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Jason's Cardiovascular Block > Ventricular Hypertrophy then Cardiac Failure > Flashcards

Ventricular Hypertrophy then Cardiac Failure Flashcards

1
Q

how long does embryonic heart hyperplasia last for?

A

only first few months of life

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2
Q

How do you control heart hypertrophy in childhood?

A

Growth Hormone
IGF
Thyroxine

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3
Q

Mean ventricular mass?

A

159g

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4
Q

Heart size depends on 5 things

A 
body size
genetics
atheletics
blood pressure
angiotensin II, catecholamines
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5
Q

When is ventricular hypertrophy considered hypertrophy?

A

When the ventricle mass increases RELATIVE to body size

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6
Q

What is ventricular remodelling?

A

increase wall thickness without increase in mass

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7
Q

Reasons for cardiac remodelling?

A

infarct
damage
volume overload
pressure overload

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8
Q

Does eccentric hypertrophy’s wall thickness change?

A

Nope. just the mass

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9
Q

LV mass increases in Concentric, eccentric hypertrophy and remodelling?

A

Nope. Not in remodelling

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10
Q

How does the heart remodel due to pressure overload?

A

concentric hypertrophy

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11
Q

How does the heart remodel due to volume overload?

A

eccentric hypertrophy

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12
Q

How are cardiac sarcomeres placed in concentric vs. eccentric hypertrophy?

A

concentric: parallel
eccentric: in series

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13
Q

T/F? Hypertrophy has more mitochondrion, more myfibrils, more myocardial cells, increased fibroendothelial cells, more matrix and more sarcoplasmic reticulum?

A

FALSE BITCH! Myocardial cell numbers DO NOT increase, only the SIZE increases.

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14
Q

What law dictates that a thicker wall reduces wall stress?

A

Laplace’s Law

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15
Q

Why is cardiac hypertrophy kinda paradoxical?

A

Animals with no hypertrophy actually respond better to pressure loads. Go Figure.

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16
Q

What happens prior to cardiac failure in a hypertrophied heart?

A

Decompensation from long term-ness

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17
Q

What’s Fabry’s Disease

A

Genetic cause of left ventricular hypertrophy

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18
Q

How would infiltration be a cause of left ventricular hypertrophy

A

Sneaky proteins cause amyloidosis and ninja your ass

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19
Q

Two signs of left ventricular hypertrophy on ECG?

A

inverted T-wave

Tall voltages

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20
Q

what could cause diastolic dysfunction?

A

left ventricular hypertrophy

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21
Q

Out of the three left ventricular hypertrophies: what’s the worst one for mortality post MI?

A

Concentric

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22
Q

Thick muscle is……

A

Stiff Muscle.

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23
Q

When does the ‘Atrial Kick’ more important?

A

In diastolic dysfunction

24
Q

What do you lessen if you treat someone with ACE inhibitors/beta adrenergic blocking post MI?

A

Ventricular dilation post-MI remodelling

25
Q

3 causes of Right Ventricular Hypertrophy?

A
  1. congenital
  2. pulmonary artery hypertension
  3. Right heart valves
26
Q

What is hypertrophic cardiomyopathy?

A

Autosomal dominant, sarcomere protein mutation

27
Q

What is especially thick in Left Ventricular Hypertrophy?

A

Septum

28
Q

There is only a few presentations of hypertrophic cardiomyopathy T/F?

A

False. LOTS of Variability.

29
Q

What is the most common cause of sudden cardiac death in athletes?

A

hypertrophic cardiomyopathy

30
Q

We know the cause of Dilated Cardiomyopathy.

A

Nah. it’s idiopathic.

31
Q

Athlete’s Heart’s wall thickness is greater or less than 14mm?

A

Less than 14mm wall thickness

32
Q

what kind of hypertrophy do you find in athlete’s heart?

A

eccentric

33
Q

What’s your cardiac output per minute?

A

5L/min

34
Q

Starling’s Law

A

if you increase preload + cardiac contraction you get increased SV and CO

35
Q

How is Starling’s Law regulated?

A

it’s intrinsic, purely by the muscle stretch

36
Q

What does JVP measure?

A

right ventricular/atrial EDP

37
Q

How to measure left atrial pressure through the right ride of the heart?

A

Pulmonary wedge pressure in the pulmonary artery because it equals left atrium/ventricle pressure

38
Q

What is the device used to measure pulmonary wedge pressure called?

A

Swan-Ganz Catheter

39
Q

What determines blood pressure?

A

The Arteriole.

40
Q

Oedema is when:

A

Hydrostatic pressure exceeds osmotic

41
Q

What pressure causes oedema?

A

increased venous pressure

42
Q

What are forces across capillaries called?

A

Starling Forces

43
Q

How does increased plasma protein loss leave to Oedema?

A

due to decreased osmotic pressure back into veins

44
Q

What causes pathological increased capillary permeability leading to oedema?

A

infection

45
Q

Name two uses for end diastolic pressure:

A
  1. measure filling of ventricles

2. measure venous pressure driving fluid out of capillaries

46
Q

Define Cardiac Failure

A

CO can’t keep up with body’s needs. Usually systolic failure

47
Q

Why would the body retain fluid to compensate for decrease cardiac output?

A

increases left ventricular end diastolic pressure to maintain CO. bad if >25mmHg

48
Q

Why would your lungs get congested in heart failure?

A

Cause of fluid retention compensating to get CO up and increases in LVEDP

49
Q

3 mechanisms of Cardiac Failure

A
  1. loss of myocardial muscle
  2. pressure overload (stenosis, HTN)
  3. volume overload (valve regurg)
50
Q

Clinical features of right heart failure?

A

Oedema

51
Q

Clinical fathers of left heart failure? 4 things:

A

SOB
fatigue
Tachycardia
lung crackles

52
Q

What happens to Na+, and K+ in cardiac failure?

A

Na+ retention, K+ loss, vasoconstriction

53
Q

When do you get liver congestion of blood?

A

Right heart failure

54
Q

Can left heart failure cause right heart failure?

A

Yes it can! venous hypertension will back blood up through the pulmonary circulation and cause arterial hypertension.

55
Q

How do you get diastolic heart failure?

A

reduced compliance from infarct or stiff walls

56
Q

What is only helpful short term for cardiac failure?

A

Digoxin, positive inotropics

57
Q

How to treat underlying cause of heart failure?

A 
bypass
valve replacement
pacemaker
defib
transplant

Jason's Cardiovascular Block (15 decks)

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