary artery?

A

Right

38
Q

The best view for differentiating between a pericardial effusion & pleural Effusion?

A

Parasternal long-axis

39
Q

Left atrial thrombus is often seen in PT’s with?

A

Mitral stenosis

40
Q

Pseudoaneurysms of the left ventricle have which of the following feature?

A

Narrow base & high risk of rupture

41
Q

When performing an echo on a PT with known heart failure, you should pay attention to the following Except:?

A

QP/QS evaluation, this equation is used for shunt ratios.

42
Q

A shared problem in PT’s with constrictive pericarditis & cardiac tamponade is:?

A

Decreased cardiac output

43
Q

During stress echo you can only see what LV segments in an apical two-chamber view?

A

Mid anterior, can only be seen in A2

44
Q

Which percent stenosis is considered significant coronary artery disease?

A

70%

45
Q

Papillary muscle dysfunction usually results from:?

A

Ischemic heart disease

46
Q

During a pharmacological echo stress test using dobutamine, which drug is give if PT does not reach target heart rate?

A

Atropine

47
Q

Criteria for a positive treadmill stress echo diagnosis includes:?

A

Provoked wall motion abnormalities from rest to immediate post

48
Q

What would you look for in a PT with Kawasaki disease?

A

Coronary artery aneurysms

49
Q

Which of the following is a componet(s) of Beck’s Triad?

A

Distant or muffled heart sounds

50
Q

Ischemic heart disease is usually caused by:?

A

Atherosclerosis

51
Q

What percent of stenosis is considered significant coronary artery disease?

A

70%

52
Q

A PT with dresslers syndrome the echo is performed to R/O?

A

Pericardial effusion

53
Q

By echo, a medium size percardial effusion is?

A

Less than 1cm, seen both anterior & posterior

54
Q

In PT’s with a Lg pericardial effusion the motion of the pericardium may be?

A

Damped

55
Q

A treatment of choice for constructive pericarditis is?

A

Pericardiectomy

56
Q

What occurs first with severe mitral regurg?

A

Dilated right ventricle

57
Q

An increased E point-to-septal separation more than 10 mm is an indication of a?

A

Reduced EF