Week 6b: Flashcards
the accumulation of fluid in the pericardial cavity
pericardial effusion
slow or rapid compression of the heart due to the accumulation of fluid, pus or blood in the pericardial sac
cardiac tamponade
an acute inflammatory process of the pericardium that can be acute, chronic or constrictive
pericarditis
the result of calcified scar tissue that develops between the visceral and parietal layers of the serous pericardium. Cardiac output and cardiac reserves become fixed
constrictive pericarditis
what is friction rub associated with?
pericarditis
what is beck’s triad and what is it associated with?
- Elevated JVP
- Hypotension
- Decreased heart sounds (with narrowing pulse pressure)
associated with cardiac tamponade
chronic stable angina
associated with a fixed coronary obstruction that produces a disparity between coronary blood flow and metabolic demands of the heart
stable angina
the initial manifestation of ischemic heart disease in approximately half of people with CAD. Mostly starts with exertion or stress. relieved by rest.
unstable angina (acute coronary syndrome)
unexpected chest pain that can occur while resting or is not relived by rest
what are the 3 characteristics of pain with unstable angina?
- occurs at rest and lasts more than 20 minutes
- severe pain described as frank pain with new onset
- pain is more severe, prolonged and or frequent than previously experienced
what are the 3 causes of unstable angina?
- atherosclerotic plaque disruption
- platelet aggregation
- secondary hemostasis
what 3 types of drugs are used to prevent MIs?
- aspirin
- Ticlopidine and clopidogrel (ADP inhibitors)
- platelet receptor antagonists (abciximab)
what is the preferred anti platelet agent for preventing platelet aggregation in persons with CAD?
aspirin
what preventive medications may be used when aspirin is contraindicated?
Ticlopidine and clopidogrel
what are some of the manifestations of a ST-segment elevation MI?
- abrupt onset
- severe crushing pain, usually substernal. radiating to the left arm, neck or jaw
- GI complaints
- fatigue and weakness
- tachycardia, anxiety, restlessness, feeling of impending doom,
- pale, cool and moist skin
what populations present with atypical MI symptoms?
elderly, women, heart failure, diabetes
transmural infarcts
- involve the full thickness of the ventricular wall
- occurs when there is an obstruction of a single artery
Subendocardial infarcts
- involve the inner one third to one half of the ventricular wall
- occur more frequently in the presence of severely narrowed but still patent arterial ductus
What is the treatment for MI?
M: Morphine
O: Oxygen
N: Nitrates
A: Aspirin/Antiplatelets
Persons with evidence of infarction (i.e., cardiac biomarker) should receive immediate reperfusion therapy with a fibrinolytic agent within?
30 minutes
Persons with evidence of infarction (i.e., cardiac biomarker) should receive immediate percutaneous coronary intervention within?
90 minutes
How is pain with MIs managed?
combination of nitrates, analgesics (morphine), oxygen, and beta blockers
myocarditis
inflammation of the heart muscle and conduction system without evidence of myocardial infarction
primary cardiomyopathies
heart muscle diseases of unknown origin
secondary cardiomyopathies
conditions in which the cardiac abnormality results from another cardiovascular disease such as MI
a heterogenous group of diseases of the myocardium associated with mechanical and/or electrical dysfunction that usually exhibit inappropriate ventricular hypertrophy or dilation and that are due to a variety of causes that are frequently genetic
cardiomyopathies
which type of cardiomyopathy involves disproportionate thickening of the ventricular septum and intermittent left ventricular flow obstruction?
hypertrophic cardiomyopathy
what medications are used for hypertrophic cardiomyopathy?
beta adrenergic blockers to prevent outflow obstruction
what are the symptoms of hypertrophic cardiomyopathies?
dyspnea, chest pain during exertion, exercise intolerance, syncope and palpitations. Can also be asymptomatic
colonization of heart valves and the mural endocardium by a microbial agent
infective endocarditis
what type of infections cause infective endocarditis?
staphylococcal and streptococcal infections
What are the signs and symptoms of infective endocarditis?
fever, signs of systemic infection, anemia, a change in the character of an existing heart murmur and evidence of embolic distribution of the vegetative lesions
a complication of the immune mediated response to group A hemolytic streptococcal throat infection
rheumatic fever
acute stage of rheumatic fever
- history of an initiating strep infection
- involves mesenchymal connective tissue of the heart, blood vessel, joints and subcutaneous tissues
recurrent phase of rheumatic fever
extension of the cardiac effects of the disease
chronic phase of rheumatic fever
permanent deformity of heart valves
radiographic signs for PE are?
not a specific or a sensitive test for PE
stenosis
narrowing of the valve opening so it does not open properly
incompetent or regurgitant valve
distortion of the valve so it does not close properly. permits backward flow to occur when the valve should be closed.
what occurs as mitral valve stenosis progresses?
symptoms of decreased cardiac output which occur during extreme exertion
what happens in the late stages of mitral valve stenosis
pulmonary hypertension
mitral valve stenosis may eventually lead to?
right sided heart failure
mitral valve regurgitation can occur…?
After MI, valve perforation in IE, or ruptured chord tendinae in mitral valve prolapse
mitral valve regurgitation leads to?
a rapid rise in left atrial pressure and pulmonary edema
what happens to the left ventricular wall in aortic valve stenosis?
the left ventricular wall becomes thicker (hypertrophy) but a normal chamber volume is maintained
incompetent aortic valve that allows blood to flow back to the left ventricle during diastole
aortic valve regurgitation
what can result due to aortic valve regurgitation?
pulmonary edema
congenital defects that increase resistance to aortic outflow increase?
left to right shunting
congenital defects that obstruct pulmonary outflow increase?
right to left shunting
an opening in the atrial septum permitting free communication of blood in the atria.
atrial septal defect
patent ductus arteriosus
persistence of the normal fetal vessel that joins the pulmonary artery to the aorta
what happens as a result of higher aortic pressure and PDA?
blood shunts left to right through the ductus from the aorta to the pulmonary artery
PDA leads to increased ______ _____ disease
pulmonary vascular disease
a narrowing of the aorta at varying points anywhere from the transverse arch to iliac bifurcation
coarctation
what are the 4 characteristics of the tetralogy of fallot?
1) ventricular septal defect
2) right ventricular outflow tract obstruction
3) overriding aorta
4) right ventricular hypertrophy
