Cardiac II Flashcards
(32 cards)
What are the types of congestive heart failure
Systolic dysfunction- Heart can’t generate enough force to pump blood (low cardiac output, anything below 40% ventricular volume)
Diastolic dysfunction- can’t dilate adequately to fill with enough blood
Left sided heart failure
Right sided heart failure
High output failure- cardiac output is normal but demand for blood flow is high
Low output failure- cardiac output is low but demand for blood is normal
Pathogenesis of congestive heart failure
- Increased hydrostatic pressure
- renin angiotensin aldosterone system activation
- sodium retention
What is diastolic heart failure
a condition caused by increased resistance to the filling of one or both ventricles
will have no time to relax
What is acute rheumatic fever, what causes it and main concern
Autoimmune inflammatory process due to group A strep inf
.3-3% of time will develop rheumatic heart disease
Clinical presentation of acute rheumatic fever (symptoms)
- Sore throat
- Polyarthritis (usually symmetrical and involves large jts)
- Sydenham chorea (neuro involunatry monts)
Jones criteria for dx of rheumatic fever
1 required criteria and 2 major and 0 minor (or 1 maj and 2 minor)
Required- Evidence of strep
Major- Carditis, poly arthritis, chorea, erythema marginatum,, subcutaneous nodules
Minor- Fever, arthralgia, prev fever
What kind of cells form in acute rheumatic fever
Formation of small giant cell granulomas called aschoffs bodies mainly in left atrium and ventricle
When does chronic rheumatic valve disease occur and what does it target
develops up to 30 years after first attack of RF
attacks mitral valve in 50% of cases
What is endocarditis and clinical manifestation
inflamation of the innermost layer of heart
- new cardiac murmur
- osler nodes (raised tender lesions on hand)
- Roth spots (pale lesions in retina)
- Janeway lesions (erythematous lesion palm/sole)
- Splinter hemmorrages
What is the characteristic lesion in infective endocarditis
Vegatations- occur on valve leaflets or chordae tendineae
NEVER occur on the atheromatous plaques in the aorta
Endocarditis cause in prostatic valves and elterly
prosthetic- staphylococci
Elderly- S auerus
What is the etiology of mitral valve stenosis and what is it + complications
Rheumatic heart disease is the cause of almost all cases of mitral stenosis
atrial fibrillation
thrombus in left atrium
pulmonary venous hypertension
What is the pathology of mitral incompetence
post inflammatory scarring of the mitral valve, holds the cusps in a partly open pos
increased rigidity and fusion of cusps often cause combo of stenosis and incompetence
-results in left ventricular function and failure
What is papillary mm ischemia
Loss of contractility of papillary mm as a result of mitral incompetence
-following infarction, rupture of infarcted papillary mm may cause sudden and severe incompetence with rapidly fatal left ventricular faulure
Main causes of aortic stenosis 92)
idiopathic calcified aortic stenosis
rheumatic heart disease
main complications of aortic valve stenosis
concentric left ventricular hypertrophy-> left ventricular failure
Pathology of tricuspid valve stenosis and comon causes (2)
similar to mitral valve (both stenosis or incompetence)
mc- infective endocarditis + IV drug
What are cardiomyopathies and 3 classifications
associated w mechanical or electrical dysfunction of heart
- hypertrophic cardiomyopathy
- congestic cardiomyopathy
- restrictive cardiomyopathy
What is hypertrophic cardiomyopathy, etiology and symtoms
HCM is a genetic disorder that causes myocardial hypertrophy that is inappropriate and asymmetrical and occurs in the absence of obvious inciting hypertrophic stim
s/s- Sudden death, angina, dyspnea, syncope, dizziness
What is dilated (congestive) cardiomyopathy
Progressive, irreversible, disease causing global systolic contractile dysfunction w heart
- dialated chancers unable to contract to maintain outoput
- idiopathic process
Causes of dilated cardiomyopathy
usually genetic
What is restrictive cardiomyopathy
mc causes
The myocardium is infiltrated w a material that results in impaired ventricular filling
causes- amyloidosis, hemochromatosis, collagen deposition
main causes of myocarditis, complications
Viral inf- enterovirus
complications- sudden death- lethal arryhymias
what is transudate pericardial disease
Transudate is an extra cellular fluid and a result of increased fluid pressure or low oncotic pressure
- low pro conc
- low spec gravity
- clear
- low lactate dehydrogenase
