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Pathophysiology Year 2 > Week 5- Cardiac > Flashcards

Week 5- Cardiac Flashcards

1
Q

Name layers of the heart from the outside

A

Pericardium (fibrous)
Myocardium (cardiac muscle)
Epicardium

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2
Q

What sign shows pathological issues of the heart

A

Altered cardiac output

Leaks in system (plumbing)
Obstruction to flow
Valve problems
Electrical conduction

Most cardiovascular;ar form a complex interplay of genetics and environment

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3
Q

What is congenital heart disease

A

Structural or functional abnormalities sin the heart that are present at birth

Results in shunting of blood between right and left circulation or cause outflow of blood

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4
Q

Name classifications. of heart failure

A

Acute cardiac failure= heart attack

Chronic or congestive heart failure = mechanisms trying to maintain CO

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5
Q

What is the difference between systole failure and diastole failure

A

S= CONTRACTION
D= RELAXATION

S=Ventricles loose ability to contract
normally
D=Ventricles loose ability to relax

S= Myocardium; thin, dilated, compliant
D=myocardium, fibrotic, stuff, thickened and non compliant

S= Stasis of blood behind weakened
ventricle
D=can progress to systolic failure

• Examples:
Myocardial infarction
Dilated cardiomyopathy
M & T valve regurgitation, arrythmia

D= myocardial infarction
Aortic stenosis
Constricted pericarditis

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6
Q

Signs of left sided heart failure

A

Tired
Cynotic (bluish colour)
High hr
Body not getting enough o2
Pulmonary odema- shallow breath

Increased breathing rate, normal range is 12-20 breaths pm

Night sweats
Confusion
In exercise rapid hr
Dizziness when stand up

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7
Q

What is left sided heart failure caused by

A

Ischiameic heart disease
Aortic and mitral valve disease

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8
Q

List clinical effects of left SIded heart failure

A

Statins in left chambers
Passive congestion
Blood backing upo in pulmonary circulation
Inadequate perfusion to downstream tissues leading to organ dysfunction

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9
Q

What is right sided heart failure caused by

A

Left sided heart failure

Occurs in patients with lung disorders

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10
Q

Clinical effects of right sided hf

A

Kidney and brain affected

Systemic venous congestion can lead to odema

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11
Q

Signs of right sided heart failure

A

Fatigue
Odema in ankles and spleen
Struggle to breath due to deoxygenated blood and co2 not unloading

Weight gain
Anorexia and GI distress
Distended jugular veins
Ascites
Enlarged liver and spleen
Peripheral venous pressure incraesed

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12
Q

What is ischaemica heart disease/ coronary artery disease

A

Imbalance between myocardial supply and cardiac demand for oxygenated blood

If coronary arteries are blocked local ischaemia is where heart muscle isn’t getting enough o2. Leads to that part of heart mot contracting

Years later fibrotic and wont contract. Restricted HB

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13
Q

Name four clinical presentations of ischameic heart disease

A

Angina pectoris

Myocardial infarction

Chronic IHD

Sudden cardiac death

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14
Q

Name four clinical presentations of ischameic heart disease

A

Angina pectoris

Myocardial infarction

Chronic IHD

Sudden cardiac death

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15
Q

List angina pectoris

A
  1. Stable= induced by activities that increase requirement , pain
  2. Prinzmental is uncommon caused by a coronary artery spasm not related to energy
  3. Unstable= increasingly frequent and prolonged over 20min low levels of exercise. Prelude to heart attack

Nitroglycerin is a vasodilator med

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16
Q

What is a myocardial infarction

A

Heart attack
Prolonged ischameic causes death of cardiac muscle
Increases with age and sex (more common in males)

17
Q

Aetiology of myocardial infarction

A

Increased myocardial metabolic demand

Physical exertion

Severe hypertension

Severe aortic stenosis

High BP

Decreased delivery of o2 and nutrients to the myocardium via the coronary circulation

Atherosclerosis or dynamic coronary artery sclerosis

18
Q

Clinical presentation of myocardial infarction

A

Sudden chest pain
Radiation of pain in to left jaw, teeth, shoulder, arm and back
Sweating
Impairment of cognitive function
Unusual tired

19
Q

What is chronic ischameic heart disease

A

Caused by accumulated ischameic myocardial damage or inadequate response due to long standing atherosclerotis obstruction

Thick, fibrosis
Grow new muscular wall

20
Q

What is sudden cardiac death

A

Unexpected death from cardiac causes either without symptoms of within 1 to 24 hours of symptom onset

Too much demand on eart
Coronary artery disease is the leading cause

21
Q

What is arrhythmias

A

Deviations from normal heart beat pattern

Abnormalities in origin, rate, rhythm, conduct, velocity and seuqnce of atrial and ventricular activation

Sustained or sporadic

Any flutter- get it checked

22
Q

Pathogenesis of arrythmiasd

A

Pathological heart disease

Electrolyte disturbance or acid- base imbalances

Physical and chemical factors or toxicosis (alcoholism and drugs)

Systemic disease

Heritable conditions like congenital abnormalities, hyoertiohc and cardiomyopathy

23
Q

What does systemic mean

A

Systemic= affects all part of the body

24
Q

What is hypertensive heart disease

A

Increase demands placed on heart by hp=hypertension causing pressure overload and ventricular hyoertiphy

No1 cause of death associated with high bp

25
Q

What is pulmonary (r-sided) hypertrophic heart disease

A

Right ventricular pressure overload

Hypertrophy, dilation, r-sided failure

Caused by disordered of the lungs

Decreased benticlar space
Increased cardiac muscle

26
Q

Why do we look on the palm of the hands

A

Xanthomas - hypercholesterolaemia. Deposits of cholesterol

Olsers nodes- lesions of the fingers

Tanning staining- smoking

27
Q

What is schemroth window test

A

Get the patient to form a heart with index. If there’s a little diamond there is a negative sign

Positive sign= no diamond. Digital clubbing

CV. Disease

28
Q

In a heart exam what do we observe

A

Shortness of breath, cyanosis (blue), pallor (colour, pink in knuckles and palm), odema

29
Q

Why do we look palm down

A

Peripheral cyanosis (congenital heart disease or heart failure)

Splinter haemorrhages in nail (visualities or infective endocarditis)

30
Q

What is a collapsing pulse

A

Radial pulse and lift arm in air. Forecdul and knocking sensation indicated aortic valve regurgitation

31
Q

When we do heart exam, why do we check their eyes

A

Eyes= xanthelasma yellow bump on or near eyelid. Cholesterol deposit

Cornea arcus(white ring around eye) high cholesterol

Conjunctival pallor
White under eye sign of anaemia

32
Q

In heart exam why do we inspect the mouth

A

Bad dental hygein

High arched palate

Angular stomatosis (inflamed around the mouth, sores)

Central cyanosis (bluish colour)

33
Q

Why would we check chest wall in heart exam

A

Chest wall deformities

Scars for pacemaker, sternotomy

34
Q

How to stethoscope

A

2nd rib on right- aortic
2nd rib on left - pulomarfy

Max area- central between 3rf and 4th rib

Tricuspid- 4th

Mitral-between 5th and 6th left

35
Q

List vital signs

A

Blood pressure 120/80

Oxygen saturation

Heart rate and rhythm 60-100bpm
Over= tachycardia
Under=bradycardia

Temperature 37c 37.7c

36
Q

List vital signs

A

Blood pressure 120/80

Oxygen saturation

Heart rate and rhythm 60-100bpm
Over= tachycardia
Under=bradycardia

Temperature 37c 37.7c

37
Q

Tachycardia vs bradychardia

A

T= 100+
Fever
Anxiety
Dehydration
Infection
Arrythmiuas
Medication
Endmia

Symptoms= dizziness, chest pain, fainting, palpitations

B= <60
Aging
Heart disease
Hypothyroidism
Electrolyte imbalances
Medications
Hypothermia

Symptoms= fatigue
Dizziness
Fainting
Shortness of breath
Chest pain
Confusion

38
Q

What is Virchow Triad

A

3 primary factors which contribute to formation of thrombus (blood clot) in veins and arteries,

  1. Stasis of blood flow
    -blood flow which is slow or stagnant is a risk factor. It allows platelets and clotting factors to accumulate.
    -immobility, heart failure and varicose veins can affects this.
  2. Endothelial injury
    -damage to endothelial from trauma, surgery or inflammation can trigger the clotting process
    -atherosclerosis (plaque build up) high bop can affect this.
  3. Hypercoagubility
    -heightened tendency of blood clot. Hormones, medications, inflammation and dehydration can affect this.
39
Q

In a heart exam, what should heart beat sound like

A

A clear, rhymic noise
Lub dub

If there was fluid this heart beat will not be clear

Pathophysiology Year 2 (16 decks)

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