Video Review Ch. 10 Flashcards
What is the #1 killer in the US
Heart disease
What is the MC mechanism of cardiac pathology
Pump failure
What pathology is: heart cannot supply tissue demand
Common end-point for many cardiac Dx
3 types of dysfunction
Congestive heart failure
What is loss of the myocardial contractility
Systolic dysfunction
What is abnormal relaxation/filling (females mc)
Diastolic dysfunction
Endocarditis, valvular stenosis, and HTN are all types of what
Valvular dysfunctions
What is forward/backward failure
insufficient output/venous congestion
What is the Frank-Starling mechanism
Inc. ventricular stretch = stronger contraction
What is eccentric cardiac hypertrophy, Inc. in chamber size and the m. mass/wall thickness (L ventricle)
Athlete’s heart (physiologic)
What is concentric cardiac hypertrophy
Left ventricle gets bigger, HTN, Valvular stenosis, inc pressure
What is the primary myocardial disease, hypertrophy and dilation, and may cause pulmonary edema
Left sided heart failure
What is the MC cause of right sided heart failure
Left sided heart failure
What is development of right sided heart failure secondary to pulmonary HTN
Cor pulmonale
What will we see with right sided heart failure
Peripheral edema
What % of congenital heart diseases are idiopathic
90%
Genetically, what is congenital heart disease linked to
Trisomies 13,15,18,21
What % of congenital heart diseases are VSDs? ASDs?
VSD 42%
ASD 10%
What kind of shunt bypasses pulmonary circulation
Right-to-left shunts, Cyanosis
What kind of shunt is MC
Left-to-Right shunt
Other than shunts, what can cause congenital heart disease
Obstruction of vasacular flow (vavlular stenosis, aortic coarctation)
What is the MC structural abnormality (20-30% iso, 42% of all)
VSD
What is a VSD, R. ventricular outflow obstruction, Overriding of VSD by aorta, and R ventricular hypertrophy
MC cause of cyanosis at birth secondary to CHD
Tetralogy of Fallot
What happens with TGA
Right vent gets aorta
Left vent gets pulmonary artery. Shunting is required
What is aortic coarcation
Narrowing of aorta
Who is at greater risk for aortic coarcation
Males 2x, Turner syndrome
What % of ischemic heart disease is from atherosclerosis (CAD)
90%
What is the leading cause of death in the US
Ischemic heart disease
What is occlusion of the coronary arteries that may have catastrophic consequences
Acute coronary syndrome
When is it considered critical stenosis
> 70% occlusion
What is sub-sternal chest pain “crushing” “squeezing” jaw or left arm. Stable or varient or unstable
Angina pectoris
How is stable angina tx
Relived with rest and nitroglycerin
How is variant angina tx
Vasospasm at rest, responds to vasodilators. rare
Crescendo angia, inc. frequency, intensity, duration,
90% fixed coronary artery occlusion
Unstable angina
What is the MC cause of a MI
acute ischemia from thrombosis (90%)
What is the MC artery affected in a MI “widowmaker a.”
L ant. descending coronary artery 40-50%
Unrelieved by nitroglycerine Referred pain "thready" pulse Dsypnea 10-15% silent
Myocardial Infarction
How does myocardium act in chronic ischemic heart disease
As though it is deconditioned
What is the MC stimulus for sudden cardiac death
CAD 80-90%
What dramatically improves SCD prognosis
Defibrillation
Blow to sternal region, Arrhythmia, adolescent males (~15), 65% fatal
Commotio Cordis
L sided heart disease
L ventricular hypertrophy
HTN
Asymptomatic MC, “silent killer”
Systemic hypertensive heart disease
What is failure of a valve to completely open
Stenosis MC mitral valve
What is failure of a valve to completely close
Insufficiency (regurgitation) murmur
What is the MC cause of aortic valve stenosis (elderly 60-80, MC valvular disease)
Calcific aortic valve disease
Rheumatic fever is what kind of reaction
Hypersensitivity
Scarlet fever is what kind of reaction
Reaction to erythrogenic toxins
What is the MC infection of the heart chambers of valves
Bacteremia
What is the MC type of prothestetic valve
Mechanical (other is bioprosthetic)
Diastolic dysfunction, won’t relax, “asymmetrical septal hypertrophy”
Hypertrophic cardiomyopathy
Stiff myocardium, Endomyocardial fibrosis, helminth can cause
Amyloidosis
Restrictive cardiomyopathy
What is the MC cause of myocarditis
Secondary to viral infections
What is heart compressed by fluid
Cardiac tamponade
What is the MC cause of cardiac neoplasm
Metastasis
What is the MC primary malignant tumor of the heart
Angiosarcoma
What is the MC primary cardiac tumor
Myxoma (benign)
Where do 90% of myxomas develop
Fossa ovalis of L atrium