Cardiac Pathologies

Question 1

causes of valve abnormalities

Answer 1

rheumatic fever
viral infn
calcification
weak papillary muscles or chordea tendineae for AV valves
ischemic heart disease

Question 2

mitral stenosis

what happens to BPs?

Answer 2

narrowing of mitral valve
LA= increase
LV sys= decrease
LV dia= decrease
Aorta= decrease

Question 3

mitral regurgitation

what happens to BPs?

Answer 3

blood flows back into LA
LA= increase
LV sys= decrease
LV dia= increase
aorta= decrease

Question 4

aortic stenosis

what happens to BPs?

Answer 4

narrowing of the aortic valve
LA= increase
LV sys= increase
LV dia= increase
Aorta= decrease

Question 5

TAVR

Answer 5

transcatheter aortic valve replacement

treatment for aortic stenosis

Question 6

aortic regurg

what happens to BPs?

Answer 6

regurg back into LV from aorta
LA= increase
LV sys= increase
LV dia= increase
aorta sys= increase
aorta dia= decrease

Question 7

what happens to the pulse pressure with aortic regurg?

Answer 7

wide pulse pressure

Question 8

possible symptoms of valvular abnormalities (8)

Answer 8

decrease exercise tolerance
dizziness/ short of breath
ventricular hypertrophy
ventricular dilation
atrial and ventricular arrhythmias
decreased CO
pulmonary edema
HF

Question 9

what causes ventricular hypertrophy

Answer 9

high afterload

Question 10

what causes ventricular dilation

Answer 10

high preload

Question 11

when would you hear the aortic stenosis murmur?

Answer 11

ventricular systole

Question 12

when would you hear the aortic regurg murmur?

Answer 12

ventricular diastole

Question 13

when would you hear mitral valve regurg murmur?

Answer 13

ventricular systole

Question 14

when would you hear mitral valve stenosis murmur?

Answer 14

ventricular diastole

Question 15

dilated cardiomyopathy cause

Answer 15

virus
pericarditis
toxins
MI
volume overload
cocaine
autoimmune

Question 16

why is dilated cardiomyopathy bad?

Answer 16

weaked portion of heart
low EF
increased diastolic and systolic volumes
leads to HF and arrhythmias

Question 17

cardiac hypertrophy

Answer 17

concentric hypertrophy (growing inward)
lower filling volume
weaker muscle per cross sectional area

Question 18

what are the two ways that hypertrophy muscles are weaker?

Answer 18

decreased ability to handle calcium

shift in myosin isoform type

Question 19

physiological hypertrophy

Answer 19

heart chamber can grow outward
exercise is cause
increases CO

Question 20

MI

Answer 20

myocardial infarction
heart attack
damage or death of heart muscle

Question 21

3 MI causes

Answer 21

blood clots in coronary circulation
LDL/cholesterol/plaques
coronary artery dissection

Question 22

can myocardium regenerate well?

Answer 22

no

just leaves scar tissue

Question 23

what labs can you run to tell someone had an MI?

Answer 23

troponin T and troponin I the cardiac ones

Question 24

coronary artery dissection

Answer 24

when the endothelium cracks and then blood fills between endo and muscle and occludes the vessel

Question 25

what happens immediately after MI on EKG?

Answer 25

Vfib

Question 26

causes of HF

Answer 26

severe valve disease pathological hypertrophy dilated cardiomyopathy MI

Question 27

2 problems of HF

Answer 27

CO decreases | cant supply organs with blood

Question 28

systolic HF (HFrEF)

Answer 28

HF with reduced EF SV is low dilation "volume overload"

Question 29

diastolic HF (HFpEF)

Answer 29

HF with preserved EF SV and EDV is low pathological hypertrophy "pressure overload"

Question 30

aortic regurg | dilation or hypertrophy?

Answer 30

dilation

Question 31

aortic stenosis | dilation or hypertrophy?

Answer 31

hypertrophy

Question 32

mitral regurg | dilation or hypertrophy?

Answer 32

dilation

Question 33

mitral stenosis | dilation or hypertrophy?

Answer 33

neither

Question 34

changes in cardiac myocytes with HF

Answer 34

``` release BNP/ANP lower contractility Calcium channels dont work right anymore decreased SERCA increased Na/Ca exchanger decreased RyR2 ```

Question 35

what can HF do to action potential

Answer 35

longer AP | altered refractory periods

Question 36

bodys compensation during mild HF

Answer 36

sympathetics to increase CO | RAAS to increase BP

Question 37

what to treat mild HF?

Answer 37

beta block and antihypertensive

Question 38

chronic (decompensated) HF

Answer 38

blood backs up in circulation fluid build up cardiogenic shock

Question 39

what are the 4 things that fluid build up in HF can do?

Answer 39

pulmonary edma systemic edema dyspnea fatigue

Question 40

what would be a good treatment for HF?

Answer 40

dobutamine

Question 41

are the treatments for HFrEF and HFpEF the same?

Answer 41

yes

Question 42

circulatory shock

Answer 42

severe circulatory failure inadequate BF through body cant supply tissues with oxygen

Question 43

what are the 4 types of circulatory shock?

Answer 43

hypovolemic cardiogenic vasogenic (septic, anaphylactic) neurogenic

Question 44

hypovolemic shock

Answer 44

low blood volume decrease preload decrease CO

Question 45

what are the compensatory mechanism for hypovolemic shock?

Answer 45

baroreceptor reflex chemoreceptor reflex increase in RAAS

Question 46

cardiogenic shock

Answer 46

reduction of CO caused by inability of heart to pump blood

Question 47

3 causes of cardiogenic shock

Answer 47

mI cardiomyopathy arrhythmias

Question 48

symptom of cardiogenic shock

Answer 48

pulmonary edema

Question 49

what are the 4 common drugs used for short term treatment of HF?

Answer 49

digoxin dobutamine milrinone levosimendan

Question 50

septic shock

Answer 50

whole body inflammatory response due to system wide infxn | limited treatment

Question 51

what is septic shock commonly spread from?

Answer 51

GI rupture UTI skin strep or staph infxn pulmonary infxn

Question 52

what is the treatment for septic shock?

Answer 52

Ang II

Question 53

anaphylactic shock

Answer 53

MABP drops histamine release vadodilation increased capillary permeability

Question 54

neurogenic shock

Answer 54

loss of vasomotor tone (massive dilation) | lose pressure and reduces preload

Question 55

what are the causes of neurogenic shock

Answer 55

general anesthesia spinal anesthesia spinal cord damange brain damage

Question 56

which two types of shock effect the CO?

Answer 56

hypovolemic | cardiogenic

Question 57

what two types of shock effect the vascular resistance?

Answer 57

vasogenic (septic, anaphylactic) | neuorgenic

Question 58

what type of loop is shock?

Answer 58

postive feedback loop | until tissue death