Alterations in Cardiac Function

Question 1

5 areas for listening to the heart

Answer 1

all people enjoy time magazine
-aortic
-pulmonic
-erb’s point
-tricuspid
-mitral

Question 2

blood flow through cardiac valves

Answer 2

tight pussy my ass
-tricuspid>pulmonary>mitral>aortic

Question 3

cardiac ischemia

Answer 3

when the hearts need for O2 blood exceeds its supply
-usually from impaired flow in the coronary arteries
-can be caused by coronary vasospasm, hypoxemia, low perfusion from low volume or shock

Question 4

coronary artery disease (CAD)

Answer 4

main cause: atherosclerosis of the coronary arteries>symptoms happen when plaques burst/with thrombi/emboli
rare causes: abnormal blood O2, low pressure of the coronary arteries, ischemic heart disease
risk factors: same as atherosclerosis

Question 5

coronary circulation

Answer 5

coronary arteries supply blood to the heart-if blocked, poor circulation of blood throughout the heart

Question 6

angina pectoris

Answer 6

chest pain-either stable angina or vasospastic angina

Question 7

chronic ischemic cardiomyopathy

Answer 7

heart failure resulting from ischemia to the heart

Question 8

acute coronary syndrome

Answer 8

unstable angina and myocardial infarction (MI, heart attack)

Question 9

cardiac arrest

Answer 9

usually from lethal dysrhythmias-sudden death from cardiac causes within an hour of symptoms

Question 10

chronic/stable angina

Answer 10

chest pain from physical activity that is relieved by rest
-NO permanent heart damage
-happens with CAD

Question 11

vasospastic angina

Answer 11

unpredictable chest pain from an artery closing

Question 12

unstable angina

Answer 12

from a plaque rupture that results in a partially obstructed coronary artery with some necrosis
-NOT AN MI
-not enough dead cells to show up on blood work, minor damage
-pain is not relieved with rest

Question 13

myocardial infarction (heart attack)

Answer 13

reduced or stopped blood flow that causes cardiac ischemia, injury, or necrosis
-symptoms: severe/unrelieved chest pain, nausea and vomiting, diaphoresis, shortness of breath, inflammation
-diagnostics: EKG monitoring, serum biomarkers

Question 14

serum biomarkers of MI

Answer 14

look for troponin and then myoglobin elevations after MI
-myoglobin is an early marker but returns to normal within a day
-troponin is the most sensitive and specific-can be elevated for weeks

Question 15

myocardial infarction symptoms

Answer 15

angina, uneasy feeling, fatigue, nausea, vomiting, shortness of breath, cool limbs, diaphoresis, anxiety, tachycardia

Question 16

nursing interventions after MI

Answer 16

goal: decrease heart O2 demand, increase O2 delivery
-morphine, O2, nitroglycerine, aspirin
-fibrinolytic therapy, CABG stop further damage
-grafts-remove clot/blockage

Question 17

heart complications from MI

Answer 17

arrhythmias, shock, heart failure, extensions of the original infarction, ruptured vessel walls, aneurysm, low contractibility from scarring

Question 18

lung complications from MI

Answer 18

pulmonary edema from fluid build-up, pulmonary emboli from damage

Question 19

brain complications from MI

Answer 19

cerebral emboli, brain disorder from tissue hypoxia>physiological and personality problems

Question 20

heart valve function

Answer 20

direct blood flow through the chambers of the heart

Question 21

heart valve dysfunction manifestations

Answer 21

congenital defects, trauma, ischemic damage, degenerative changes, inflammation

Question 22

valve stenosis

Answer 22

thickening of the valve that makes it harder to open/close
-extra work for the heart

Question 23

incompetent valves

Answer 23

causes backwards flow of blood when the valve should be closed
-extra work for the heart

Question 24

aortic stenosis

Answer 24

obstruction to the blood the left ventricle pumps out
-high pressure between left ventricle and aorta
-heart murmurs during systole are radiated to the neck
-causes hypertrophy and failure of LV from increased work

Question 25

aortic regurgitation

Answer 25

high systolic, low diastolic BP and bounding pulse
-murmur during diastole from blood leakage during relaxation
-causes LV failure from increased work

Question 26

mitral senosis

Answer 26

high pressure between atrium and left ventricle during diastole
-low pitched rumbling during diastole
-causes pulmonary hypertension, RV hypertrophy, right sided heart failure

Question 27

mitral regurgitation

Answer 27

back-flow of blood from the LV to LA during systole
-causes left sided heart failure
-loud, high murmur from systole that radiates to the left axilla

Question 28

rheumatic heart disease

Answer 28

rare-a consequence of rheumatic fever from an autoimmune attack

Question 29

infective endocarditis

Answer 29

invasion of endocardium by microorganisms that causes inflammation

Question 30

cardiac vegetations

Answer 30

growth of microorganisms in fibrin deposits