LP #111 Cardiomyopathies & Infectious

Question 1

• most bacterial or viral
• affect different hear structures
• may cause:
• permanent damage d/t inflammation, exudation & fibrosis
• chronic heart disease & sudden death

Answer 1

Infectious heart disease

Question 2

• acute, recurring inflammation condition
• mainly in young children
• complications of streptococcal infection
• can result in:
• pericarditis
• myocarditis
• endocarditis
• often associated w/valvular dysfxn
• mitral & aortic valves most commonly affected

Answer 2

Rheumatic fever

Question 3

Rheumatic fever pathogenesis & tx

Answer 3

Path:

• acute inflammation of valves
• lesion formation on valve leaflets
• fibrosis resulting in dysfxn all valves

Tx: ABX

Question 4

• inflammation of pericardium
• idiopathic or d/t variety of viruses
• increase capillary permeability in serous pericardium
• result: pericardial effusion

Answer 4

Pericarditis

Question 5

Compresses bv’s & heart, leads to decrease venous return & CO

Answer 5

Pericardial effusion

Question 6

Pericarditis Effect on heart fxn depends on

Answer 6

• amount of exudates
• rate of accumulation
• elasticity of pericardium

Question 7

Pericarditis prognosis

Answer 7

• resolution

- fibrosis & adhesions

Question 8

Acute s/s pericarditis

Answer 8

• chest pn-radiate to neck, back, abs & sides
• pn worse w/deep breathing, coughing, swallowing & positional changes
• pericardial friction d/t rubbing & friction b/w inflamed pericardial layers
• ABN ECG

Question 9

-scar tissue forms b/w visceral & parietal layers

Answer 9

Constrictive pericarditis

Question 10

• acute inflammation of myocardium
• 2nd to viral infection- often a complication of rheumatic fever
• usually self-limiting
• may lead to chronic heart failure or death
• pathogenesis:
• viral infection causes inflammation
• if unresolved- may lead to myocardial necrosis

Answer 10

Myocarditis

Question 11

Myocarditis s/s: from asymptomatic to sudden death

More common?

Answer 11

• fever
• fatigue
• heart palpitations
• chest pn
• increase WBC count
• dyspnea & tachycardia
• transient (1-2 mos.)

Question 12

• acute inflammation of endocardium
• d/t bacterial infection
• major concern: damage to heart valves
• at increase risk: people w/pre-existing heart conditions
• infection can lead to:
• inflammation of valves-fibrosis & stenosis
• regurgitant valves

Answer 12

Endocarditis

Question 13

S/s endocarditis

Answer 13

• fever
• emboli
• cough & dyspnea
• arthralgia or arthritis

Question 14

• aka coronary heart disease (CHD)

- inability of coronary aa to provide adequate blood supply to myocardium (leads to myocardial ischemia)

Answer 14

Ischemic heart disease (IDH)

Question 15

Types of IHD

Answer 15

Chronic:

• stable angina pectoris
• variant angina pectoris
• silent ischemia

Acute:

• unstable angina
• myocardial infraction (MI)

Question 16

• inadequate blood supply to myocardium
• causes:
• atherosclerotic plaques (1*)
• thrombosis
• vasospasm
• associated conditions:
• angina pectoris
• MI

Answer 16

Myocardial ischemia

Question 17

• caused by transient myocardial ischemia
• result:
• paroxysmal chest pn, or
• feeling of P in chest
• localized to sub sterna l region
• may refer to aw, neck, L shoulder & arm
• forms:
• silent ischemia
• stable
• varient
• unstable

Answer 17

Angina pectoris

Question 18

• cardiac ischemia w/ no pn

- may cause heart arrhythmia, leading to syncope or sudden death

Answer 18

Chronic IHD ( silent ischemia)

Question 19

• aka. Classic or exertion all angina
• d/t obstruction in coronary aa- BF does not meet myocardium’s needs
• 1st sign of IHD
• six: acute chest pn- relieved by rest or vasodilation meds
• triggers: exertion, emotional distress & cold
• tx: prevent MI, manage Sx’s & avoid stress

Answer 19

Chronic IHD (stable angina pectoris)

Question 20

• aka vasospastic angina
• chest pn d/t vasospasm of coronary aa & BF interruption to heart
• d/t coronary stenosis
• pn at rest or w/ min exercise
• nocturnal pn
• caused by overactive SNS response

Answer 20

Chronic IHD (variant angina pectoris)

Question 21

• caused by injury to atherosclerotic plaques
• platelets aggregate at plaque injury site
• increase bv occlusion d/t thrombus formation
• leads to complete bv occlusion & MI

Answer 21

Acute coronary syndromes (unstable angina pectoris)

Question 22

• ischemic death of myocardial tissue d/t severe decrease BF
• s/s:
• pn not relieved by rest or meds
• fatigue & weakness (limbs)
• tachycardia, anxiety & restlessness
• cold sweats
• indigestion
• female (classic MI Sx’s): referred pn that radiates to L arm, neck & jaw
• male Sx’s: sudden jaw pn, sleep disturbances, dyspnea * vertigo
• elderly tend to c/o SOB

Answer 22

Acute coronary syndrome (myocardial infarct)

Question 23

Aka. Coral art artery bypass graft (CABG, pronounced cabbage) surgery, (heart bypass or bypass surgery)

• surgical procedure consisting of diverting a systemic artery
• proximal end of diverted vessel is attached to aorta or one of its major branches
• distal end is attached immediately beyond a partially obstructed coronary artery (target vessel)
• purpose: restore norm blood flow to obstructed coronary artery
• obstruction is due to arteriosclerosis, atherosclerosis or both

Answer 23

Coronary artery bypass surgery