Cardiac Muscle Dysfunction Flashcards

(30 cards)

1
Q

What condition impairs the heart’s ability to pump or receive blood?

A

Cardiac Muscle Dysfunction

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2
Q

List characteristics of CMD (read)

A
  • Ejection fraction is 30-40%
  • Angina and myocardial ischemia is brought on by lack of O2 supply/demand to heart
  • Cardiac arrhythmias from decreased myocardial function
  • Myocardial infarction
  • Hypertension
  • Myocardium stiffens
  • LV weakens and dilates
  • Renal insufficiency
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3
Q

What is the most common cause of CHF?

A

Cardiac muscle dysfunction from dilated cardiomyopathy

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4
Q

How is CHF manifested?

A

Pulmonary congestion or edema

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5
Q

What is the most common cause of CMD?

A

MI

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6
Q

What is cardiomyopathy?

A

Abnormality of heart muscle

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7
Q

How is the heart affected from cardiomyopathy?

A

Lack of pumping of the heart - contraction/relaxation issues

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8
Q

What happens to the heart as it compensates for cardiomyopathy?

A

It becomes larger - cardiomegaly

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9
Q

What does ischemic cardiomyopathy result from?

A

From coronary artery disease

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10
Q

What does nonischemic cardiomyopathy result from?

A

Disease of heart muscle itself:
- Dilated
- Hypertrophic
- Restrictive

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11
Q

What are the three types of cardiomyopathy?

A

Dilated
Hypertrophic
Restrictive

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12
Q

Dilated cardiopathy is [idiopathic/non-idiopathic]

A

Idiopathic

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13
Q

What age group is typically affected by dilated cardiomyopathy?

A

Middle-aged
Men > Women

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14
Q

What are causes of dilated cardiomyopathy?

A

Family genetics
Viral infection
Alcoholism
Toxins
Cancer drugs
Pregnancy and childbirth
Smoking

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15
Q

Describe structural changes of dilated cardiomyopathy.

A

Dilated left ventricle and atrium
Bulging interventricular septum from left to right
Thin ventricular walls
Myocardial mitochondria dysfunction

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16
Q

How does heart function change due to dilated cardiomyopathy?

A

Ineffective/inefficient pumping
Heart is working at end-range, not enough cardiac output

17
Q

Describe structural changes of hypertrophic cardiomyopathy.

A

Increased thickness of LV wall
Increased thickness of interventricular septum
Decreased LV cavity size

18
Q

How does heart function change due to hypertrophic cardiomyopathy?

A

Exaggerated pump function (hypercontractile systolic function)
Poor heart relaxation (diastolic dysfunction)

19
Q

What type of cardiomyopathy is rarest?

20
Q

What type of cardiomyopathy has the worst prognosis?

21
Q

Describe structural changes of restrictive cardiomyopathy.

A

Stiffened wall of ventricles with loss of flexibility due to infiltration by abnormal tissue

22
Q

What are signs to look for CHF?

A
  • Cardiac silhouette (ball sack) on chest x-ray
  • Fluid in lungs
  • EF < 30%
  • Cold, cyanotic extremities
  • Abnormal S3 heart sound
  • Sinus tachycardia
  • Quick, shallow breaths
  • Peripheral edema
  • Crackles/Rales during inspiration
  • Systolic BP with controlled expiratory maneuver
  • Jugular vein distension (JVD)
  • Decreased exercise tolerance
23
Q

What is an abnormal S3 sound indicate?

A

LV is non-compliant and poor relaxation during diastole

24
Q

What are symptoms that patients will report indicating CHF?

A

Dyspnea
“difficulty breathing”

25
Why does dyspnea occur?
- Poor gas transport due to acute/chronic pulmonary edema - Abdominal ascites from peripheral edema and limited diaphragm descent - Ventilatory muscle weakness - Lack of O2 supply from increased tidal volume and RR
26
What symptom will patients report at night due to CHF?
Paroxysmal nocturnal dyspnea and orthopnea "suddenly can't breathe that wakes me up at night"
27
How should be position patient with paroxysmal nocturnal dyspnea/orthopnea?
- HOB propped up in bed or chair - Avoid lying supine
28
Why is digitalis (Digoxin) used for treatment?
- Blocks the Na/K pump to activate Na-Ca exchange - Leads to increased myocardial contractility - Increases renal perfusion (diuretic effect) - Relief symptoms of heart failure - Decreases sympathetic influence on heart and increases parasympathetic activity (thru AV node)
29
What are side effects of digitalis?
Bradycardia Fatigue, nausea ST segment depression, 1st degree block, PVS< V-tach, A-fib Slightly toxic if dosage increased
30
How does digitalis help with exercise?
Improve LV function Improve EF