Week 10: Cardiovascular Disorders Flashcards

1
Q

What is congenital heart disease?

A

Abnormality of the heart that is present from birth

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2
Q

Different congenital heart anomolies result in two primary pathologic processes which are?

A
  1. Shunting of blood through abnormal pathways in heart or great vessels
  2. Obstruction to blood flow because of abnormal narrowing
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3
Q

What are some abnormalities that heart defects are commonly associated with during embryologic development?

A

Development of atrial septum
Development of the ventricular septum
Division of the main outflow tract (truncus arteriosus) into the pulmonic and aortic arteries
Development of the valves

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4
Q

What is the most common heart disorder in children?

A

Congenital heart disease

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5
Q

What are 3 attributions that congenital heart disease may be related to in childrem?

A

Maternal rubella during first trimester of pregnancy
Exposure to cardiac teratogens (exposure to harmful things like drugs, chemicals during pregnancy etc)
Genetic influences

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6
Q

Difference between cyanotic vs acyanotic congenital heart defects?

A

Cyanotic: Lowers amount of oxygen in blood
Acyanotic: Doesn’t lower amount of oxygen in blood

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7
Q

Acyanotic congenital defects include:

A

Atrial septal defect
Ventricular septal defect
Patent ductus arteriosus
Coarctation of the aorta
Pulmonary and aortic stenosis or atresia

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8
Q

Cyanotic congenital defects include:

A

Tetralogy of Fallot, Transposition of the great arteries

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9
Q

What is atrial septal defect?

A

Majority of atrial septal defects occur at the location of the foramen ovale

Long-term increase in pulmonary blood flow may eventually lead to pulmonary hypertension, right ventricular hypertrophy, and reversal to a right-to-left shunt

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10
Q

What is ventricular septal defect?

A

Most common congenital cardiac anomaly

Typically located in the membranous septum, near the bundle of HIS???

Increase in pulmonary blood flow can result in pulmonary hypertension, right ventricular hypertrophy, and reversal of the shunt

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11
Q

What is patent ductus arteriosus?

A

Conditions that cause low blood oxygen tension may contribute to continued patency
No clinical significance in early life
Continued patency identified by harsh, grinding systolic murmur or thrill
Results in pulmonary hypertension, and can lead to right-sided heart failure

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12
Q

What is coarctation of the aorta?

A

Narrowing or stricture of the aorta that impedes blood flow
Commonly located just distal to the left subclavian artery
Usually accompanied by systolic murmurs and ventricular hypertrophy

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13
Q

What is pulmonary stenosis or atresia?

A

Pulmonary atresia: blood must enter the lungs by traveling through a septal opening and/or a patent ductus arteriosus because valve to pulmonary arteries is shut

Pulmonary stenosis: usually due to abnormal fusion of the valvular cusps and can lead to right ventricular hypertrophy

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14
Q

What is aortic stenosis or atresia?

A

Aortic atresias are not compatible with survival because the aorta is closed off (i.e. no blood to myocardium or rest of body)

Aortic stenosis may involve the valvular cusps or the subvalvular fibrous ring and results in high left ventricular afterload with left ventricular hypertrophy

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15
Q

What are four defining features of tetralogy or fallot?

A
  1. Ventricular septal defect
  2. Aorta positioned above the ventricular septal opening (overriding aorta)
  3. Pulmonary stenosis that obstructs right ventricular outflow
  4. Right ventricular hypertrophy b/c of pulmonary stenosis
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16
Q

Aorta and pulmonary artery arise from where?

A

Aorta from right ventricle
Pulmonary artery from left ventricle

  • Resulting in two separate non-communicating circulations
17
Q

What is a commo factor among all types of shock?

A

HYPOperfusion and impaired ability of cells to use oxygen

18
Q

What may inadequate cellular oxygenation result from?

A
  • Decreased cardiac output
  • Maldistribution of blood flow
  • Reduced blood oxygen content
19
Q

Impaired tissue oxygen results in what?

A

Cellular hypoxia

20
Q

What are 3 things that cellular hypoxia may cause?

A

Anaerobic metabolism
Free radical production
Macrophage induction

21
Q

Failure of microcirculation to ______ leads to activation of coagulation

A

autoregulate blood flow

22
Q

What is the compensatory stage of shock?

A

homeostatic mechanisms are sufficient to maintain adequate tissue perfusion despite a decrease in cardiac output
SNS activation attempts to maintain blood pressure even though cardiac output has fallen

23
Q

Progressive stage of shock is marked by what?

A

Hypotension and tissue hypoxia

24
Q

What is refractory shock?

A

occurs when the person does not respond to medical interventions.

25
Q

What is cardiogenic shock?

A

Severe inability of left, right or both ventricles to pump blood effectively.

26
Q

Cardiogenic shock is usually the result of what?

A

Result of severe ventricular dysfunction associated with MI

27
Q

What are diagnostic features of cardiogenic shock?

A

Decreased cardiac output
Elevated left ventricular end-diastolic pressure
S3 heart sounds
Pulmonary edema

28
Q

What is hypovelemic/ hemorrhagic shock?

A

Results from inadequate circulation blood volume related to hemorrhage, burns, dehydration, or leakage of fluid into interstitial spaces

Low cardiac output and intracardiac pressures lead to SNS activation = increased heart rate, vasoconstriction, increased contractility

29
Q

What can be used for fluid replacements during hypovolemic shock?

A

Colloids, crystalloids, and blood products

30
Q

What is preload?

A

The volume of blood in heart chamber just before systole (contraction)

31
Q

What is afterload?

A

Resistance the heart chamber (ventricle) has to overcome in order to eject blood from the chamber; systemic vascular resistance is the main factor that determines left ventricular afterload

32
Q

What is contractility?

A

The ability of the heart muscle to contract

33
Q

What is stroke volume (SV)?

A

Volume of blood ejected from the ventricle per contraction