Chapter 9 Flashcards
(158 cards)
1
Q
how do myocardial cells function
A
one large cell
2
Q
how many chambers are in the heart
A
4
3
Q
what are the heart chambers
A
right/left atria and ventricles
4
Q
role of atria
A
receiving chambers
5
Q
role of ventricles
A
pumping chambers
6
Q
how many systems are in the heart
A
2
7
Q
pulmonary system
A
right side
deoxygenated blood to lungs
8
Q
systemic system
A
left side
oxygenated blood to rest of body
9
Q
electrocardiogram
A
electrical activity
10
Q
true or false: the heart generates it’s own electricity
A
true
11
Q
p wave
A
atrial depolarization
12
Q
qrs complex
A
ventricle depolarization (contraction)
13
Q
t wave
A
ventricle repolarization
14
Q
what do all heart disorders affect
A
cardiac output and/or effort
15
Q
examples of heart disorders/affects
A
pump failure
obstructed flow
regurgitant flow
shunted flow
abnormal conduction
16
Q
congenital heart disease
A
cyanotic or acyanotic
atrial/ventricular septal defects
tetralogy of fallot
17
Q
cyanotic CHD
A
right to left
less common
poorly oxygenated blood flows to oxygenated
BLUE
18
Q
acyanotic CHD
A
left to right
more common
adds to right side workload, more blood
19
Q
types of atrial/ventricular septal defects
A
shunt
20
Q
manifestations of ASD/VSD
A
murmur
easily fatigued
RIGHT sided heart failure
21
Q
tetralogy of fallot defects
A
VSD
pulmonary stenosis
right ventricle hypertrophy
misplaced aorta
22
Q
manifestations of tetralogy of fallot
A
cyanosis
digital clubbing
slow growth
heart failure
variable life expectancy
23
Q
treatment for tetralogy of fallot
A
surgery shortly after birth
24
Q
ductus arteriosus
A
allows blood to bypass lungs using pulmonary artery to descending aorta
normally closes at birth
25
patent ductus arteriosus
shunt stays open after birth
cyanosis
blood shunted from aorta to pulmonary artery
26
is heart failure a disease
no, syndrome
27
what is the meaning of heart failure
describes several types of cardiac dysfunction that results in inadequate perfusion of tissues with blood-borne nutrients
28
is heart failure age associated
yes
29
is heart failure prevalence increasing or decreasing? why?
increasing, people are living longer
30
what are 2 ways the heart compensates to inadequate perfusion
increase SNS and cardiac muscle hypertrophy
31
systolic heart failure
impaired contraction caused by incomplete emptying
32
what happens to EF in systolic heart failure
decreases
less than 40%
33
normal ejection fraction
55%
34
what causes systolic heart failure
coronary artery disease
ischemia
cardiomyopathy
previous heart attack
35
diastolic heart failure
impaired filling
relaxation phase
36
what happens to EF in diastolic heart failure
remains same
37
what causes diastolic heart failure
ventricular stiffness caused by hypertension
results in smaller chamber size
38
compensated heart failure
failing ventricles dilate, increases chamber size to maintain cardiac output
don't know you're in heart failure
39
uncompensated heart failure
increased stretching results in weaker contractions
40
uncompensated forward failure
low cardiac output
41
uncompensated backward failure
upstream venous conjestion
42
is left or right sided heart failure more common
left
43
what causes left sided failure
cardiac muscle damage (MI)
valve defects
hypertension
cardiomyopathy
44
what causes right sided failure
LUNGS
pulmonary hypertension
pulmonary valve defect
45
forward heart failure
inadequate cardiac output
decreased perfusion (kidneys)
organs downstream don't get as much oxygen
46
backward heart failure
increased pressure due to blood backing up
pulmonary edema
hepatomegaly
47
symptoms of left sided failure
dyspnea
increased heart rate
pulmonary edema
LVent dilation
FATAL due to hypoxia, acidosis, arrhythmias
48
symptoms of right sided failure
dilated neck veins
swelling
ascites
edema in liver and spleen
NO DYSPNEA
49
how do you diagnose heart failure
ECHO
50
ways to treat heart failure
diet, drugs
51
dietary treatment for heart failure
weight loss
low salt diet
stop smoking
52
drug treatment for heart failure
diuretics
ACE inhibitors
aldosterone receptor blockers
digoxin
53
prognosis for heart failure
poor unless underlying cause is treatable
54
what is the role of coronary arteries relative to the heart
supply blood to heart through right and left arteries
55
coronary artery atherosclerosis
atherosclerosis blocks coronary arteries leading to ischemia
56
what is ischemia
low oxygen due to low flow
57
what can ischemia cause
angina
myocardial infarction
arrhythmias
conduction deficits
heart failure
sudden death
58
acute ischemia
may result in angina pectoris
comes on quickly
unremitting
59
angina pectoris
chest pain due to ischemia
60
types of angina pectoris
stable and unstable angina
silent myocardial ischemia
61
stable angina
most common and predictable
pain when heart's oxygen demand increases
62
unstable angina
no pattern, comes quickly
caused by aggregation of platelets on plaque
MEDICAL EMERGENCY
63
silent myocardial ischemia
myocardial ischemia without pain
64
myocardial infarction
necrosis of heart muscle due to ischemia
65
what causes MI
sudden disruption of plaque, leads to thrombus
thrombus occludes vessel
66
what is the rank of MI in deaths in US
leading cause of death
1.5million cases/yr
⅓ die
67
percent of MI that occurs without warning
20%
68
percent of MI patients arriving alive
80-90%
69
cause of death in MI patients in die before hospital
cardiac arrhythmia
70
are there complications of MI?
yes, most develop clinical complications
71
what areas are affected by MI
left ventricle
anterior
72
what type of necrosis is MI
coagulative
73
symptoms of acute MI
angina...severe, crushing, constrictive, or heartburn
SNS responses...GI distress, nausea, vomiting
tachycardia, vasoconstriction
anxiety, restlessness, feeling of impending doom
hypotension...shock, weakness in extremities
74
men vs. women MI symptoms
men have more hallmark symptoms
75
women MI symptoms
unusual fatigue
sleep disturbances
indigestion
anxiety
76
do all MI patients have symptoms
no
77
diagnosis of MI
ECG abnormalities
elevation of blood enzymes
78
ECG abnormalities of MI
ischemia in ventricles
T wave of ST segment
79
elevated blood enzymes of MI
due to tissue necrosis
creatine kinase
cardiac CK
cardiac troponin
80
what are the enzyme levels in more severe heart attacks?
stronger/larger enzyme levels
81
does angina have elevated enzymes
no
82
what is the most common cause of CAD
thrombus blocking blood flow
83
goals of CAD treatment
reverse thrombosis
control pain
limit infarct size
reduce cardiac workload w/beta blockers
treat complications
84
lifestyle treatments for CAD
lose weight
low salt
stop smoking
increased physical activity
85
drug treatments for CAD
nitroglycerin (vasodilator)
antiplatelet/anticoagulant (warfarin, aspirin)
beta blockers (inhibits SNS)
antiarrhythmias (maintains stability)
86
surgery treatments for CAD
destroy clot via (angioplasty)
cardiac bypass (INVASIVE, rerouting blood flow)
stent (brace lumen so vessel remains open)
87
long term complications of MI
heart failure
cardiogenic shock
pericarditis
thromboemboli
cardiomyopathy
heart rupture
ventricular aneurysms
88
late complications of MI
heart failure
89
early complications of MI
arrhythmias
90
hypertensive heart disease
due to hypertension ONLY
LEFT SIDE
91
manifestations of HTN heart disease
LVent hypertrophy
enlarge heart...chamber size decreases resulting in diastolic failure...heart may be so thick and result in angina
left heart failure
pulmonary edema
92
treatment for HTN heart disease
reduce blood pressure
93
is HTN heart disease reversible
yes
94
what is the role of valves
control direction of flow
must fully open/close
95
types of valves in heart
AV values
semilunar valves
96
stenosis
failure to open completely
97
regurgitation
failure to close tightly
blood regurgitates to previous chamber
98
valvular stenosis
aortic/mitral stenosis
99
valvular insufficiency
aortic regurgitation (LVent)
mitral regurgitation (LAtria)
tricuspid regurgitation (RVent)
100
degeneration
most common cause of valve disease
101
types of degeneration
aortic stenosis
calcification of mitral valve
mitral prolapse (regurgitation)
102
why is left valvular degeneration more common
age, greater workload, higher pressure
103
what causes valve disease
rheumatic fever
104
valvular dysfunction
irregular blood flow
stenosis
regurgitation
105
manifestations of valvular dysfunction
ASYMPTOMATIC
murmur
easily fatigued
shortness of breath
106
aortic stenosis
most common valve defect w/age
107
what causes aortic stenosis
age-associated wear and tear
calcification
108
manifestations of aortic stenosis
increase LVent pressure during ejection...increased resistance to flow/reduced stroke volume
LVent hypertrophy...impaired filling
back up blood into LAtria....increases LAtrial pressure
109
what is aortic stenosis a risk factor for
heart failure
arrhythmia
atrial fibrillation
110
is aortic stenosis a systolic or diastolic murmur
systolic
111
causes of mitral stenosis
rheumatic fever
112
manifestations of mitral stenosis
difficulty emptying blood into LVent during diastolic...reduces EDV and Q
blood backs up into LAtria...hypertrophy, pulmonary congestion and hypertension
113
is mitral stenosis a systolic or diastolic murmur
diastolic
114
regurgitation of mitral valve
backflow of blood into LAtria
115
manifestations of regurgitation of mitral valve
LAtria pressure increases, hypertrophy
atrial fibrillation
increase LVent EDV...increase preload and Q
net amount of blood ejected is reduced because it's going back to where it came from
116
what can regurgitation of mitral valve lead to
right side heart failure
117
is regurgitation of mitral valve a systolic or diastolic murmur
systolic
118
regurgitation of aortic valve
backflow of blood into LVent
119
manifestations of regurgitation of aortic valve
volume overload...LV pressure increases
increase LV EDV
hypertrophy of LVent...heart failure
120
is regurgitation of aortic valve a systolic or diastolic murmur
diastolic
121
acute rheumatic fever
autoimmune disorder
streptococcal infection
122
cardiomyopathy
pathology of heart muscle
123
what causes cardiomyopathy
inflammation
acquired (diet...alcohol, radiation)
genetic
124
symptoms of cardiomyopathy
asymptomatic
125
types of cardiomyopathy
dilated, hypertrophic, restrictive
126
dilated cardiomyopathy
ventricles weaken because of too much stretching, enlarge
MOST COMMON
reduced systolic function....no strong contraction
127
cause of dilated cardiomyopathy
idiopathic
128
what does dilated cardiomyopathy lead to
heart failure, valve disease, irregular heart rate
129
hypertrophic cardiomyopathy
ventricles and septum enlarge and thicken
affects mitral valve (diastolic) function if chamber gets too thick
cellular changes in myocardium
130
who is the most at risk for hypertrophic cardiomyopathy deaths
young athletes
131
what causes hypertrophic cardiomyopathy
genetic (mutation in myosin)
acquired (hypertension)
idiopathic
132
how to screen for hypertrophic cardiomyopathy
familial history
ECHO
blood genetic tests
133
restrictive cardiomyopathy
heart is rigid and restricted from increased stretching
ventricles don't thicken
DIASTOLIC
134
what does restrictive cardiomyopathy lead to
heart failure
valve problems
135
causes of restrictive cardiomyopathy
idiopathic
amyloidosis
chemotherapy
136
symptoms of cardiomyopathy
NONSPECIFIC
asymptomatic
murmur
dyspnea
angina
syncope
arrhythmia
137
complications of cardiomyopathy
heart failure
blood clots
valve defects
cardiac arrest
sudden death
138
pericardial disease
inflammation of pericardium
139
what causes pericardial disease
MI due to inflammation factors
140
is pericardial disease primary or secondary
secondary to other conditions like virus, bacteria, infection
141
complications of pericardial disease
leads to chronic scarring and restrictive pericarditis
142
restrictive pericarditis
interference with heart ability to pump
143
primary tumors of the heart
rare
myxoma
90% benign
90% occur in left atria
144
what is most common with tumors of the heart
metastasis
145
normal sinus rhythm
cardiac conduction system important for coordination of pumping
146
arrhythmias
disturbance of heart rhythm (irregular heartbeat)
147
classification of arrhythmias
abnormal impulse formation
abnormal conduction
tachycardia
bradycardia
148
automaticity arrhythmia
SA node is natural pacemaker
enhanced or suppressed automaticity
149
factors enhancing automaticity
increase SNS, CO2, H+, stretch
decrease PNS, O2
hypokalemia
150
atria arrhythmia
atrial fibrillation (disorganized)
atrial flutter (beats faster than ventricle)
stroke
151
ventricular arrhythmias
premature ventricular contractions (PVC)
ventricular tachycardia
ventricular fibrillation (no ejection of blood)
152
re-entry
mechanism for arrhythmia
2 distinct pathways come together to form loop
153
examples of re-entry
afib
atrial flutter
ventricular tachycardia
154
complications of ventricular arrhythmias
sudden cardiac death
155
complications of atrial arrhythmias
atrial thrombi
increase risk for stroke
156
treatment for arrhythmias
anti-arrhythmic drugs
defibrillation
ablation
pacemaker
157
sudden cardiac death
natural death from cardiac causes within one hour of acute symptoms
158
what causes sudden cardiac death
arrhythmia
MI
aortic aneurysm
electrocution
drugs like cocaine
