Flashcards in Advance pathpharm week 6 REVISED Deck (73):
This disease results in inflammation of the pericardium; causes include idiopathic origin, infection, radiation, uremia, and fibrous lesions:
Infective Endocarditis is:
infection of the endocardium; central venous catheterization, valve surgery, IV drug use
This is a disease in which permanent heart damage that leads to scarring and deformities of cardiac structures occurs as a result of rheumatic fever; RF is caused by delayed immune response to infection by group A beta-hemolytic streptococci
Rheumatic Heart Disease
What is Valvular Stenosis?
narrowed valve orifice that impedes bloodflow; d/t inflammation, congenital defect, or degeneration thickening and calcification
__________________ occurs when valve leaflets fail to close completely allowing leaking and backflow of blood; caused by rheumatic fever, endocarditis, syphilis, hypertension, connective tissue disorders (e.g., Marfan syndrome). and atherosclerosis
What is Mitral Valve Prolapse?
displacement of an abnormally thickened mitral valve leaflet into the left atrium during systole; causes include genetics and physical damage.
_____________ happens when all four chambers are dilated; causes include MI, CAD, valvular disease, diabetes, drugs (cocaine, amphetamines, doxorubicin, daunorubicin)
______________ refers to thickening of the myocardium; cause is usually unknown, can be attributed to genetics and prolonged HTN
What is Restrictive Cardiomyopathy and what causes it?
myocardium is infiltrated with substances (deposits of protein, iron, cells); causes include cardiac amyloidosis, hemochromatosis, and sarcoidosis.
Define Atrial septal defect:
opening in the dividing wall between the right and left atria.
An______________allows oxygen-rich (red) blood to pass from the left atrium, through the opening in the septum, and then mix with oxygen-poor (blue) blood in the right atrium.
atrial septal defect
T or F: Atrial septal defects are usually easy to dectect because the patient will be very symptomatic.
FALSE. Atrial septal defects are usually asymptomatic.
Fatigue, poor growth, and tachypnea are all symptoms of:
atrial septal defects
Is an artial septal defect cyanotic or acyanotic?
acyanotic-oxygenated blood mixes with deoxygenated blood and is sent to the lungs to be oxygenated again-will not cause cyanosis in the body because the body is still getting oxygen
Define Ventricular Septal Defect:
opening in the wall dividing the right and left ventricles.
A _______________allows oxygen-rich (red) blood to pass from the left ventricle, through the opening in the septum, and then mix with oxygen-poor (blue) blood in the right ventricle.
ventricular septal defect
If not treated, this heart defect can cause lung disease:
ventricular septal defect
How does a ventricular septal defect cause lung disease?
When blood passes through the VSD from the left ventricle to the right ventricle, a larger volume of blood than normal must be handled by the right side of the heart. Extra blood then passes through the pulmonary artery into the lungs, causing higher pressure than normal in the blood vessels in the lungs. The lungs are able to cope with this extra pressure for while, depending on exactly how high the pressure is. After a while, however, the blood vessels in the lungs become diseased by the extra pressure.
Is a ventricular septal defect cyanotic or acyanotic?
Acyanotic because the body is receiving oxygenated blood, just an abnormal volume of oxygenated blood.
A bluish tint to the skin, lips and fingernails, Swelling (edema) in your legs, ankles and feet, and Tires easily when eating or playing are all symptoms of:
ventricular septal defect
T or F: The ductus arteriosus is a normal fetal structure, allowing blood to bypass circulation to the lungs.
How does a Patent Ductus Arteriosus occur?
The high levels of oxygen which a baby is exposed to after birth causes the ductus arteriosus to close in most cases within 24 hours. When it doesn’t close, it is termed a Patent Ductus Arteriosus.
How does a Patent Ductus Arteriosus affect hemodynamics?
A patent ductus arteriosis creates an opening between the aorta and pulmonary arteries-oxygenated blood from the aorta is pushed back into the pulmonary arteries to go to the lungs. This creates an abnormal blood volume in the lungs, L artium, and L ventricle.
Is a patent ductus arteriosis cyanotic or acyanotic?
Acyanotic since the body is still receiving oxygenated blood from the L ventricle
T or F: A small PDA may cause no signs or symptoms, and may go undetected for some time, even until adulthood.
Sweating with crying or eating, Persistent fast breathing or breathlessness, Easy tiring, Rapid heart rate, A bluish or dusky skin tone are all symptoms of:
Patent ductus arteriosis
Define Transposition of the Great Vessel:
the aorta is connected to the right ventricle, and the pulmonary artery is connected to the left ventricle - the exact opposite of a normal heart's anatomy.
Describe the route of blood flow when transposition of the great vessel has occurred:
Oxygen-poor (blue) blood returns to the right atrium from the body, passes through the right atrium and ventricle, then goes into the misconnected aorta back to the body. Oxygen-rich (red) blood returns to the left atrium from the lungs, passes through the left atrium and ventricle, then goes into the pulmonary artery and back to the lungs. Two separate circuits are formed - one that circulates oxygen-poor (blue) blood from the body back to the body, and another that recirculates oxygen-rich (red) blood from the lungs back to the lungs.
T or F: Transposition of the great vessel is compatible with life.
FALSE. Surgery must be done to correct the issue.
Is transposition of the great vessel cyanotic or acyanotic?
Cyanotic since the body is receiving deoxygenated blood.
Cyanosis is the most common symptom of this heart abnormality, along with tachypnea, tachycardia, and cool, clammy skin (d/t poor perfusion).
transposition of the great vessel
_______________ refers to problems with valve development which prevent the leaflets from opening; therefore, blood cannot flow forward from the right ventricle to the lungs.
Is Pulmonary Stenosis/Atresia cyanotic or acyanotic?
The obvious indication of __________ is a newborn who becomes cyanotic (blue) in the transitional first day of life when the maternal source of oxygen (from the placenta) is removed. The degree of cyanosis is related to the presence of other defects that allow blood to mix, including a patent (open) ductus arteriosus.
Define Coarctation of the Aorta:
narrowing of the aorta
Is coarctation of the Aorta cyanotic or acyanotic?
Acyanotic-the body is still receiving oxygenated blood, just less of it.
Coarctation of the aorta causes:
narrowing restricts the amount of oxygen-rich (red) blood that can travel to the lower part of the body
Coarctation of the Aorta will cause an (increase/decrease) in (preload/afterload). Why?
increase, afterload. Because the left ventricle has to work harder to try to move blood through the narrowing in the aorta
Coarctation of the aorta causes the L ventricle from emptying normally, so L atrium can’t empty normally, which creates:
pulmonary edema and congestive heart failure
T or F: In Pulmonary stenosis the walls of the ascending aorta, the aortic arch, or any of the arteries in the head and arms may become weakened or tear by high pressure which can cause a stroke or uncontrollable bleeding.
FALSE. This occurs when a person has coarctation of the aorta
_________ is a combination of four heart defects.
Tetralogy of Fallot
Tetrology of Fallot encompasses which 4 defects and which optional defect?
i. A large ventricular septal defect (VSD)
ii. Pulmonary stenosis
iii. Right ventricular hypertrophy
iv. An overriding aorta
v. Atrial Septal Defect (ASD): optional
What effect does tetrology of fallot have on hemodynamics?
In combination the defects cause an enlarged Right atrium and ventricle, and at first blood will flow from L atrium into R atrium. Eventually the pressure from the build-up of muscle on the R side will cause de-oxygenated blood to enter the L atrium and ventricle, thus pumping de-oxygenated blood to the body
Is tetrology of fallot cyanotic or acyanotic?
At first it is acyanotic, but when the R side of the heart's muscles enlarge and the pressure gradient changes it will become cyanotic. *It is generally considered a CYANOTIC condition*
Shortly after birth, babies with this heart defect usually show the major symptom: cyanosis (bluish tinge to skin)
tetrology of fallot
Heart disease kills roughly the same number people in the United States each year as:
cancer, lower respiratory diseases (including pneumonia), and accidents combined.
How mny people in the US die each day from heart disease?
How many people die each year from heart disease in the US?
800,000 (150,000 under age 65)
1 in 4 deaths in the US is due to:
1 in 3 adults:
have some form of heart disease, stroke, or other blood vessel diseases.
How many heart attack occur each year in the US?
In this cardiac myopathy all 4 chambers are dilated with some hypertrophy.
Dilated (congestive) cardiomyopathy
Dilated (congestive) cardiomyopathy involves:
Diminished myocardial contractility, which is reflected in diminished systolic performance of the heart
Dilated cardiomyopathy causes:
decreased ejection fraction, increased end-diastolic and residual volumes, decreased ventricular stroke volume, and biventricular failure
This cardiac myopathy is caused by asymmetric interventricular septal hypertrophy, which results in left ventricular outflow obstruction
What is the most common form of Hypertrophic Cardiomyopathy?
Idiopathic Hypertrophic Subaortic Stenosis (IHSS)
Restrictive Cardiomyopathy occurs when:
Myocardium is infiltrated with a material that results in impaired ventricular filling
This cardiac myopathy results in reduced diastolic volume of either or both ventricles:
In this cardiac myopathy the myocardium becomes rigid and noncompliant, impeding ventricular filling pressures during diastole
What 5 drug categories can be used to treat stage I hypertension?
Thiazide- type diuretic (for most)
ACE Inhibitors, Angiotensin II Receptor Blockers, Beta Blocker, Ca+ Channel Blockers, or combination.
Define Stage I Hypertension:
Systolic BP: 140-159 mmHg; Diastolic BP: 90-99 mmHg
What are common combinations of drugs for treating Stage II hypertension?
Thiazide- type diuretic and ACEI, ARB, or CCB.
Define Stage II hypertension:
Systolic BP: 160 or more mmHg; Diastolic BP: 100 or more mmHg
What 6 drug categories can be used to treat myocardial ischemia?
Aspirin or other blood thinner (anticoagulants)
Cholesterol- lowering medications
Ca+ Channel Blockers
Anti-inflammatory medications (NSAIDs) and Corticosteroids can be used to treat:
Long term antibiotics are effect in treating:
What 4 categories of drugs can be used to treat cardiomyopathy?
List at least 3 modifiable risk factors of cardiac diseases (more given):
○ Tobacco use
○ Raised blood glucose (diabetes)
○ Physical Inactivity
○ Unhealthy diet
List 3 non-modifiable risk factors for developing cardiac disease:
age, gender, family history
T or F: A man and a woman both in their 30's are at equal risk for heart disease.
FALSE. Men are more at risk than pre-menpausal women. After menopause men and women are affected more equally.
T or F: Men are at higher risk of stroke than women.
FALSE. Men and women are at equal risk of stroke
Why does the risk of developing CVD increase with age?
As a person gets older, the heart undergoes subtle physiologic changes, even in the absence of disease.