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Cardiorespiratory > Structural Heart Disease > Flashcards

Structural Heart Disease Flashcards

1
Q

What are the determinants of stroke volume?

A 
arterial pressure (preload/afterload)
energy of contraction: (starling's law, contractility)
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2
Q

What is Starling’s Law?

A

the more the heart fills the harder it will contract therefore the bigger the stroke volume (up to a point)

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3
Q

What is the Anrep effect?

A

autoregulation method in which myocardial contractility increases with afterload

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4
Q

What is the law of Laplace?

A

the tension within the wall of a sphere filled to a particular pressure depends on the thickness of the sphere (inversely proportional)

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5
Q

Give an equation for the law of Laplace.

A

pressure = (2 x thickness x stress)/radius = 2x tension/radius

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6
Q

Label a normal pressure volume loop.

A 
valves opening and closing
isometric relaxation/contraction
diastolic filling
ventricular ejection
SBP/DBP
ESV/EDV
SV
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7
Q

What is aortic stenosis?

A

narrowing of the aortic valve opening

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8
Q

What is mitral stenosis?

A

narrowing of the mitral valve opening

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9
Q

Classify types of valvular dysfunction.

A

narrowing ie stenotic lesions

dilatation ie regurgitation

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10
Q

Valvular dysfunction is more clinically significant on what side of the heart?

A

left

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11
Q

When is aortic stenosis classified as severe?

A

when aortic valve area is <1cm2

speed of blood flow >4m/s

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12
Q

What investigation can be done to assess severity of aortic stenosis?

A

trans thoracic echocardiogram

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13
Q

Common causes of aortic stenosis

A

bicuspid aortic valve
degeneration of valve in elderly
rheumatic heart disease

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14
Q

Rare causes of aortic stenosis

A

infective endocarditis

hyper urethemia

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15
Q

Causes of mitral stenosis

A

rheumatic fever
congenital mitral stenosis
features of lupus, rheumatoid arthritis

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16
Q

How does aortic stenosis affect the heart?

A

increased afterload > contraction of LV is less effective > LV abnormally remodels > LV hypertrophy

17
Q

How does mitral stenosis affect the heart?

A

increased pressure on LA > more strain on LA > LA dilates

18
Q

Aortic stenosis can be discovered by what heart sound heard when?

A

murmur

systole

19
Q

Dilation of mitral and aortic valves causes?

A

mitral regurgitation

aortic regurgitation

20
Q

Cause of mitral regurgitation?

A 
rheumatic fever
mitral valve prolapse
coronary artery disease or heart attack rheumatoid arthritis
endocarditis
ventricular dilation
21
Q

What effect does regurgitation have on cardiac output?

A

decreases

22
Q

Cause of aortic regurgitation?

A 
Congenital heart valve disease
Age-related changes to the heart
Endocarditis
Rheumatic fever
Other diseases
Trauma
23
Q

Classify cardiomyopathies.

A

hypertrophic
dilated
arrhythmogenic right ventricular

24
Q

List treatment modalities.

A

valve replacement (surgery/intervention via catheter)

25
Q

What are types of valve replacement?

A

aortic+mitral

aortic only

26
Q

What are advantages and disadvantages to metallic valve replacement?

A

adv - last up to 20 years, can avoid multiple surgeries/scarring
disadv - have to take warfarin (complicated monitoring/interactions with other meds)

27
Q

Define cardiogenic shock.

A

impairment of cardiac systolic function resulting in reduced cardiac output causing end organ dysfunction

28
Q

How do you treat cardiogenic shock?

A

early coronary angiography > PCI > reassess haemodynamics/tissue perfusion : if improved, review and wean as indicated. if persistent, reimage for RV involvement/mechanical complications > advanced support

29
Q

the majority of cardiogenic shock cases are caused by?

A

myocardial infarction

30
Q

define inotrope

A

an agent that influences the force of muscular contraction

31
Q

list inotropes used in cardiogenic shock

A

cAMP

phosphodiesterase inhibitor

32
Q

what types of drugs are used to treat cardiogenic shock?

A

inotropes

vasopressors

33
Q

list vasopressors used in cardiogenic shock

A

dopamine
epinephrine
norepinephrine

Cardiorespiratory (20 decks)

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