Ischemic Heart Disease Flashcards
Some etiology for ischemic heart disease?
Coronary artery disease (artherosclerosis)
Congenital coronary anomalies
Coronary artery spasm
The size of aneurysms during systole?
Increase
Name some complications associated w ischemic heart disease?
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
The most common (mechanical) complication of an MI?
Aneurysm formation
Pathophysiology for ischemic heart disease?
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)
Physical signs for ischemic heart disease?
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
What would you expect to see with patient myocarditis?
Ventricular dysfunction, global or regional in nature.
Cardiac tamponade is rapid filling of fluid?
Restrictive diastolic filling
Pericardial fluid drains into what normally?
Lymphatic system
A medium size pericardial effusion is defined as?
Less than 1cm but seen anterior and posterior
In patient with possible cardiac tamponade echo helps to determine all the following except?
Degree of diastolic dysfunction(but is not clinically relevant)
Which of the following cardiomyopathies is characterized by ventricular dilation and poor overall contrActile function?
Congestive
The size of left ventricular aneurysms during systole?
Increase. Yes true aneurysms of the LV usually increase during systole. Commonly referred to as “systolic bulging”
In the majority of human hearts the posterior descending artery is a branch of which coronary artery?
Right. This means they are “right dominant”
Filling of the main coronary arteries occurs during which part of the cardiac cycle?
Ventricular diastole
The most common cardiac valvular tumor is a? (Primary)
Fibroelastoma
Children w tuberous sclerosis complex TSC develop what type of cardiac tumors?
Rhabdomyomas
A pericardial effusion can often be seen I pts w?
Renal failure
Constrictive pericarditis involves which of the following?
Pericardial thickening and scarring, this restricts right side filling
The majority of human hearts the posterior descending artery is a branch of which coronary artery?
Right
Which of the following best describes unstable angina?
Chest pain at rest
The most sensitive way to diagnose cardiac tamponade?
Respiratory variation of mitral inflow
What might be the first indication of metastatic cardiac disease?
Pericardial effusion
Which cardiac chamber is most likely to be involved with metastatic tumors?
Right Atriumu
During a treadmill stress echo, the most common stages captured on screen?
Rest and Impost
Which of the following is considered a risk factor for ischemic heart disease?
Systematic hypertension, a risk factor for ischemic
Myocardial infarction means what?
Actual tissue death
True aneurysms of the left ventricle have which of the following features?
Wide base, walls containing myocardium & low risk of rupture
The diastolic function of hypertrophic CM is most commonly characterized by:?
Delayed relaxation with E<A mitral inflow pattern.
All of the following are components of Beck’s Triad Except:?
Systematic hypertension
Decreased myocardial contractility can be caused by all of the following Except:?
Marantic endocarditis, (non-bacterial)
Myocardial ischemia means what?
Lack of oxygen to myocardium, means lack of H20 to tissue.
Which of the following pathologies would most likely affect coronary artery circulation?
Aortic regurgitation
Disease process which could cause infiltrative CM do not include:?
Carcinoid
All of the following are risk factors for ischemic heart disease Except:?
Pulmonary hypertension
The sac that surrounds the heart is the:?
Fibrous pericardium
PT’s with constrictive pericarditis and those in cardiac tamponade will have all of the following Except:?
Left ventricular hypertrophy
Blood supply of the inferior wall of the left ventricle is by which coronary artery?
Right
The best view for differentiating between a pericardial effusion & pleural Effusion?
Parasternal long-axis
Left atrial thrombus is often seen in PT’s with?
Mitral stenosis
Pseudoaneurysms of the left ventricle have which of the following feature?
Narrow base & high risk of rupture
When performing an echo on a PT with known heart failure, you should pay attention to the following Except:?
QP/QS evaluation, this equation is used for shunt ratios.
A shared problem in PT’s with constrictive pericarditis & cardiac tamponade is:?
Decreased cardiac output
During stress echo you can only see what LV segments in an apical two-chamber view?
Mid anterior, can only be seen in A2
Which percent stenosis is considered significant coronary artery disease?
70%
Papillary muscle dysfunction usually results from:?
Ischemic heart disease
During a pharmacological echo stress test using dobutamine, which drug is give if PT does not reach target heart rate?
Atropine
Criteria for a positive treadmill stress echo diagnosis includes:?
Provoked wall motion abnormalities from rest to immediate post
What would you look for in a PT with Kawasaki disease?
Coronary artery aneurysms
Which of the following is a componet(s) of Beck’s Triad?
Distant or muffled heart sounds
Ischemic heart disease is usually caused by:?
Atherosclerosis
What percent of stenosis is considered significant coronary artery disease?
70%
A PT with dresslers syndrome the echo is performed to R/O?
Pericardial effusion
By echo, a medium size percardial effusion is?
Less than 1cm, seen both anterior & posterior
In PT’s with a Lg pericardial effusion the motion of the pericardium may be?
Damped
A treatment of choice for constructive pericarditis is?
Pericardiectomy
What occurs first with severe mitral regurg?
Dilated right ventricle
An increased E point-to-septal separation more than 10 mm is an indication of a?
Reduced EF
