Flashcards in Cardiac Path Deck (112)
Define heart failure, and name key symptoms.
Cardiac pump dysfunction
- cardiac dilation
- dyspnea on exertion
Name 3 classes of drugs used to treat heart failure.
- ACE inhibitors
Is right- or left-sided heart failure more common?
Left. (Right often follows left)
Contrast the causes of left-sided (systemic) vs. right-sided (pulmonic) heart disease?
Left (systemic problems): HTN, ischemia, MI, cardiomyopathy
Right (pulmonic problems): L side failure (or L-->R shunt, chronic lung disease/cor pulmonale)
The "nutmeg liver" is associated with what diagnosis?
Right-sided heart failure (pulmonary heart disease)
Contrast stable vs unstable angina.
Stable (angina pectoris):
- pain with exertion/stress,
- >70% vessel occulsion
- <20 mins
- reversible injury
- ST depression
- pain at rest
- 90% vessel occusion
- reversible injury (until MI)
- normal EKG
Define prinzmetal (variant) angina.
Chest pain due to vasospasm of coronary artery
- normal EKG (except ST elevation only during a spasm)
Contrast NSTEMI and STEMI.
Both show elevated cardiac enzymes in labs ( troponin, CK, CK-MB)
- NSTEMI: normal EKG
- STEMI: abnormal EKG (ST elevation)
Which coronary arteries are most commonly occluded (in order)?
- L Circumflex
Where in the heart is affected by occluding the LAD?
- anterior LV near apex
- anterior 2/3 of septum
Where in the heart is affected by occluding the RCA?
- posterior LV
- posterior 1/3 of septum
- possibly some of the RV
Where in the heart is affected by occluding the L circumflex?
- lateral LV
What are possible causes of sudden cardiac death? (7)
- ventricular arrhythmia
- mitral valve prolapse
Splinter hemorrhages are indicative of what cardiac diagnosis?
Findings with hypertensive heart disease?
- High blood pressure
- Enlarged heart and irregular heartbeat
- Fluid in the lungs or lower extremities
- Unusual heart sounds
A systolic ejection click and crescendo-decrescendo systolic murmur indicate what?
Generally, what is stenosis, and what population is it likely to affect?
Stenosis = fibrosis/calcification because of wear and tear
Normally affects >60 yrs old, unless the valve or vessel is previously compromised
High pitched, blowing, early diastolic decrescendo murmur indicates what?
What can cause aortic regurgitation?
- Aortic root dilation
- Aneurysm, dissection
- Valve damage
What is Quincke pulse, and what diagnosis is it associated with?
Alternating filling and blanching of the capillary beds in the fingernails
Seen in aortic regurgitation
An opening snap with late diastolic rumble indicates what?
Patients with aortic stenosis may present clinically with ___?
What developmental abnormality predisposes to aortic stenosis?
A biscuspid aortic valve
Explain mitral valve prolapse, and the causes.
= Systolic balooning of mitral valve
- rheumatic fever
- chordae rupture
Shortened fibrotic cordae tendinae are associated with what diagnosis?
Chronic rheumatic heart disease
Which diseases preferentially affects the mitral valve?
- Chronic rheumatic heart disease
What diagnosis results in the "fish mouth" mitral valve deformity?
Chronic rheumatic heart disease
What diseases preferentially affects the tricuspid valve?
- infective endocarditis
A holosystolic high pitched "blowing" murmur indicates what?
- (louder with squatting/expiration)