Flashcards in 9 11 Clinical Coorilations-Table 1 Deck (22):
what biomechanical process can lead to heart valve calcification?
Turbulent flow through the valve (bicuspid aortic valve)
how can a stenosed valve lead to hypertrophy
the heart has to work harder to get the blood through the vavle, muscle working harder will grow larger therefore hypertrophy
why does hypertrophy lead to heart failure
a hypertrophy of the heart or a dialation and hypertrophy of the heart will lead to a lower ejection fraction, that is it will be a lower efficiency!
what are some known etiologies of heart failure?
valve problems; infection; ischemic damage; idiopathic; arrhythmias (atrial fibrillation)
what are the symptoms of heart failure
lower extremity edema; shortness of breath (worse with exertion, lying flat); Distended neck viens
why do they get edema in the lower extremities
back up of blood in the venus systm and therefore higher hydrostatic pressure that will push fluid out in the cappilaries.
how do you get rid of the edema in the lower extremities
compression socks, or elevating the legs
why is the neck vessels distened
becuase of a back up of venous blood, and when you get the atrial kick and the closing of the tricuspid valve, you will see the right jugular vein pump noticably.
what is systolic dysfunction
the enlarged ventricles can't squeeze the blood out very well, and the ejection fraction goes down
what is diastolic dysfunction?
the ventricle can't fill as much (the ejection fraction can be normal though since this is a measure of the fraction of blood that comes in that goes out). but it is not enough blood.
what is a normal ejection fraction
around 50% or so
how does ischemic damage lead to heart failure?
by causing damage and death of cells, that leads to a lower efficiency of pumping.
what hints at a histology section that is dead heart cells?
no nucleus in the cells and the presence of extra immune cells.
how does ischemic damage occure
by blockage or just narrowing of the coronary arteries
infarct Vs. Ischemia
Infarct is dead tissue and a whole area is visibly dead; Ischemic is a lower level of damage where the cells just aren't getting enough oxygen, and this can lead to infarct.
how can rheumatic fever lead to higher pulmonary artery pressure
by cuasing stenosis of valves, such as the Left AV that would lead to a back flow of blood into the lungs and to the pulmonary artery
how does rheumatic heart disease lead to problems
strep throat happens, and then repeated inflammation and fibrinous repair, leaflet thickening and shortening and thickening of chrodae teninae (other valves can too)
what is a fish mouth valve?
The characteristic appearence of mitral valve that is stenosed by rhumatic heart disease. It is curved and a little gaping at the mouth edges.
what happans to the heart in rhumatic heart disease?
Thickened mitral valve, thickened chordae tendineae, left ventricular hypertrophy
how could you describe the sounds of a heart that you are listening to.
Rythm, Rate, Number of sounds, the character of the sounds, murmers, extra sounds,
what is irregularly irregular when describing the heart.
irregular rate of an irregular rythmn