Systemic Diseases Flashcards
Hypertensive heart disease is an end-organ consequence of ____ hypertension.
Systemic
Hypertension is categorized by a systemic blood pressure above ____ mmHg and a diastolic above ____ mmHg
140 mmHg; 90 mmHg
What are the m-mode findings of hypertension?
LVH
LA enlargement
Aortic root dilation
What are the 2D findings of hypertension?
Concentric LVH and normal systolic function
Aortic valve may be sclerotic
LA enlargement
Dilation of aortic root
Mitral Annular Calcification (MAC)
What are the Doppler findings of hypertension?
- Diastolic compliance may be impaired (MV pattern = prolonged relaxation)
- Aortic regurgitation and/or MR
____ is a disease that affects the body’s ability to produce or respond to insulin, a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy.
Diabetes
What does diabetes do to heart disease?
Speeds it up
More than ____% of deaths in diabetes patients are attributed to heart and vascular disease.
65%
What are the m-mode findings of diabetes?
- Mostly normal
- LA enlargement if diastolic dysfunction is present
What are the 2D findings of diabetes?
Normal systolic function
LA enlargement, possibly
What are the Doppler findings of diabetes?
- Diastolic compliance may be impaired (MV pattern = prolonged relaxation)
- Look for MV inflow and pulmonary veins
What is it called when too little thyroid hormone is produced in the body?
Hypothyroidism
Those with hypothyroidism have symptoms associated with slow metabolism, such as:
Fatigue
Weakness
Those with hypothyroidism will often have a ____ LV performance and cardiac output.
Decreased
What is it called when there is too much thyroid hormone in tissues of the body?
Hyperthyroidism
Hyperthyroidism will cause a(n) ____ in total blood volume and LV contractility.
Increase
On 2D, hyperthyroidism will show a ____ ventricle.
Hyperdynamic
___ is when too many parathyroid hormones (maintains calcium levels in the blood) are made by the glands.
Hyperparathyroidism
Hyperparathyroidism causes an abnormally high level of ____ in the blood.
Calcium
Chronic renal insufficiency is when a disease slowly and gradually destroys the filtering capacity of the ____.
Kidneys
What are the echo findings of chronic renal insufficiency?
- LVH (due to long standing HTN)
- Systolic dysfunction (especially when on dialysis)
- Pericardial effusion
____ is a connective tissue disease and chronic autoimmune disease.
Lupus
Lupus is known as the “____ ____”
“great imitator”
Symptoms of Lupus include fever, joint pain, fatigue, general malaise, and “____” rash
“butterfly”
A cardiac complication of ____ is that it causes inflammation of any part of the heart: myocarditis, endocarditis, or pericarditis.
Lupus
Noninfectious endocarditis, called ____, forms on the valves in Lupus patients.
Libman-Sachs
With Lupus, you often find thickened leaflets, regurgitation, and leaflets that can’t ____ fully.
Coapt
____ causes thickening and hardening of the skin, joints and internal organs (heart).
Scleroderma
Echo features of scleroderma include:
- Global LV dysfunction
- Nodules in myocardium or on valves
- Pericardial constriction and/or effusion
- Pulmonary hypertension
- CHF
- Conduction Abnormalities
- Pericardial effusion (concurrent)
- Can act just like an infiltrative cardiomyopathy
____ ____ is a disorder that affects blood vessels in the fingers, toes, ears and nose.
Reynaud’s Phenomenon
____% of scleroderma patients have Reynaud’s Phenomenon.
90%
With Reynaud’s Phenomenon ____ or ____ can cause small blood vessels in the fingers and toes to constrict and change color.
Stress or cold
____ is an inflammatory arthritis that can cause the vertebrae to fuse.
Ankylosing spondylitis
____ is a rare, usually benign, adrenal tumor that produces excessive catechomalines (high BP, palpitations, headache, sweating).
Pheochromocytoma
What are the echo features of Ankylosing spondylitis?
- Dilation of aorta
- AI
What are the echo features of Pheochromocytoma?
- Increased HR and contractility
- LV systolic dysfunction
- LVH
____ occurs when excess growth hormone is secreted from the pituitary gland (usually due to benign tumor).
Acromegaly
What are the echo features of Acromegaly?
- Systolic and Diastolic Dysfunction
- LVH
- CHF
Osler-Weber-Rendu is a disorder that affects ____.
Blood vessels
A patient can get ____ disease as a result of poor cardiac output with malperfusion, or if there is long-standing RV dysfunction.
Liver
____ results from prolonged heart disease, which affects the blood flow from the liver to the heart and consequently leads to build up of pressure.
Cardiac cirrhosis
When the heart doesn’t pump as well as it should, blood “backs up” into the ____.
Liver
Pulmonary Hypertension is diagnosed when the blood pressure in the heart to lung circulation exceeds ____ mmHg at rest or___ mmHg with exercise.
25 mmHg; 30 mmHg
What are the m-mode findings of pulmonary hypertension?
- RV dilation
- Paradoxical septal motion
- Septal hypertrophy
- Right ventricular hypertrophy (RVH)
What are the 2D findings of pulmonary hypertension?
- Dilated PA, RV, and RA; LV may be small
- Paradoxical septal motion
- Flattened IVS in PSAX - “D” shaped LV
- Dilated IVC and hepatic veins
What are the numbers for pulmonary hypertension - right heart systolic pressure?
Normal: 18-25 mmHg
Mild: 30-40 mmHg
Moderate: 40-70 mmHg
Severe: >70 mmHg
What are the numbers for pulmonary hypertension - acceleration time?
Normal: > 100 msec
Mild: 80-100 msec
Moderate: 60-80 msec
Severe: < 60 msec
Eisenmenger syndrome is a form of ____.
Pulmonary HTN
When right heart systolic pressure increases past 70 mmHg is can turn into this. Right heart pressures become higher than the left heart pressures.
Eisenmenger syndrome
Cor Pulmonale is ____ heart failure.
Right sided
____ means the heart can’t pump enough blood to meet the body’s needs.
Congestive heart failure
____ can occur when something suddenly affects the heart’s ability to function.
Acute heart failure
Signs and symptoms of acute heart failure are similar to those of chronic heart failure, but are more ____ and start or worsen suddenly.
Severe
For acute heart failure, do a complete exam looking very hard for evaluation of both:
- Systolic function: EF, WMA, dp/dT (if MR is present) etc.
- Diastolic function: MV inflow, pulmonary veins, TDI
Hypereosinophilic syndrome occurs when there is too many ____.
white blood cells
