Quiz 3 Study Guide: Heart Disease

Question 1

What are 6 symptoms of a Myocardial Infarct?

Answer 1

Retrosternal Chest Pain
Dyspnea (short of breath)
Diaphoresis (Sweating)
Nausea
Palpitations
Anxiety

Question 2

What is the Diagnostic Criteria for a Myocardial Infarct?

Need at least 2

Answer 2

Ischemic type chest pain > 20 minutes
Acute EKG changes
Rising then falling serum cardiac biomarkers (troponin)
OR
Pathological documentation of an infarct at autopsy.

Question 3

What is a Transmural Infarct?

Answer 3

Full thickness (endocardium to epicardium)
More severe

• Usually involving LV anterior and posterior free wall or septum.
• Correlates with STEMI (ST segment Elevation)

Question 4

What Causes a subendocardial infarct?

Answer 4

Due to hypotension, global ischemia

Question 5

What is a subendocardial infarct?

Answer 5

Multifocal or defuse areas of necrosis confined to the inner 1/3-1/2 of the LV wall.
Less severe

Correlates with NSTEMI (Non-ST segment elevation)

Question 6

What are MI complications?

Answer 6

None 10-20%
Arrhythmias 75-95%
Congestive Heart Failure, Pulmonary Edema (60%)
Cardiogenic Shock 10-15%
Mural Thrombosis 40%
Rupture (ventricle or papillary muscle) 4-8%
Extension of infarct

Question 7

What are symptoms of Valvular heart disease?

Answer 7

Stenosis - Valve won’t open
Regurgitation - Can’t close completely

(Aortic)

Question 8

Types of Valvular Heart Disease…

Answer 8

Rheumatic Fever
Infective Endocarditis (Strep or Staph)
Pre-injured valve

Question 9

Endocarditis complications…

Answer 9

Very destructive
Can cause thrombi
Destroy and perforate valvular tissue
Systemically dangerous

Question 10

What are complications of artificial valves?

Answer 10

Can cause thrombi
Increased risk of Infective endocarditis
Wears out valves and leaks (murmurs)

Question 11

What are arrhythmias?

Answer 11

Electrical problems in the heart
-Premature beats (usually not dangerous)
Tachyarrhythmias (less common but more serious -Fibrillations)

Question 12

What are symptoms of arrhythmias?

Answer 12

Palpitations
syncope (fainting)
sudden cardiac death (atherosclerosis involvement)

Question 13

Causes of conduction disturbances.

Answer 13

Ischemic Heart disease - Scarring
degenerative changes
antiarrythmic drugs
hyperkalemia
MI
Trauma
Congenital

Question 14

What is Bradycardia?

Answer 14

< 60 BPM

Question 15

What is Tachycardia?

Answer 15

> 100 BPM

Question 16

What is a 1st degree heart block?

Answer 16

Slowed impulse propagation.

Question 17

What is a 2nd degree heart block?

Answer 17

Impulse propagation to ventricles sometimes fails.
Irregular ventricular contraction
Causes Syncope
Pacemaker can be needed.

Question 18

What is 3rd degree heart block?

Answer 18

Complete AV block
No conduction from AV
Only latent pacemakers of ventricles

• More p waves that QRS complexes
• Syncope and risk of sudden death.

Question 19

What are ectopic beats?

Answer 19

• Originates at sites other than sinus node.
• Increased rate of depolarization at any site to a rate faster than the sinus node results in a premature depolarization.

Question 20

Where can Ectopic beats originate from?

Answer 20

The Atria
Specialized conduction system ( av node or bundle of HIS)
The Ventricles

Question 21

Examples/causes of Ectopic Beats…

Answer 21

Atrial premature depolarization 
VPB's
Tacky-arrythmias
A Fib
Cong. Heart Failure (Valve disease/hypertension)