Week 2- Other Cardiac Pathologies Flashcards
PART 1
PART 1
List of Other Cardiac Pathologies.
- Valvular Disease (regurgitation, stenosis)
- Arrhythmias (a.fib and v.fib)
- Myocarditis
- Pericarditis
What are (2) types of valvular disease? Describe each.
Regurgitation
-Valve leaflets fail to completely close or edges do not fully meet. This permits backward flow of blood.
Stenosis
-Leaflets do not provide a full opening for blood to flow through.
- Aortic regurgitation leads to increased LV _______/______.
- This then leads to LV dysfunction and myocardial _______.
- Ultimately leads to what?
- volume/mass
- ischemia
- LV FAILURE
What are Arrhythmias/Dysrhythmias?
Disturbances of rate and/or rhythm of the heart.
Describe the PQRST complex.
- P wave = atrial depolarization (contraction)
- QRS complex = ventricular depolarization
- T wave = ventricular repolarization
- Bracycardia = ___ BPM
- Tachycardia = ____ BPM
- Bracycardia = <50 BPM
- Tachycardia = >100 BPM
Is atrial or ventricular fibrillation more serious? Why?
-V.fib, because ventricular arrhythmias are more likely to interrupt the pumping of blood, or undermine the heart’s ability to supply the body with oxygen-rich blood.
What is a treatment method for A.fib?
A.fib ablation
Why are patients with A.fib often on blood thinners?
- If the atria go into fibrillation, there is an increased risk of clot formation.
- Can then migrate through tricuspid valve, into the R ventricle, and go to the lungs to cause a PE.
- Can also return to heart and go into systemic circulation and likely that embolism will end up in brain causing stroke.
What area is likely to cause clot formation in right atrium?
Right Auricle
Can we live without the atria? How?
-Yes, because most ventricular filling occurs during atrial diastole. Atrial systole acts to “top off” ventricles.
What is Myocarditis?
Inflammation of the myocardium.
Myocarditis is usually cause by _____ infection and can lead to HF, Dilated Cardiomyopathy, Arrhythmias, and Sudden Death.
viral infection
What (4) things can lead to Diabetic Heart Disease?
- ) Metabolic effects due to FFA, insulin resistance.
- ) Structural: myocardial fibrosis and ECM changes.
- ) Reduced perfusion due to small vessel disease.
- ) Autonomic dysfunction reduced HRR.
What is Pericarditis?
Swelling and irritation of thin saclike membrane surrounding the heart.
Pericarditis:
- May be caused by _____ infection or a ___.
- In many cases, it is __________.
- Associated with _________ diseases.
- Sharp chest pain-plaural memranes rubbing against one another.
- Unique sound = “___________”
- viral infection or MI
- idiopathic
- autoimmune disease (RA, SLE, radiation therapy)
- “pericardial rub”
- How is pleuritic chest pain worsened?
- How is it decreased?
- Worsened lying in supine, inhaling deeply, or cough.
- Decreased by leaning forward.
- What is Constrictive Pericarditis?
- What does it result in?
- Constrictive Pericarditis is characterized by a fibrotic, thickened and adherent pericardium that may be constricting secondary to limited expansion during systole.
- Results in restricted movement and function and often causes Right Sided HF.
- What is Pericardial Effusion?
- What does it result in?
- Pericardial Effusion is fluid accumulation within the pericardial sac.
- Results in compression of the heart, reduces ventricular diastolic filling, and hence CO.
PART 2
PART 2
What are some other cardiac pathologies?
-Aneurysm
What is an aneurysm?
Abnormal stretching in the wall of an artery, vein, or the heart with a diameter that is at least 50% greater than normal.
What are the 3 types of true Aneurysms?
-Saccular: unilateral outpouching
-Fusiform: diffuse dilation involving the entire circumference of the artery wall
Dissecting: a bilateral outpouching in which layers of the vessel wall separate, with creation of a cavity
What is a false Aneurysm?
The wall ruptures, and a blood clot is retained in an outpouching of tissue.
What is the most common Aneurysm?
Abdominal Aortic Aneurysm
- What is a way to treat aneurysms?
- What is the problem with these?
- Endovascular Stent Graft
- Aren’t able to expand and contract, therefore cannot assist with cardiac function.
The heart is one of the first organs to become functional in the fetus. It becomes functional within __-__ weeks of fertilization.
-8-10 weeks
Describe the formation of the heart.
- At ~17 days the heart-forming cells appear.
- U-shaped tube is formed.
- U shaped tube merges to create a single midline tube.
- At ~23 days the heart begins to beat.
- Formation of the cardiac loop occurs.
- At ~27 days, separation begins and we start to see formation of the 4 chambers.
- At ~37 days separation is complete.
- In fetal circulation, anatomical structures function to circumvent __________ circulation.
- In fetal circulation, which side is predominant and why?
- pulmonary
- Left side is predominant because lungs are not formed until 3rd trimester and systemic circulation is of more importance.
Describe these structures function in fetal circulation:
- Foramen Ovale
- Ductus Arteriosus
- Ductus Venosus
- Foramen Ovale: Allows a R → L atrial shunt
- Ductus Arteriosus: Pulmonary Artery → Aorta shunt
- Ductus Venosus: Umbilical cord → IVC to bypass the liver
- What structure transfers blood from the umbilical cord to the IVC to bypass the liver?
- What structure allows a R → L atrial shunt?
- What structure provides a shunt from the pulmonary artery → aorta shunt?
- Ductus Venosus
- Foramen Ovale
- Ductus Arteriosus
Foramen Ovale:
-Shunts blood from the ___ → ____.
-Does it close?
After birth left atrial pressure _______ that of the right, forcing the “valve” against the atrial septal wall.
-The “valve” fuses with the septum, sealing the foramen.
- RA → LA
- Yes, closes at birth.
- exceeds
Ductus Arteriosus:
- A normal fetal artery that links the _______ artery to the _______.
- In doing so blood bypasses the RV and hence _________ circulation.
- Closes within ___ hours of birth and permanently closes within __-__ weeks after birth.
- What does this become?
- pulmonary artery to the aorta
- pulmonary circulation
- 15 hours, 2-3 weeks
- ligamentum arteriosum
Ductus Venosus:
- Shunts a portion of __________ blood directly to the _________.
- Allows blood from the placenta to bypass the _______ and enter directly into central circulation.
- Does it close?
- What does this become?
- umbilical cord to the IVC
- liver
- Yes, closes within 3-7 days of birth
- ligamentum venosum
Defects Associated - Patent Foramen Ovale:
- Most need no _________.
- Provide a passage way for __________ movement-anticlotting medication.
- Open heart surgery.
- intervention
- thrombus
Defects Associated - Patent Ductus Arteriosus:
- Occluded by a plug inserted via a catheter.
- Closed off by physically tying it off.
- Approach is via a __________.
-thoracotomy
Defects Associated - Patent Ductus Venosus:
-Is treated with medicines, _________-based procedures, and surgery
-catheter-based
What is the most typical symptom of patency of the three fetal circulation vessels?
Failure to thrive.
Ventricular Septal Defect:
- What is a Ventricular Septal Defect (SD)?
- Symptoms are dependent on what?
- What are 2 effects of Ventricular SD?
- Hole in the wall separating the 2 lower chambers of the heart, causing mixing of oxygenated and deoxygenated blood in the right side of the heart.
- Symptoms dependent on size of the hole.
- LV can fail due to overwork, pulmonary HTN
What is Hypoplastic Left Heart Syndrome (HLHS)?
Underdeveloped left side of the heart. The aorta and LV are too small and the holes in the artery and septum did not properly mature and close.
What is Transposition of Great Arteries?
Proximal ends of the aorta and pulmonary arteries hook up to wrong ventricles.
What is Tetralogy of Fallot?
Congenital heart defect involving 4 anatomical abnormalities.
- ) RV hypertrophy
- ) Ventricular Septal Defect (VSD)
- ) Overriding Aorta (connected to both R/L ventricle)
- ) Pulmonary Infundibular Stenosis (narrowing of the right ventricular outflow tract)
List some additional anomalies of TOF. (4)
- Stenosis of left pulmonary artery (40% of patients)
- Coronary artery anomalies (10% of patients)
- Patent foramen ovale or atrial septal defect
- Forked ribs and scoliosis
Congenital Defect Symptoms. (6)
-Which is unique to this patient population?
- ↑ pulse
- ↑ respirations
- Retarded Growth***
- Dyspnea, Orthopnea
- Fatigue
- URI
