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S7- Cardiopulmonary > Week 2- Other Cardiac Pathologies > Flashcards

Week 2- Other Cardiac Pathologies Flashcards

1
Q

PART 1

A

PART 1

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2
Q

List of Other Cardiac Pathologies.

A
  • Valvular Disease (regurgitation, stenosis)
  • Arrhythmias (a.fib and v.fib)
  • Myocarditis
  • Pericarditis
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3
Q

What are (2) types of valvular disease? Describe each.

A

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.

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4
Q
  • Aortic regurgitation leads to increased LV _______/______.
  • This then leads to LV dysfunction and myocardial _______.
  • Ultimately leads to what?
A
  • volume/mass
  • ischemia
  • LV FAILURE
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5
Q

What are Arrhythmias/Dysrhythmias?

A

Disturbances of rate and/or rhythm of the heart.

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6
Q

Describe the PQRST complex.

A
  • P wave = atrial depolarization (contraction)
  • QRS complex = ventricular depolarization
  • T wave = ventricular repolarization
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7
Q
  • Bracycardia = ___ BPM

- Tachycardia = ____ BPM

A
  • Bracycardia = <50 BPM

- Tachycardia = >100 BPM

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8
Q

Is atrial or ventricular fibrillation more serious? Why?

A

-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.

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9
Q

What is a treatment method for A.fib?

A

A.fib ablation

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10
Q

Why are patients with A.fib often on blood thinners?

A
  • 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.
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11
Q

What area is likely to cause clot formation in right atrium?

A

Right Auricle

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12
Q

Can we live without the atria? How?

A

-Yes, because most ventricular filling occurs during atrial diastole. Atrial systole acts to “top off” ventricles.

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13
Q

What is Myocarditis?

A

Inflammation of the myocardium.

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14
Q

Myocarditis is usually cause by _____ infection and can lead to HF, Dilated Cardiomyopathy, Arrhythmias, and Sudden Death.

A

viral infection

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15
Q

What (4) things can lead to Diabetic Heart Disease?

A
  1. ) Metabolic effects due to FFA, insulin resistance.
  2. ) Structural: myocardial fibrosis and ECM changes.
  3. ) Reduced perfusion due to small vessel disease.
  4. ) Autonomic dysfunction reduced HRR.
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16
Q

What is Pericarditis?

A

Swelling and irritation of thin saclike membrane surrounding the heart.

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17
Q

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 = “___________”
A
  • viral infection or MI
  • idiopathic
  • autoimmune disease (RA, SLE, radiation therapy)
  • “pericardial rub”
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18
Q
  • How is pleuritic chest pain worsened?

- How is it decreased?

A
  • Worsened lying in supine, inhaling deeply, or cough.

- Decreased by leaning forward.

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19
Q
  • What is Constrictive Pericarditis?

- What does it result in?

A
  • 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.
20
Q
  • What is Pericardial Effusion?

- What does it result in?

A
  • Pericardial Effusion is fluid accumulation within the pericardial sac.
  • Results in compression of the heart, reduces ventricular diastolic filling, and hence CO.
21
Q

PART 2

A

PART 2

22
Q

What are some other cardiac pathologies?

A

-Aneurysm

23
Q

What is an aneurysm?

A

Abnormal stretching in the wall of an artery, vein, or the heart with a diameter that is at least 50% greater than normal.

24
Q

What are the 3 types of true Aneurysms?

A

-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

25
Q

What is a false Aneurysm?

A

The wall ruptures, and a blood clot is retained in an outpouching of tissue.

26
Q

What is the most common Aneurysm?

A

Abdominal Aortic Aneurysm

27
Q
  • What is a way to treat aneurysms?

- What is the problem with these?

A
  • Endovascular Stent Graft

- Aren’t able to expand and contract, therefore cannot assist with cardiac function.

28
Q

The heart is one of the first organs to become functional in the fetus. It becomes functional within __-__ weeks of fertilization.

A

-8-10 weeks

29
Q

Describe the formation of the heart.

A
  • 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.
30
Q
  • In fetal circulation, anatomical structures function to circumvent __________ circulation.
  • In fetal circulation, which side is predominant and why?
A
  • pulmonary
  • Left side is predominant because lungs are not formed until 3rd trimester and systemic circulation is of more importance.
31
Q

Describe these structures function in fetal circulation:

  • Foramen Ovale
  • Ductus Arteriosus
  • Ductus Venosus
A
  • Foramen Ovale: Allows a R → L atrial shunt
  • Ductus Arteriosus: Pulmonary Artery → Aorta shunt
  • Ductus Venosus: Umbilical cord → IVC to bypass the liver
32
Q
  • 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?
A
  • Ductus Venosus
  • Foramen Ovale
  • Ductus Arteriosus
33
Q

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.

A
  • RA → LA
  • Yes, closes at birth.
  • exceeds
34
Q

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?
A
  • pulmonary artery to the aorta
  • pulmonary circulation
  • 15 hours, 2-3 weeks
  • ligamentum arteriosum
35
Q

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?
A
  • umbilical cord to the IVC
  • liver
  • Yes, closes within 3-7 days of birth
  • ligamentum venosum
36
Q

Defects Associated - Patent Foramen Ovale:

  • Most need no _________.
  • Provide a passage way for __________ movement-anticlotting medication.
  • Open heart surgery.
A
  • intervention

- thrombus

37
Q

Defects Associated - Patent Ductus Arteriosus:

  • Occluded by a plug inserted via a catheter.
  • Closed off by physically tying it off.
  • Approach is via a __________.
A

-thoracotomy

38
Q

Defects Associated - Patent Ductus Venosus:

-Is treated with medicines, _________-based procedures, and surgery

A

-catheter-based

39
Q

What is the most typical symptom of patency of the three fetal circulation vessels?

A

Failure to thrive.

40
Q

Ventricular Septal Defect:

  • What is a Ventricular Septal Defect (SD)?
  • Symptoms are dependent on what?
  • What are 2 effects of Ventricular SD?
A
  • 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
41
Q

What is Hypoplastic Left Heart Syndrome (HLHS)?

A

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.

42
Q

What is Transposition of Great Arteries?

A

Proximal ends of the aorta and pulmonary arteries hook up to wrong ventricles.

43
Q

What is Tetralogy of Fallot?

A

Congenital heart defect involving 4 anatomical abnormalities.

  1. ) RV hypertrophy
  2. ) Ventricular Septal Defect (VSD)
  3. ) Overriding Aorta (connected to both R/L ventricle)
  4. ) Pulmonary Infundibular Stenosis (narrowing of the right ventricular outflow tract)
44
Q

List some additional anomalies of TOF. (4)

A
  • 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
45
Q

Congenital Defect Symptoms. (6)

-Which is unique to this patient population?

A
  • ↑ pulse
  • ↑ respirations
  • Retarded Growth***
  • Dyspnea, Orthopnea
  • Fatigue
  • URI

S7- Cardiopulmonary (24 decks)

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