Chapter 10 Pt 1 - Kailey

Question 1

What is the #1 cause of death in the U.S

Answer 1

Heart Disease

Question 2

What is the most common mechanism of heart disease

Answer 2

contractile (pump) failure

- Heart not pumping enough blood to supply the body

Question 3

What is the most common cause of Heart Failure

Answer 3

Decreased cardiac output

- can also be caused by an increase in tissue demands

Question 4

What causes decreased cardiac output

Answer 4

Systolic dysfunction, diastolic dysfunction and valvular dysfunction

Question 5

Systolic dysfunction is when the heart will not relax which means it won’t fill enough

Answer 5

False, this is Diastolic Dysfunction

Systolic Dysfunction - is when there is weak contraction

Question 6

Would pericardial tamponade cause diastolic or systolic dysfunction

Answer 6

Diastolic Dysfunction - it compresses the heart not allowing it to relax completely

Question 7

______ occurs when the heart cannot generate sufficient output to meet the metabolic demands of the tissues

Answer 7

Congestive Heart Failure

Question 8

Forward Failure (Insufficient output) is almost never combined with Backward Failure (Venous Congestion)

Answer 8

False, almost always combined

Question 9

What is the adaptation in which the heart tissues will stretch in response to and increase in end diastolic volumes in order to increase contraction strength

Answer 9

Frank-Starling Mechanism

Question 10

In the Frank-Starling Mechanism when in the patient said to be in “compensated heart failure”

Answer 10

When the dilated ventricle is able to maintain cardiac output
- this increases the oxygen demand of the heart muscles which it cannot keep up for a long time and will eventually lead to failure

Question 11

What effect does norepinephrine have on heart rate

Answer 11

Increases HR,contractility and BP

Question 12

What effect does the Renin-Angiotesin-Aldosterone System have on the heart

Answer 12

It initiates salt and water retention which increases vascular tone

Question 13

What effect does ANP have on circulation

Answer 13

Vasodilation

Question 14

Overload on the heart causes Cardiac Hyperplasia

Answer 14

False, Hypertrophy

Question 15

Concentric Hypertrophy occurs when the ventricular wall thickness increases without an increase in size of the chamber

Answer 15

True

• Concentric is the bad kind - the walls grow in filling the ventricle
• • this is a pathologic response

Question 16

Eccentric Hypertrophy occurs when there is proportional dilation of the heart and a decrease in capillary denisity

Answer 16

False, Proportional dilation of heart and INCREASE in capillary density

• Cross section of ventricle remains the same
• • this is a Physiologic Response

Question 17

What are the most common causes of left sided heart failure

Answer 17

Ischemic Heart Disease (CAD)- Not enough blood to heart
Hypertension
Valve Disorders
Primary diseases of Myocardium (amyloidosis)

Question 18

What occurs as a result of Left Sided Heart Failure

Answer 18

Decreased Cardiac Output and Pulmonary Edema

Question 19

What are the symptoms associated with Left Sided Heart Failure

Answer 19

Dyspnea (shortness of breath) upon exertion, cough, Orthopnea (Dyspnea when recumbent), rales and tachycardia

Question 20

Is right sided or left sided heart failure more common?

Answer 20

Left Sided

** Hardest working side fails first

Question 21

Which sided heart failure will cause fluid back up into the lungs

Answer 21

Left

Question 22

Right sided heart failure is usually the consequence of left sided heart failure

Answer 22

True

- left side causes fluid backup in the right side which puts stress on right side

Question 23

What is the cause of Isolated right sided heart failure

Answer 23

Pulmonary Hypertension causing COR PULMONALE

Question 24

In Isolated right sided heart failure does the problem typically originate in the lungs or in the heart

Answer 24

In the lungs/pulmonary Circulation (HTN)

Question 25

Isolated right sided heart failure causes major pulmonary congestion

Answer 25

False, Minimal pulmonary Congestion | ** Left sided heart failure causes Pulmonary Congestion

Question 26

20% of birth defects are congenital heart disease, and prematurity increases risk

Answer 26

False, 30%

Question 27

Which chromosomes are effected in Genetic Congenital Heart Disease

Answer 27

Trisomies 13, 18 and 21

Question 28

in the embryological heart the right atrium communicates with the left atrium

Answer 28

True - through the Foramen Ovale

Question 29

What percentage of congenital heart diseases are idiopathic?

Answer 29

90%

Question 30

What is the most common congenital heart disease

Answer 30

Ventricular Heart Disease (42%) - second most common @ 10% is Atrial Septal Defects But together Septal Defects make up over half of Congenital Heart Disease Cases

Question 31

What percent os congenital heart cases are caused by tetralogy of fallot

Answer 31

5%

Question 32

What occurs in a congenital right to left shunt?

Answer 32

Blood bypasses the lungs and the baby's appear "dusky blue" as a result of cyanosis

Question 33

A Left to right Shunt occurs when blood bypasses the lungs

Answer 33

False, Left to Right means Left is forcing blood into Right/pulmonary circulation - causes right ventricular hypertrophy and Pulmonary Hypertension

Question 34

Which type of shunt is most common, left to right or right to let

Answer 34

Left to right | * higher pressure coming from left forcing blood into right

Question 35

What are the three main structural abnormalities in congenital heart failure

Answer 35

1) Right to Left Shunt 2) Left to right Shunt 3) Obstruction of Flow

Question 36

ASD's, VSD's and PDA's are examples of left to right shunts

Answer 36

True

Question 37

What is the Most common cause of Cyanosis at birth

Answer 37

Tetralogy of Fallot

Question 38

Tetralogy of fallot and transposition of the great arteries are examples of right to left or left to right shunts?

Answer 38

Right to Left

Question 39

What are the 4 defects that make up tetralogy of fallot

Answer 39

1) Ventricular Septal Defect 2) Right Ventricular Outflow Obstruction 3) Overriding Aorta 4) Right Ventricular Hypertrophy

Question 40

What condition is associated with the description of a "boot shaped heart"

Answer 40

Tetralogy of Fallot