Pathophys Cardiac Exam Questions Flashcards
difference between primary HTN and secondary HTN?
secondary has a specific case such as renal artery stenosis
What is Cardiomyopathy?
dysfunction in size and structure relating to the hearts ability to deliver blood to the rest of the body
3 types for us to know: Hypertrophic , Restrictive, Dilated
clinical manifestations: potentially nothing, but can lead to dyspnea, SOB, heart valve issues, abnormal cardiac rhythms, chest pain
Diagnostics: echocardiogram
complications: death, cardiac rhythms or heart failure
How do you calculate the ejection fraction?
end-diastolic volume - end systolic volume / end diastolic volume
example 120 - 90 = 30 . 30/120 = 25%
if it is less than 40%, then it is HFREF
Classifications of Heart Failure with Left Ventricular Eject Fraction
HFrEF = LVEF <= 40%
HFimpEF = previous LVEF <=40%, follow up >40%
HFmrEF = LVEF 41%-49%
HFpEF = LVEF >= 50%
systolic = squeezing diastolic == filling
:)
systolic heart failure
inability of the heart to pump blood
diastolic heart failure
not as much volume can fill in the heat
what are the two things happening with left sided heart failure?
backup of fluid in the lungs, and decreased perfusion to the body
manifestations:
Dyspnea, confusion, cyanosis, pulmonary crackles, tachypnea, blood tinged sputum, fatigue
right sided heart failure
1)decrease in blood delivered to the pulmonary circulation
2)backup of blood into the right atrium and venous systemic circulation
3)right atrial and ventricular enlargement
manifestations include:
JVD, GI Disturbances, Hepatomegaly, Splenomegaly, peripheral edema
primarily caused from:
left sided heart failure
right ventricular myocardial infarction
ascites
fluid collects in spaces in your abdomen, seen in right sided heart failure
initial heart failure compensation mechanisms
1) sympathetic nervous system stimulation, stimulation of RAAS, Natriuretic Peptides, Frank Starling Law
Frank Starling Law
a stretched muscle (increase in ventricular filling) will squeeze more (enhance systolic performance) and have higher output, but only up to a point (it will fail eventually)
Pericarditis can cause pericardial effusion. What life threatening condition can that lead to?
Cardiac Tamponade = accumulation of fluid in the pericardial sack
what should you look for if you see
-low blood pressure
-JVD
-decreased or muffled heart sounds on auscultation
That is Beck’s Triad
this could be Cardiac Tamponade
What are common causes of pericarditis?
surgery (coronary bypass especially), viruses, infection,
stenosis
narrowing
Can valve issues cause arrythmias?
yes
5 Valvular Disorders: aortic valve stenosis
*patho: valve related outflow obstruction of the left ventricle
leads to an increase in left ventricular pressure and hypertrophy
*blood back up in the Left ventricle
*concerns: heart initially adapts but stenosis worsens over time leading to reduced cardiac output
A PDA will cause a shunt resulting in less oxygenated blood going to the body from the heart
yes
an atrial septal defect will normally result in:
a left to right shunt
because the left side of the heart has a lot more pressure
What are examples of supraventricular tachycardias?
Atrial Flutter and Atrial Fibrillation
ventrical dysrhythmias
ventricular tachycardia
ventricular fibrillation
characteristics of Atrial Fibrillation (A-FIB)
“irregularly irregular”
rapid disorganized atrial activity
what happens: blood is not pushed out all the way, so it is vulnerable to clotting–> risk for stroke, pulmonary edema
5 valvular disorders: Aortic valve regurgitation
backflow resulting in volume overload in the left ventricle
increase in end-diastolic volume
blood back up: Left ventricle
concerns: eventually the heart cant compensate and this leads to heart failure
5 valvular disorders: Mitral Valve Stenosis
patho: impaired flow from left atrium to left ventricle
blood back up: left atrium
concerns: dysrhythmias such as atrial fib, pulmonary HTN, pulmonary edema
5 valvular disorders: Mitral Valve Regurgitation
patho: backflow from left ventricle to left atrium during ventricular systole
blood back up: left atrium
concerns: atrial fibrillation and eventual increase in pulmonary pressures
5 valvular disorders: Tricuspid Valve Regurgitation
patho: blood will backflow from the right ventricle into the right atria
blood back up in the right atrium
concerns: may be caused by dilation and failure of the right ventricle
thrombophlebitis vs thromboembolus
thrombophlebitis is a blood clot with vessel inflammation
a thromboembolus is a traveling blood clot
