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PAT401 > W1: Cardiovascular Alterations > Flashcards

W1: Cardiovascular Alterations Flashcards

1
Q

Disorders of pericardium

A

Acute Pericarditis
Constrictive/restrive Pericarditis
Percardial Effusion

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2
Q

Acute Percarditis

A

acute inflammation of the eprcardium

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3
Q

Acute Percarditis: CM

A

fever
malaygia
malaise
sudden onset of severe chest pain

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4
Q

Acute Percarditis: Tx

A

rest
salicylates
non-steroidal inflammatory drugs (nonsteroidals + colchicine)

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5
Q

Restrictive Percarditis

A

fibrous scarring + calcification of percardium = parietal and visceral layers of percarium sticking

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6
Q

Restrictive Percarditis: CM

A

exercise intolerance
dyspnea upon exertion
fatigue
anorexia

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7
Q

Restrictive Percarditis: Tx

A

dietary restriction of sodium
diueretics (CO)
antiinflammatory drugs
surgical excision

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8
Q

Percardial Effusion

A

accumulation of fluid in percardial cavity

tamponade

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9
Q

Percardial Effusion: Tx

A

percardiocentesis

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10
Q

Disorders of the myocardium: overview

A

d/t neurohumoral responses to ischemic heart disease OR HTN –> remodelling

cause is idiopathic

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11
Q

Cardiomyopathies

A

dilated cardiomyopathy

hypertrophic cardiomyopathy
- hypertrophic obstructive cardiomyopathy
- hypertensive / valvular cardiomyopathy

restrictive cardiomyopathy

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12
Q

Dilated Cardiomyopathy

A

impaired systolic function –> inc. intracardiac volume, ventricular dilation, systolic HF

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13
Q

Dilated Cardiomyopathy: Cause

A

ischemic heart disease
hypothyroidism
alcohol
drug toxicity
valvular disease
renal faliure
diabetes
infection
dec. Vit D, selenium, niacin

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14
Q

Dilated Cardiomyopathy: CM

A

dyspnea
fatigue
pedal edema

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15
Q

Dilated Cardiomyopathy: Tx

A

dec. BV
inc. contractility
reverse underlying cause

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16
Q

Hypertrophic Obstructive Cardiomyopathy

A

defect of thick septal wall

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17
Q

Hypertrophic Obstructive Cardiomyopathy: CM

A

angina
syncope
palpitation
symps of MI
symps of L. HF

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18
Q

Hypertrophic Obstructive Cardiomyopathy: Tx

A

beta-blockers, ACE Inhibators
surgical resection
septal ablaiton
cardioverterfibrillators (high-risk)

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19
Q

Hypertensive/Valvular Hypertrophic Cardiomyopathy

A

hypertrophy of the myocytes- to compensate for inc. cardiac workload

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20
Q

Hypertensive/Valvular Hypertrophic Cardiomyopathy: CM

A

asymptomatic
angina
syncope
dyspnea upon exertion
palpitationsR

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21
Q

Restrictive Cardiomyopathy

A

myocardiu becomes rigid + non-complicant = impedes ventricular filling, increased filling pressure during diastole

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22
Q

Restrictive Cardiomyopathy: CM

A

R-Heart Faliure
systemic venous congestion

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23
Q

Restrictive Cardiomyopathy: Tx

A

treat underlying cause

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24
Q

Valvular Heart Disease: Tx

A

fluig mgt
valve repair/replacement + LT anticoagulation therapy + lifelong antibiotic prophylaxis before invasive procedure

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25
Q

What to valaves normally do?

A

maintain normal direction of blood flow

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26
Q

Most common cause for valvular heart disease

A

rheumatic heart disease

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27
Q

Valvular Heart Disease: patho

A

wear and tear

hyperlipdemia, HTN, infammation –> calcification (stenosism, regurg, arrythmias)

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28
Q

Valvular Stenosi

A

narrowing of the orrifice

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29
Q

Aortic Stenosis

A

narrowing of the aortic valve orrifice = dec BF from LV into aorta

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30
Q

Aortic Stenosis: CM

A

angina
dyspnea
syncope

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31
Q

Aortic Stenosis: Tx

A

valave repair/ replacement + LT anticoag therapy

transcatheter aortic valve implantation

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32
Q

Aortic Stenosis: patho

A

stenosis –> inc LV pressure –> LV dec contractility —> inc LA pressure –> pulmonary edema (cough, dyspnea, orthopenea) AND dec CO –> tissue ischemia (oliguria, stroke, syncope, angina)

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33
Q

Mitral Stenosis

A

narrowing of the mitral valve
impaired BF from LA -> LV

d/t rheumatic fever

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34
Q

Mitral Stenosis: Tx

A

valve repair/replacement

35
Q

Mitral Stenosis: Patho

A

stenosis –> inc LV pressure –> LV dec contractility —> inc LA pressure –> pulmonary edema (cough, dyspnea, orthopenea) AND dec CO –> tissue ischemia (oliguria, stroke, syncope) AND LA dilation –> Afib –> palpitation

36
Q

Aortic Regurgitation

A

can’t close during diastole

37
Q

Aortic Regurgitation: CM

A

widened pulse pressure

38
Q

Aortic Regurgitation: Tx

A

inatrophic agents
vasodilators
valve replacement

39
Q

Mitral Regurgitation

A

backflow of blood from LV into LA

40
Q

Mitral Regurgitation: Cause

A

mitral valve prolapse
rheumatic heart disease
infective endocarditis
MI
connective tissue disease
dilated cardiomyopathy

41
Q

Mitral Regurgitation: Tx

A

surgical repair
valve replacement

42
Q

Triscupid Regurgitation

A

volume overload in RA and RV –> inc systemic venous pressure –> R HF

43
Q

Mitral Valve Prolapse Syndrome

A

anterior and posterial cusps of the mitral valave prolapse into the LA during systole

44
Q

Mitral Valve Prolapse Syndrome: CM

A

asymptomatic

45
Q

Mitral Valve Prolapse Syndrome: tX

A

None
or beta blockers

46
Q

Classification of Congenital Heart DIsease

A

based on blood flow

  1. inc pulmonary bf (L-R, pulm congestions, acyanotic)
  2. dec pulm blood flow (R-L, cyanosis)
  3. obstructive lesions (outflow tract obstruction, no bf, no shunting)
  4. mixing lesions (blood mixing)
47
Q

Acyanotic Heart Defects

A

L–>R shunt

inc volume on the R side
inc bf in pulmonary circulation

blood still gets oxygenated before entering systemic ciruclation, no decrease in deoxygenation, cyanosis

48
Q

Cyanotic Heart Defects

A

R–> L shunt

dec bf through pulmonary system
dec oxygenation = cyanosis

49
Q

Acyanotic: classifications

A

inc blood flow
obstruction bf from ventricles

50
Q

Cyanotic: classifcations

A

dec pulmonary bf
mixed blood flow

51
Q

Acyanotic: Inc Pulmonary bf

A

atrial septal defect
ventricular septal defect
patent ductus arteriosus
atrioventricular canal defect

52
Q

Acyanotic: Obstruction to bf from ventricles

A

coarctation of aorta
aortic stenosis
pulmonic stenosis

53
Q

Cyanotic: dec pulm bf

A

tetralogy of fallot
tricuspid artesia

54
Q

Cyanotic: mixed blood flow

A

transposition of the great arteries
total anamolous pulmonary venous connection
tricuspid arteriosus
hypoplastic L heart syndrome

55
Q

Patent Ductus Atreiosus

A

ductus arteriosus doesn’t close (usually closes after birth)

before birth it allows blood to shunt from pulmonary artery to aorta

56
Q

Patent Ductus Atreiosus: CM

A

machinery type murmur
bounding pulses
active precordium
thrill upon palpitation
S/S pulmonary overcirculation

57
Q

Patent Ductus Atreiosus: tx

A

surgical closure

58
Q

Atrial Septal Defect

A

abnormal comm btw atria (L –> R shunt)

59
Q

Atrial Septal Defect: CM

A

symptomatic
dx with murmur

60
Q

Atrial Septal Defect: Types

A
  1. ostium primum
  2. ostium secondum
  3. sinus venosus
61
Q

Atrial Septal Defect: Tx

A

surgical closure before school age

62
Q

Ventricular Septal Defect

A

abnormal communication btw ventricles ( L –> R)

63
Q

Ventricular Septal Defect: CM

A

HF
poor weight gain
murmur + systolic thril

64
Q

Ventricular Septal Defect: Tx

A

minimal tx before surgical repair

65
Q

Atrioventricular Septal Defect

A

d/t nonfusion endocardial cushions
abn. in atrial + vent septal & AV valves

complete, partial, transitional AVC

66
Q

Atrioventricular Septal Defect: CM

A

murmur
HF
resp tract infections

67
Q

Atrioventricular Septal Defect: tx

A

repair btw 3-6 mo

68
Q

Coarctation of Aorta

A

narrowing of thr aorta lumen = dec BF

usually juxtaductal position but can be from thr aortic arch –> bifurcation of the aorta in the lower abdomen

69
Q

Coarctation of Aorta: CM (newborns)

A

HF
hypotension –> acidosis –> shock

70
Q

Coarctation of Aorta: CM (older kids)

A

HTN (upper extrem.)
absent pulses (lower extrem)
cool motteled skin
leg cramps during exercise

71
Q

Coarctation of Aorta: Tx

A

prostaglandim administration
inatrophic agents
mechanical ventilation
maintain CO
surgery

72
Q

Aortic Stenosis

A

narrowing of aortic outflow tract

d/t malformation/fusion of the cusps = inc LV workloard

73
Q

Aortic Stenosis: CM

A

asymptomatic

murmur
exercise intolerance (preadolescence)
syncopal episodes
epigastric pain
exhertional CP

74
Q

Aortic Stenosis: Tx

A

ross procedure
aortic valvotomy
commisturotomy

75
Q

Pulmonic Stenosis

A

narrowing of the pulmonic outflow tract or valve
pulmonic atresia
thickening of leaflets

76
Q

Pulmonic Stenosis: CM

A

asymptomatic

exhertional dyspnea
murmur
fatigue
thrill
cyanosis
HF

77
Q

Pulmonic Stenosis: Tx

A

mild; none

severe: pulmonic valvotomy
balloon angioplasty

78
Q

Tetralogy of Fallot

A
  1. large ventricular septal defect
  2. pulmonary stenosis
  3. ovverrriding aorta straddles ventricular septal defect
  4. R ventricular hypertrophy
79
Q

Tetralogy of Fallot: CM

A

cyanosis
hypoxia
clubbing
feeding difficulty
dyspnea
restlessness
squatting

tet spell: crying exhertion

80
Q

Tetralogy of Fallot: Tx

A

surgery <1yr

blalock-taussing shunt
transcatheter pulmonary valve replacement
patch

81
Q

Tricuspid Atresia

A

blocked tricuspid valve
no communciation btw RA & RV

  • septal defect
    -hypoplastic/absent RV
    -enlarged mitral valve or LV
    -pulmonic stenosis
82
Q

Tricuspid Atresia: CM

A

cyanosis
growth faliure
exhertional dyspnea
tachypnea
hypoxemic
polycythemia
clubbing
hepatomegaly

83
Q

Tricuspid Atresia: Tx

A

blalock-taussing shunt
PA band
rashkind procedure
prostaglandin administration
closure of septal defects

PAT401 (6 decks)

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