Mod8(valvular,pericardial heart disease)

Question 1

Mitral Stenosis

Answer 1

restriction of mitral valve opening that impedes diastolic blood flow from the left atrium to left ventricle; dilation of left atrium from volume overload

Question 2

Mitral Regurgitation

Answer 2

occurs when valve is compromised in some way causing retrograde blood flow from left ventricle to left atrium during ventricular systole; atrial fibrillation

Question 3

Tricuspid Stenosis

Answer 3

restriction of tricuspid valve opening that impedes diastolic blood flow from right atrium to right ventricle

Question 4

Tricuspid Regurgitation

Answer 4

Occurs when valve is compromised causing retrograde blood flow from right ventricle to right atrium during ventricular systole; see RA enlargement from vol overload

Question 5

Aortic Stenosis

Answer 5

narrowing and restriction of aortic valve opening that impedes systolic blood flow from left ventricle into aorta; aortic leaflets thicken leading to greater resistance for LV to pump therefore LV enlarge and LA dilate

Question 6

Aortic Regurgitation (insufficiency)

Answer 6

occurs when valve is compromised in some way, causing retrograde blood flow from aorta to LV during diastole; LV enlargement (from vol overload) and LA enlargement, tachycardia and atrial fibrillation in chronic AR

Question 7

Pulmonary stenosis

Answer 7

narrowing of pulmonary orifice impeding blood flow from RV during systole; right valvular hypertrophy and RA dilation

Question 8

Pulmonary regurgitation (insufficiency)

Answer 8

occurs when valve is compromised causing retrograde blood flow from pulmonary artery back in RV during diastole; may indicate pulmonary hypertension; will see RV hypertrophy and RBBB

Question 9

Cardiomyopathies

Answer 9

dysfunction restricted to the myocardium that is UNRELATED to ischemic, valvular, hypertensive, pericardial or congenital heart disorders.

Question 10

Pericarditis

Answer 10

inflammation of pericardial layers; may cause visceral pericardium to secrete additional fluid resulting in pericardial effusion

Question 11

how the valves work

Answer 11

blood flow through AV valves (tricuspid/mitral) during diastole and blood flow through semilunar valves (pulmonic/aortic) during systole

Question 12

Stenosis

Answer 12

impeded blood flow; therefore will see enlargement from pressure/volume overload in atria/ventricles; #1 cause of stenosis in valves is rheumatic heart disease

Question 13

1. Dilated Cardiomyopathy (DCM)

Answer 13

ventricular enlargement; dilation of mitral and tricuspid valve leads to MR and TR; high risk of thromboembolism due to stagnant blood pooling in poorly contracting ventricles and dilated atria

Question 14

Symptoms of DCM

Answer 14

Low CO (fatigue, lightheaded, exertional dyspnea), and Pulmonary congestion symptoms (dyspnea, orthopnea, pulmonary rales, peripheral edema)

Question 15

2. Hypertrophic Cardiomyopathy (HCM)

Answer 15

LV hypertrophy; impaired diastolic relaxation from LV stiffening- 3 types

Question 16

Obstructive hypertrophic cardiomyopathy (HOCM)

Answer 16

subaortic due to systolic anterior motion of mitral leaflet ; **with obstruction will show BISFERIENS CAROTID (double beat over carotid); will see LA and LV enlargement with obstruction

Question 17

Mid Ventricular Obstructive hypertrophic cardiomyopathy

Answer 17

at level of papillary muscles

Question 18

Non-Obstructive hypertrophic cardiomyopathy (HCM)

Answer 18

no resting obstruction

Question 19

Restrictive Cardiomyopathy (RCM)

Answer 19

increased resistance to ventricular filling due to myocardial stiffening; systolic function is unaffected; presents the same as constrictive pericarditis

Question 20

RCM symptoms

Answer 20

low CO (fatigue, lightheaded, dyspnea), Pulmonary congestion symptom (JVD, ascites, peripheral edema, pulmonary rales)

Question 21

Acute Pericarditis

Answer 21

most common type of pericardial disease; will see positional sharp pleuritic chest pain, pericardial friction rub (from inflammation)

Question 22

Constrictive Pericarditis

Answer 22

pericardial disease; restriction of diastolic filling of heart caused by thickening fibrosis and adhering of pericardium; will see exertional dyspnea, chronic fatigue, JVD, HF, peripheral edema

Question 23

Peripheral Effusion

Answer 23

pericardial disease; accumulation of fluid in pericardial space; experience dull left side angina, dysphagia (swallowing) and dyspnea; soft heart sounds, decreaed intensity of friction rub, ewart signs (dull left lung sound)

Question 24

three factors that determine if peripheral effusion progresses to tamponade

Answer 24

volume of fluid, rate of fluid accumulation and pericardium compliance (***ECHO is most useful to evaluate whether pericardial effusion has haemodynamic consequences leading to tamponade)

Question 25

Pericardial Tamponade

Answer 25

accumulation of fluid causing elevation of intrapericardial pressures causing elevation and equalization of intracardiac pressure; compromises cardiac chamber and limits ventricular filling; immediate treatment to remove fluid