Ischemic Heart Disease

Question 0

Some etiology for ischemic heart disease?

Answer 0

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

Question 1

The size of aneurysms during systole?

Answer 1

Increase

Question 2

Name some complications associated w ischemic heart disease?

Answer 2

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

Question 3

The most common (mechanical) complication of an MI?

Answer 3

Aneurysm formation

Question 4

Pathophysiology for ischemic heart disease?

Answer 4

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)

Question 5

Physical signs for ischemic heart disease?

Answer 5

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

Question 6

What would you expect to see with patient myocarditis?

Answer 6

Ventricular dysfunction, global or regional in nature.

Question 7

Cardiac tamponade is rapid filling of fluid?

Answer 7

Restrictive diastolic filling

Question 8

Pericardial fluid drains into what normally?

Answer 8

Lymphatic system

Question 9

A medium size pericardial effusion is defined as?

Answer 9

Less than 1cm but seen anterior and posterior

Question 10

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

Answer 10

Degree of diastolic dysfunction(but is not clinically relevant)

Question 11

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

Answer 11

Congestive

Question 12

The size of left ventricular aneurysms during systole?

Answer 12

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

Question 13

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

Answer 13

Right. This means they are “right dominant”

Question 14

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

Answer 14

Ventricular diastole

Question 15

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

Answer 15

Fibroelastoma

Question 16

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

Answer 16

Rhabdomyomas

Question 17

A pericardial effusion can often be seen I pts w?

Answer 17

Renal failure

Question 18

Constrictive pericarditis involves which of the following?

Answer 18

Pericardial thickening and scarring, this restricts right side filling

Question 19

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

Answer 19

Right

Question 20

Which of the following best describes unstable angina?

Answer 20

Chest pain at rest

Question 21

The most sensitive way to diagnose cardiac tamponade?

Answer 21

Respiratory variation of mitral inflow

Question 22

What might be the first indication of metastatic cardiac disease?

Answer 22

Pericardial effusion

Question 23

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

Answer 23

Right Atriumu

Question 24

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

Answer 24

Rest and Impost

Question 25

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

Answer 25

Systematic hypertension, a risk factor for ischemic

Question 26

Myocardial infarction means what?

Answer 26

Actual tissue death

Question 27

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

Answer 27

Wide base, walls containing myocardium & low risk of rupture

Question 28

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

Answer 28

Delayed relaxation with E

Question 29

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

Answer 29

Systematic hypertension

Question 30

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

Answer 30

Marantic endocarditis, (non-bacterial)

Question 31

Myocardial ischemia means what?

Answer 31

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

Question 32

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

Answer 32

Aortic regurgitation

Question 33

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

Answer 33

Carcinoid

Question 34

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

Answer 34

Pulmonary hypertension

Question 35

The sac that surrounds the heart is the:?

Answer 35

Fibrous pericardium

Question 36

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

Answer 36

Left ventricular hypertrophy

Question 37

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

Answer 37

Right

Question 38

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

Answer 38

Parasternal long-axis

Question 39

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

Answer 39

Mitral stenosis

Question 40

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

Answer 40

Narrow base & high risk of rupture

Question 41

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

Answer 41

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

Question 42

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

Answer 42

Decreased cardiac output

Question 43

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

Answer 43

Mid anterior, can only be seen in A2

Question 44

Which percent stenosis is considered significant coronary artery disease?

Answer 44

70%

Question 45

Papillary muscle dysfunction usually results from:?

Answer 45

Ischemic heart disease

Question 46

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

Answer 46

Atropine

Question 47

Criteria for a positive treadmill stress echo diagnosis includes:?

Answer 47

Provoked wall motion abnormalities from rest to immediate post

Question 48

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

Answer 48

Coronary artery aneurysms

Question 49

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

Answer 49

Distant or muffled heart sounds

Question 50

Ischemic heart disease is usually caused by:?

Answer 50

Atherosclerosis

Question 51

What percent of stenosis is considered significant coronary artery disease?

Answer 51

70%

Question 52

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

Answer 52

Pericardial effusion

Question 53

By echo, a medium size percardial effusion is?

Answer 53

Less than 1cm, seen both anterior & posterior

Question 54

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

Answer 54

Damped

Question 55

A treatment of choice for constructive pericarditis is?

Answer 55

Pericardiectomy

Question 56

What occurs first with severe mitral regurg?

Answer 56

Dilated right ventricle

Question 57

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

Answer 57

Reduced EF