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
