Lecture 5.2 Highlights Flashcards
Differentiate between systolic and diastolic dysfunction
1) The cardiac muscle contracts weakly and chambers can’t empty properly = systolic dysfunction
2) Muscle can not relax or open completely and thus doesn’t fill = diastolic dysfunction
Define systolic and diastolic heart failure
1) Systolic Heart Failure: refers to inadequate contractile function.
-Usually due to coronary artery disease
2) Diastolic Heart Failure: refers to inability of heart to relax and fill.
What type of heart failure is left ventricular hypertrophy?
Diastolic heart failure
How do neural-humoral systems regulate HF?
Norepinephrine increases heart rate and augments myocardial contractility and vascular resistance
What exacerbates left-sided HF?
Decreased output to systemic circulation > decreased renal perfusion > renin-angiotensin-aldosterone axis > increasing intravascular volume
List some causes of isolated right-sided HF
1) Cor pulmonale
2) Pulmonic or tricuspid valve disease
3) Congenital heart diseases with left-to-right shunt
True or false: Pure right-sided HF does not generally cause respiratory symptoms directly
True
ASDs less likely than VSDs to close spontaneously, so this means what?
They are the most common congenital heart defects to first be diagnosed in adults
What type of shunt is cyanotic?
Right to left
MC causes of ASDs
1) Ostium _________ (90%) near the foramen Ovalle
2) Ostium ____________ (5%) lowest part of atrial septum
1) secundum
2) premium
What can be used to close the ductus arteriosus?
Indomethacin
The ductus arteriosus may be intentionally kept open in some congenital heart disease by giving prostaglandins, in particular _______________
Prostaglandin E
1) What can Tetralogy of Fallot develop?
2) What is it the most common cause of?
1) Right-to-left shunt
2) Cyanotic congenital heart disease;
TGA:
1) Oxygen poor blood enters the R heart and is pumped where?
2) Oxygen rich blood from the lungs enters the L heart and is pumped where?
1) Back to the body through the aorta
2) Back to the lungs
Ischemic Heart Disease (IHD):
1) What blood supply can’t meet demand?
2) What usually causes it?
1) Cardiac blood supply
2) “Coronary artery disease”
What type of angina occurs on exertion?
Stable angina
What type of angina has worse/ increasing pain at rest?
Unstable angina
What type of angina is caused by a coronary artery spasm?
Prinzmetal angina
Most MIs are caused by acute coronary artery thrombosis; what happens?
1) Sudden plaque disruption
2) Platelets adhere
3) Coagulation cascade activated
4) Thrombus occludes lumen within minutes
5) Irreversible injury/cell death in 20-40 minutes
Reperfusion post-MI can be achieved by what 3 things?
Thrombolysis, stent placement, or coronary artery bypass graft CABG
What might be seen on an EKG of an MI?
ST-segment elevation
Define Chronic Ischemic Heart Disease
Progressive heart failure from ischemic myocardial damage
SCD results from what?
fatal arrhythmia
Muscle grows causing “concentric hypertrophy” Ventricle wall thickens in what states?
Pressure overload states
Fiber length increases and ventricles dilate when?
Volume overload states (hypertrophy)
Valvular Heart Disease: What are the 2 causes?
Stenosis or regurg
When does rheumatic fever occur?
A few weeks after streptococcal pharyngitis
Define Infective Endocarditis
Bacterial invasion of heart valves
What causes large, friable vegetations and fever/ flu like Sx?
Infective endocarditis
List some causes of dilated cardiomyopathy
1) Viral
2) Alcohol/toxin
3) Peripartum
4) 25% to 35% caused by genetic mutations in genes that encode cytoskeletal proteins
Almost all cases of HCM caused by ___________ mutations in at least 12 genes that encode the ___________ proteins that form the ___________ apparatus of striated muscle
missense; sarcomeric; contractile
Hypertrophic Cardiomyopathy (HCM)
Reduced cardiac output and secondary increase in pulmonary venous pressure
True or false: Hypertrophic Cardiomyopathy (HCM) can cause sudden death
True
Restrictive Cardiomyopathy: What is the issue?
Ventricle wall is stiffer, impairing filling during diastole
What causes Restrictive Cardiomyopathy?
Idiopathic or amyloidosis, hemochromatosis, sarcoidosis
1) What is pericarditis usually secondary to?
2) What is primary pericarditis caused by?
3) What are the Sx?
4) What may it cause?
1) Acute MI, cardiac surgery, irradiation, pneumonia, uremia
2) Very rare; mainly infection by viruses
3) Atypical chest pain, not related to exertion, often worse on reclining
-Prominent friction rub
4) May cause cardiac tamponade
List 5 potential causes of pericardial disease
1) Acute MI
2) Cardiac surgery
3) Irradiation
4) Pneumonia
5) Uremia
List 3 different kinds of pericardial effusions
1) Serous
2) Serosanguinous
3) Chylous
1) What may a slow pericardial effusion cause?
2) What abt a sudden one?
1) Asymptomatic
2) Fatal cardiac tamponade
