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Pathophysiology > Chapter 18 Exam 3 > Flashcards

Chapter 18 Exam 3 Flashcards

1
Q

Unstable Angina enzymes*

A
  • no cardiac enzymes created, but chest pain will be very strong
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2
Q

Angina Pectoris*

A
  • chest pain associated with intermittent myocardial ischemia
  • no permanent damage occurs to the heart
  • crackles/rales are indicative of left side congestion, they are bubbling and rattling of buildup of fluid in the lungs
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3
Q

3 patterns of Angina Pectoris *

A
  • stable, unstable, and prinzmetal
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4
Q

Nitroglycerin*

A

dilates the coronary arteries

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5
Q

Stable Angina *

A
  • most common
  • characterized by stenoic atherosclerotic coronary vessels
  • relived by rest and nitroglycerin
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6
Q

Unstable or crescendo angina*

A
  • can progress to acute ischemia

- very similar to nonSTEMI heart attack, only difference is absence of serumbiomarker troponin

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7
Q

Prinzmetal/Variant angina*

A
  • unpredictable
  • vasospastic
  • caused by coronary artery occlusions
  • calcium channel blocking agents used for treatment
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8
Q

Acute Coronary Syndrome*

A
  • Myocardial infarction (MI) or unstable angina

- ECG and biomarkers used for diagnosis

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9
Q

ACS ECG changes*

A
  • t wave inversion or s wave depression
  • ST elevation in case of a heart attack; also known as STEMI (st elevation; myocardial infarction)
  • Q wave means old heart attack
  • T wave inversion with biomarkers is a nonSTEMI
  • segment depression means ischemia
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10
Q

Treatment of ACS with drugs*

A
  • antiplatelets and statin drugs are the best thing for ACS with nonSTEMI/unstable angina
  • reperfusion therapy is best thing for ACS with STEMI
  • morphine, oxygen, nitrates, and aspirin together treat acs
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11
Q

Acute occulsion*

A
  • blockage in an artery, vein, or within the heart
  • can cause a range of cellular events depending on the availability and adequacy of collateral blood flow, relative workload, & length of time that flow is interrupted
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12
Q

Diagnosis of ACS*

A

depends on

  • signs and symptoms
  • electrocardiographic changes
  • elevatioins of specific marker proteins in the blood
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13
Q

Signs and symptoms of ACS*

A
  • sever crushing, excruciating chest pain that may radiate to the arm, shoulder, jaw, or back
  • nausea
  • vomiting
  • diaphoresis (sweating)
  • shortness of breath
  • diabetics and elderly may not have pain due to neuropathy
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14
Q

More ACS info: Asymptomatic MI *

A
  • lasts more than 15 min and is not relieved by rest or nitroglycerin
  • can be asymptomatic MI (silent MI) which is typical in women, the elderly, and patients with diabetic neuropathies
  • ECG for asymptomatic includes st segment elevation, large Q waves, and inverted T waves
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15
Q

ACS serum marker changes*

A
  • myoglobin
  • lactate dehydrogenase
  • creatine kinase
  • increased CK-MB and troponin I and T
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16
Q

ACS Treatment Steps

A
  • Decreasing myocardial oxygen demand (rest, heart rate control, pain relief, afterload reduction)
  • Increasing myocardial oxygen supply (thrombolysis, angioplasty, coronary bypass grafting)
  • Monitoring and managing complications (early detection and management of dysrhthmias and conduction disorders, continuous ECG monitoring)
  • beta blockers are given
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17
Q

Sudden Cardiac Arrest

A
  • also called sudden cardiac death
  • unexpected death from cardiac causes within 1 hour of symptom onset
  • lethal dysrhythmia is usually primary case
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18
Q

Chronic Ischemic Cardiomyopathy

A
  • heart failure develops insiduously due to progressive ischemic myocardial damage
  • typically have history of angina or MI
  • appears to be a consequence of slow, progressive apoptotic death of myocytes from chronic ischemia
  • more common in older adults
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19
Q

Endocardial and Valvular Disease

A

endocardial & valvular structures may be damaged by:
- inflammation and scarring
- calcification
- congenital malformations
causes altered hemodynamics of the heart and increase myocardial workload
- will include stenosis. regurgitation, and prolapse

20
Q

Stenosis

A

failure of the calve to open completely results in extra pressure work for the heart

21
Q

Regurgitation (insufficiency)

A

inability of a valve to close completely results in extra volume work for the heart

22
Q

Mitral Stenosis*

A
  • blood flow from the left atrium to left ventricle is impaired during ventricular diastole
  • increased pressure of the left atrium leads to atrial chamber enlargement and hypertrophy
23
Q

Results of Mitral Stenosis *

A
  • chronic pulmonary hypertension
  • right ventricular hypertrophy
  • right sided heart failure
24
Q

Signs and symptoms of Mitral Stenosis *

A
  • low pitched, rumbling diastolic murmur
  • opening snap (sound)
  • atrial dysrhythmias
  • atrial clots
  • exertional dyspnea
25
Q

Mitral Regurgitation*

A
  • backflow of blood from left ventricle to the left atrium during ventricular systole
  • mitral valve should snap open and then close, but it does not snap closed and the blood experiences backflow
26
Q

Results of Mitral Regurgitation *

A
  • left atrium and ventricle dilate and hypertrophy due to the extra volume
  • may lead to left sided heart failure
27
Q

Signs and symptoms of Mitral Regurgitation*

A
  • high pitched, pansystolic blowing murmur
  • giant V waves
  • chronic weakness and fatigue
28
Q

Mitral Valve Prolapse*

A
  • displacement (ballooning) of the mitral valve leaflets into the left atrium during ventricular systole
  • women are affected more than men
  • typically asymptomatic
29
Q

Signs ad symptoms of Mitral Valve Prolapse *

A
  • Midystolic click or systolic murmur
  • palpitations
  • rhythm abnormalities
  • diziness
  • fatigue
  • dyspnea
  • chest pain
  • or depression and anxiety
30
Q

Aortic Stenosis

A
  • predominant cause is age related calcium deposits on the aortic cusps
  • results in obstruction of the aortic outflow from the left ventricle into the aorta during systole
31
Q

Signs and Symptoms of Aortic Stenosis

A
  • left ventricle hypertrophy may result in ischemia and left sided heart failure
  • crescendo-decrescendo murmur during ventricular systole with prominent S4 (s3 follows s2, S4 proceeds S1, s4 is indicative of a stiff left ventricle)
  • syncope
  • fatigue
  • angina
32
Q

Aortic Regurgitation

A
  • incompetent aortic valve allows blood to leak back from the aorta into the left ventricle during diastole
  • causes include abnormal aortic valve or aortic root dilation
  • leafs to left ventricular hypertrophy and dilation with eventual left sided heart failure
33
Q

Signs and symptoms of Aortic Regurgitation

A
  • high pitched blowing murmur during ventricular diastole
  • high systolic blood pressure
  • diastolic blood pressure usually low
  • palpitations
34
Q

Rheumatic Heart Disease

A
  • acute inflammatory disease that follows infection with group a beta hemolytic streptococci
  • damage is due to immune attack on individuals own tissues
  • damage occurs in CT of joints, heart, and skin
  • occurs mainly in children
35
Q

Signs and symptoms of Rheumatic Heart Disease

A
  • fever
  • sore throat
  • joint inflammation
  • involuntary movements (sydenham chorea)
  • distinctive truncal rash
36
Q

Infective endocarditis

A
  • invasion and colonization of endocardial structures by microorganisms with resulting inflammation - vegetations
  • most common bacteria are strep and staph
  • Can be acute (poor prognosis) or subacute (predisposing risk factors typically present)
37
Q

Myocarditis

A
  • inflammatory disorder of the heart muscle characterized by necrosis and degeneration of myocytes
  • clinical course is acute or stormy with recovery or death from cardiac failure occurring weeks to months after onset of symptoms
38
Q

Cardiomyopathy

A
  • classified by cause or functional impairment
  • primary: dysfunction or unknown cause
  • Secondary: known cause
  • Functional classifications: dilated, hypertrophic, restrictive
39
Q

Dilated Cardiomyopathy

A
  • cardiac failure associated with dilation of one or both ventricular chambers
  • can be related to alcohol toxicity, pregnancy, postviral myocarditis, or genetic abnormality
  • slow progression of biventricular heart failure with low ejection fraction ( ejection fraction less than 40% is heart failure
40
Q

ICD

A

Implantable Cardioverter Defribrillator

41
Q

Hypertrophic Cardiomyopathy

A
  • thickened, hyperkinetic ventricular muscle mass
  • septum may be affected, leading to idiopathic subaortic stenosis
  • caused by a genetic abnormality
  • can be asymptomatic or show signs of dyspnea and angina
42
Q

Restrictive Cardiomyopathy

A
  • Rarest form
  • stiff, fibrotic, rigid, noncompliant ventircle with impaired diastolic filling
  • mosy commonly associated with amyloidosis
  • decreased cardiac output and left sided heart failure can result
  • exerrcise intolerance, dyspnea, and weakness
43
Q

Pericardial Diseases

A

Typically sequelae of other disorders such as

  • systemic infection
  • trauma
  • metabolic derangement
  • neoplasia
44
Q

Pericardial Effusion

A
  • accumulation of noniflammatory fluid in the pericardial sac
  • composition of usual fluids includes serous, serosanguineous, chylous(fatty), and blood
45
Q

Cardiac Tamponade

A
  • when fluid accumulation in the pericardial sac is large/sudden it can lead to external compression of the heart chambers such that filling is impaired (basically a medical emergency in which there is a sudden build up of fluid in the lungs)
46
Q

Manifestations of Cardiac Tamponade and treatment

A
  • reduced stroke volume
  • compensatory increases in heart rate
  • pulsus paradoxus
  • jugular venous distension
  • Beck’s Triad
  • Treatment is pericardiocentesis
47
Q

Pericarditis

A
  • acute or chronic inflammation of the Pericardium

Pathophysiology (34 decks)

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