Cardiac Pathophysiology

Question 1

What are causes of valvular abnormalites?

Answer 1

Question 2

What is mitral stenosis, and what would happen to the pressures in the LA and LV?

Answer 2

Question 3

What is mitral regurgitation? What would happen to the LA and LV pressures compared to normal?

Answer 3

Blood flows back into the LA during systole, causing the LA to expand

Question 4

What is aortic stenosis? What happens to LA and LV pressure, and pressure in the aorta compared to normal?

Answer 4

• Narrowing of the aortic valve, slow to open
• Increased afterload
• Cardiac hypertropy
• SV decreased
• LV pressure increases due to increased afterload

Question 5

What are the three ways to do a transcatheter aortic valve replacement (TAVR)?

Answer 5

Question 6

What does aortic regurgitation (insufficiency) do to LA, aortic, and LV pressure compared to normal?

Answer 6

• Blood flows back into LV from the aorta
• Increasing preload and stroke volume
• Chamber dilation

Question 7

What are symptoms that a patient could have indicating valvular abnormalities?

Answer 7

Question 8

When would you hear heart murmors for the different vavular abnormalites?

Answer 8

Question 9

What are some causes of dialated cardiomyopathy and problems that it can lead to?

Answer 9

Question 10

What are some causes of pathological hypertrophy and problems that it can lead to?

Answer 10

Question 11

How is physiological hypertrophy different than pathological?

Answer 11

Question 12

Possible causes of an MI? What problems does it lead to?

Answer 12

Question 13

What are cardiomyocyte marker for an acute MI? At what levels is it indicitave of one?

Answer 13

Question 14

What happens immediately after someone experiences an MI, and the following weeks after?

Answer 14

Question 15

How does aspirin work and what does it do?

Answer 15

Question 16

What do fibrate (Gemfibrozil) medications do and how do they work?

Answer 16

Question 17

What do Statins (atorvastatin - Lipitor) do and how do they work?

Answer 17

Question 18

What do PCSK9 inhibitors do and how do they work?

Answer 18

Question 19

What is the difference between diastolic HF and systolic HF?

Answer 19

Question 20

HFrEF is also called ______________

Answer 20

Systolic heart failure or volume overload

Question 21

HFpEF is also called __________________

Answer 21

Diastolic HF or pressure overload

Question 22

What changes happen in cardiomyocytes after heart failure?

Answer 22

Question 23

What causes arrythmias during heart failure?

Answer 23

Question 24

How is there compensation during mild HF?

Answer 24

Question 25

What are symptoms of chronic (decompensated) HF?

Answer 25

Question 26

What are key symptoms to lood for with patients that have HF?

Answer 26

Question 27

What is circulatory shock?

Answer 27

Question 28

What are the different types of circulatory shock?

Answer 28

Question 29

What type of shock would these symptoms be indicative of? How would the body compensate?

Answer 29

Question 30

What are common inotropic agents used for treatment of acute HF?

Answer 30

Question 31

Would dobutamine increase myocardial O2 demand because it increases HR?

Answer 31

Yes and no. Dobutamine is a chronotropic agent but also a vasodilator, so by dilating vessels you would decrease afterload and the demand of the heart

Question 32

T or F. If you increase intracellular calcium you have the potential to induce arrhythmias?

Answer 32

True indeed

Question 33

Of these four inotropic agents (Digoxin, Dobutamine, Milrinone, Levosimendan) which one is _not_ a vasodilator?

Answer 33

Digoxin

Question 34

Of these four inotropic agents (Digoxin, Dobutamine, Milrinone, Levosimendan) which ones do not increase HR (chronotropic)?

Answer 34

Digoxin and Levosimendan

Question 35

Of these four inotropic agents (Digoxin, Dobutamine, Milrinone, Levosimendan) which one does not increase calcium and possibly induce arrhythmias?

Answer 35

Levosimendan

Question 36

What are some causes of septic shock?

Answer 36

Question 37

What can septic shock lead to? What is an alternative treatment to vasopressors in septic shock?

Answer 37

Question 38

What is the mechanism behind septic shock?

Answer 38

Question 39

What is and what occurs during anaphylactic shock?

Answer 39

Question 40

What is neurogenic shock, and causes of it?

Answer 40

Question 41

Regardless of the type of shock, all lead to these symptoms?

Answer 41

Question 42

Explain the positive feedback loop of the progression to shock starting from decreased tissue perfusion

Answer 42

Question 43

What is ECMO and indications for use?

Answer 43