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Clin Med III - Exam 1 > 2A: Cardiac Pathologies II > Flashcards

2A: Cardiac Pathologies II Flashcards

(52 cards)

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1
Q

What is the goal for treating CAD?

A

Halt progression and possible improvement with risk factor modification

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2
Q

What is the definition of an MI?

A

Ischemic event that may result in injury or irreversible tissue death at the myocardium

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3
Q

What are the three signs and symptoms of an MI?

A
  1. ECG changes
  2. Cardiac symptoms
  3. Elevation of cardiac enzymes
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4
Q

What are possible ECG changes with an MI?

A
  1. S-T segment elevation
  2. Inverted T wave
  3. Significant Q wave
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5
Q

How is an MI ruled in or out?

A

Must have 2/3 key symptoms

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6
Q

What are the three zones of infarct of MI?

A
  1. Zone of ischemia
  2. Zone of injury
  3. Zone of infarct
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7
Q

What is the zone of ischemia?

A

Tissue is viable and may not have any damage if infarct doesn’t extend

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8
Q

What is the zone of injury?

A

Viable as long as O2 delivery stays intact. Increasing O2 delivery can save the tissue

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9
Q

What is the zone of infarct?

A

Tissue is O2 deprived and has irreversible damage

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10
Q

What zones can intervention have an effect on?

A

Zone of ischemia and injury

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11
Q

What are the three main cardiac enzymes of interest with an MI?

A
  1. CPK-MB
  2. Troponin
  3. LDH-1
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12
Q

When will CPK-MB increase?

A

0-24 hrs after MI

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13
Q

Why is CPK-MB a marker for MI?

A

Because MB is an isoenzyme that is specific to cardiac tissue

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14
Q

When will troponin increase after an MI?

A

12 hrs - 4 days after

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15
Q

How does LDH-1 indicate MI?

A

Look at the ratio of LDH-1 to LDH-2. If it is greater than 1, suggests MI

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16
Q

What are the two main classifications of MI?

A

Transmural and Subendocardial

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17
Q

What is a transmural MI?

A

Goes into the wall of the myocardium, will see the most wall motion deficits

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18
Q

What is a hypokinetic transmural MI?

A

Decreased wall motion

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19
Q

What is a dyskinetic transmural MI?

A

Unorganized wall motion

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20
Q

What is an akinetic transmural MI?

A

No wall motion

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21
Q

What is a subendocardial MI?

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A

Partial thickness infarct

22
Q

How does a subendocardial MI present?

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A

Wall motion may be normal and less EKG changes compared to transmural

23
Q

What is the definition of cardiomyopathy?

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A

Disease where contraction and relaxation of the cardiac muscles are impaired

24
Q

What are possible causes of cardiomyopathy?

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A

Collagen disorder, autoimmune, viral, idiopathic, neurotransmission

25
What are the three types of cardiomyopathy?
1. Dilated cardiomyopathy 2. Hypertrophy 3. Restrictive
26
What is dilated cardiomyopathy?
Heart wall is floppy, similar to an aneurism
27
What does all cardiomyopathy lead to?
Decreased ejection fraction
28
What is hypertrophy cardiomyopathy?
Hypercontractile left ventricle
29
What does hypertrophy cardiomyopathy lead to?
Increased myocardial O2 demand, rapid ventricular emptying, decrease EF
30
What is restrictive cardiomyopathy?
Endocardial scarring that restricts the heart wall distention
31
What are the causes of right sided CHF?
Pulmonary HTN, right ventricular infarct
32
What are initial signs of right CHF?
Systemic edema with fluid accumulation in the abdomen, liver, and legs
33
What is the primary sign of right CHF, and what should you observe for?
LE edema - look for weight gain and jugular vein distension
34
What are causes of left CHF?
Resistance from systemic HTN, MV/LV dysfunction secondary to cardiomyopathy or infarct
35
How does left sided CHF initially present?
Pulmonary edema
36
What is the primary symptom of left CHF?
Dyspnea
37
What are three additional symptoms of left CHF?
1. Tachypnea 2. Mouth or lung crackles 3. Orthopnea
38
How does CHF progress?
To both sides of the heart
39
What are signs that may indicate right or left sides CHF?
S3 heart sound, tachycardia, decreased activity tolerance, weight gain, pulmonary edema
40
Describe NYHA I
No limitation to physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, or shortness of breath
41
Describe NYHA II
Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, shortness of breath, or chest pain
42
Describe NYHA III
Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, shortness of breath, or chest pain
43
Describe NYHA IV
Symptoms of heart failure at rest. Any physical activity causes further discomfort
44
What is the result of CHF?
Low cardiac output (CO)
45
How does the cardiopulmonary system respond to low cardiac output?
As if it is a low blood volume problem
46
In what four ways does the body respond to low cardiac output?
1. Retain fluid 2. Vasoconstriction 3. Increase stroke force 4. Increase HR
47
Why is medical intervention necessary for CHF?
Control stroke force and reduce vascular pressure and excess fluid to decrease workload on the heart
48
What is a concern with left sided CHF and why?
Hypertrophy of the left ventricular wall - has the largest muscle mass with high O2 consumption making it vulnerable to ischemic attack
49
What happens to skeletal muscle and muscle fibers with CHF?
Skeletal muscle atrophy and decreased type I fibers leading to decreased endurance
50
Why do muscles have a decreased ability to work with CHF?
Decreased skeletal muscle blood flow
51
How does CHF impair skeletal muscle metabolism?
Decreased ability to break down O2 for use
52
What is pulmonary edema?
Fluid leaks from pulmonary and lymphatic systems interstitially and get into alveoli creating a barrier making gas exchange between capillaries and alveoli difficult

Clin Med III - Exam 1 (21 decks)

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