Lecture 28

Question 1

cause of mitral valve prolaps (MVP)

Answer 1

cause unknown in most patients. it is most often caused by myxomatous degeneration of valve leaflets. can be a genetic collagen disorder

Question 2

long, thin extremities, dislocation of lenses and aortic aneurysm

Answer 2

marfan’s syndrome

Question 3

MVP can occur as a result of:

Answer 3

1. acute rheumatic fever
2. ischemic heart disease
3. various cardiomyopathies
4. atrial septal defect

Question 4

autoimmune disease resulting from streptococcus infection

Answer 4

acute rheumatic fever

Question 5

not enough blood and oxygen supplied to the myocardium

Answer 5

ischemic heart disease

Question 6

weakening of heart muscle or other functional problem

Answer 6

various cardiomyopathies

Question 7

congenital opening between upper chambers of the heart

Answer 7

atrial septal defect

Question 8

MVP can be mild or severe. it sometimes also leads to serious problems. these can include:

Answer 8

1. mitral regurgitation
2. endocarditis
3. heart rhythm problems
4. transient ischemic attack (TIA)
5. stroke

Question 9

usually causes no symptoms until it is severe

Answer 9

mitral regurgitation

Question 10

heart valve gets infected

Answer 10

endocarditis

Question 11

tachycardia- rarely a heart rhythm problem can cause sudden death, which when the heart suddenly stops beating

Answer 11

heart rhythm problems

Question 12

similar to a stroke but the brain isn’t damaged

Answer 12

transient ischemic attack (TIA)

Question 13

many people with MVP have no______

Answer 13

symptoms

Question 14

some people experience symptoms such as:

Answer 14

chest pain, tachycardia, fainting or dizziness, palpitations, orthopnea

Question 15

test used most often to check for MVP

Answer 15

echocardiogram

Question 16

is MVP curable?

Answer 16

no

Question 17

Medications that can be used to alleviate mild symptoms of MVP

Answer 17

1. vasodilators
2. digoxin
3. anti-arrhythmic agents
4. blood thinners

Question 18

widen the blood vessels to decrease the amount of force and effort that the heart has to endure

Answer 18

vasodilators

Question 19

use to strengthen the heart muscles for a stronger heart beat

Answer 19

digoxin

Question 20

can be used to regulate heart rhythms

Answer 20

anti-arrhythmic agents

Question 21

used to prevent blood clots from forming that can worsen the problem

Answer 21

blood thiners

Question 22

more common in ______ between the ages of 15 and 30 years old and is usually benign

Answer 22

women

Question 23

more severe cases are observed in older (>50) patients (often ______) and requires surgical treatment

Answer 23

men

Question 24

there is an increased familial incidence for some patients, suggesting an autosomal form of ______________

Answer 24

inheritance

Question 25

surgery is considered if _______ is severe and the valve is repaired or replaced

Answer 25

leakage

Question 26

condition where decreased blood flow causes decreased tissue perfusion and O2 delivery

Answer 26

circulatory shock

Question 27

caused by myocardial impairment (MI, congestive HF)

Answer 27

cardiogenic shock

Question 28

loss of vasomotor tone, which leads to venous pooling (deep general anesthesia, spinal cord injury)

Answer 28

neurogenic shock

Question 29

increased filtration across capillary walls, which leads to decreased circulating blood volume

Answer 29

septic/anaphylactic shock

Question 30

obstruction anywhere in circulatory system that can cause a local decrease in blood flow

Answer 30

mechanical obstruction to blood flow

Question 31

circulating blood volume decreased because of whole blood loss

Answer 31

hypovolemic shock

Question 32

what causes hypovolemic shock?

Answer 32

1. hemorrhage 2. surgery 3. burns 4. trauma 5. fluid loss associated with vomiting/diarrhea

Question 33

signs and symptoms of hypovolemic shock

Answer 33

1. thirst, nausea, anxiousness, weakness, light-headedness, dizziness 2. low urine output and ark yellow urine 3. increased HR and respiratory rate 4. low or normal body temp 5. decreased bicarbonate and pH (acidosis) 6. mental status change or unconsciousness 7. organ failure or multiple organ dysfunction syndrome (MODS)

Question 34

what is the pathophysiology of hypovolemic shock?

Answer 34

circulatory function over time

Question 35

compensatory mechanisms of hypovolemic shock

Answer 35

baroreceptors, chemoreceptors, norepineprhine, angiotensin II

Question 36

treatment for hypovolemic shock

Answer 36

1. fluid replacement 2. maintain hemoglobin 3. vasopressor therapy (dopamine, norepinephrine, phenylephrine, vasopressin)