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Flashcards in Cardiac Path Deck (112)
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1

Define heart failure, and name key symptoms.

Cardiac pump dysfunction
- cardiac dilation
- dyspnea on exertion
- fatigue
- rales
- JVD

2

Name 3 classes of drugs used to treat heart failure.

- ACE inhibitors
- beta-blockers
- diuretics

3

Is right- or left-sided heart failure more common?

Left. (Right often follows left)

4

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)

5

The "nutmeg liver" is associated with what diagnosis?

Right-sided heart failure (pulmonary heart disease)

6

Contrast stable vs unstable angina.

Stable (angina pectoris):
- pain with exertion/stress,
- >70% vessel occulsion
- <20 mins
- reversible injury
- ST depression
- predictable

Unstable:
- pain at rest
- 90% vessel occusion
- reversible injury (until MI)
- normal EKG
- unpredictable

7

Define prinzmetal (variant) angina.

Chest pain due to vasospasm of coronary artery
- normal EKG (except ST elevation only during a spasm)

8

Contrast NSTEMI and STEMI.

Both show elevated cardiac enzymes in labs ( troponin, CK, CK-MB)
- NSTEMI: normal EKG
- STEMI: abnormal EKG (ST elevation)

9

Which coronary arteries are most commonly occluded (in order)?

- LAD
- RCA
- L Circumflex

10

Where in the heart is affected by occluding the LAD?

- anterior LV near apex
- anterior 2/3 of septum

11

Where in the heart is affected by occluding the RCA?

- posterior LV
- posterior 1/3 of septum
- possibly some of the RV

12

Where in the heart is affected by occluding the L circumflex?

- lateral LV

13

What are possible causes of sudden cardiac death? (7)

- ischemia
- ventricular arrhythmia
- atherosclerosis
- mitral valve prolapse
- cocaine
- cardiomyopathy
- myocarditis

14

Splinter hemorrhages are indicative of what cardiac diagnosis?

Infectious endocarditis

15

Findings with hypertensive heart disease?

- High blood pressure
- Enlarged heart and irregular heartbeat
- Fluid in the lungs or lower extremities
- Unusual heart sounds

16

A systolic ejection click and crescendo-decrescendo systolic murmur indicate what?

Aortic stenosis

17

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

18

High pitched, blowing, early diastolic decrescendo murmur indicates what?

Aortic regurgitation?

19

What can cause aortic regurgitation?

- Aortic root dilation
- Aneurysm, dissection
- Valve damage

20

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

21

An opening snap with late diastolic rumble indicates what?

Mitral stenosis

22

Patients with aortic stenosis may present clinically with ___?

syncope

23

What developmental abnormality predisposes to aortic stenosis?

A biscuspid aortic valve

24

Explain mitral valve prolapse, and the causes.

= Systolic balooning of mitral valve

Causes
- marfan/ehlers-danlos
- rheumatic fever
- chordae rupture

25

Shortened fibrotic cordae tendinae are associated with what diagnosis?

Chronic rheumatic heart disease

26

Which diseases preferentially affects the mitral valve?

- Chronic rheumatic heart disease

27

What diagnosis results in the "fish mouth" mitral valve deformity?

Chronic rheumatic heart disease

28

What diseases preferentially affects the tricuspid valve?

- Libman-Sachs
- infective endocarditis

29

A holosystolic high pitched "blowing" murmur indicates what?

Mitral regurgitation
- (louder with squatting/expiration)

30

Name the JONES criteria and what diagnosis they are associated with?

Rheumatic heart disease:
- Joints (migratory polyarthritis)
- O for <3 (pancarditis)
- Nodules
- Erythema marginatum (rash on trunk/limbs)
- Sydenham chorea (Aschoff bodies of Anitschkow cells w wavy nuclei): vegetations of valves