Final Flashcards
(142 cards)
1
Q
How many beats does your heart beat per year? Lifetime?
A
40 million, 2.5 billion beats
2
Q
What is the # 1 cause of death in the U.S. ?
A
Heart disease
3
Q
What is the most common cause of heart failure?
A
Contractile failure (systolic dysfunction/ pump failure)
4
Q
What is the most common cause of CHF?
A
Decreased cardiac output
5
Q
Increased tissue demands is symptom of heart failure due to what?
A
Hyperthyroidism, severe anemia, AV fistula. (High output failure)
6
Q
What is a very common sign of congestive heart failure?
A
Pitting edema
7
Q
What is the cause of systolic dysfunction heart failure?
A
Weak contraction, CAD, systemic HTN, Shock (decreased pH)
8
Q
What is the cause of diastolic dysfunction heart failure?
A
Failed relaxation which leads to decreased filling.
9
Q
What are causes of diastolic dysfunction via failed relaxation?
A
Myocardial fibrosis/amyloidosis, left sided hypertrophy, pericardial tamponade
10
Q
What is the cause of valvular heart failure ?
A
Failure to effectively seal
11
Q
What are causes of valvular dysfunction due to failure to seal?
A
Stenosis, endocarditis, virus, SLE, rheumatic fever
12
Q
What is the cause of forward heart failure?
A
Insufficient output (hypoxia)
13
Q
What is the cause of backward heart failure?
A
Venous congestion (increase in venous blood volume/pressure)
14
Q
what type of heart failure is almost always accompanied by what?
A
Forward failure, backward failure
15
Q
What is the frank starling mechanism?
A
Increase stretch causing a stronger contraction
16
Q
What is the befit of the frank Starling mechanism?
A
Increased output
17
Q
What is the cost of the frank starling method?
A
Increased 02 and increased tension
18
Q
Structural changes of the heart are due to what?
A
Cardiac hypertrophy (cost is increased o2 consumption)
19
Q
Hypertrophy associated with the heart is due to what?
A
Increased pressure
20
Q
What is the association of dilation of the heat?
A
Increased volume
21
Q
What is another name of physiological cardiac hypertrophy?
A
Athletes heart
22
Q
What is pathological hypertrophy called?
A
Concentric hypertrophy
23
Q
What are the cause of Concentric hypertrophy ?
A
Increase pressure (via HTN, valvular stenosis)
24
Q
What is another name for physiologic hypertrophy?
A
Eccentric Hypertrophy
25
What are the causes of Eccentric Hypertrophy?
Increased blood VoLume, bradycardia, increased capillary density
26
Left sided heart failure develops following what?
Hypertension, CAD, value disorders, cardiomyopathies
27
What are some symptoms of Left sided heart failure?
LV hypertrophy (dilation when old), decreased cardiac output, cough dyspnea, RALES, orthopnea, Tachycardia
28
What is the most common cause of right sided heart failure?
Develops from Left sided failure
29
What is the cause of Isolated right sided heat failure?
Pulmonary HTN---> Cor pulmonale, lung pathology, value disorder, left to right shunt
30
What are symptoms of right sided heart failure?
Congestion/edema of peripheral tissues, as cites, hepatosplenomegaly
31
Is there a lot of or little pulmonary congestion in pure right sided heart failure?
Minimal
32
When is a congenital heart disease present?
At birth (genetic or developmental)
33
Orthopena is associated with what kind of heart failure?
Left sided heart failure
34
What is the main sign of Left sided heart failure?
Left ventricular hypertrophy and then possibly dilation in the later stages
35
Left ventricular hypertrophy due to left sided heart failure may eventually lead to what other system?
Pulmonary edema
36
If what kind of heart failure do you see orthopnea and rales in the lungs?
Left sided heart failure
37
What percent of all birth defects are congenital heart disease?
30%
38
What % of cases are idiopathic for congenital heart disease?
90%
39
What kind of heart defect causes half of congenital heart disease?
Septal, (ventricular and atrial)
40
Right to left shuts in congenital heart disease are caused by what ?
Blood bypassing the lungs causing Cyanosis (dusky blue color"
41
What are the causes of right to left shunts in congenital heart disease?
Teralogy of Fallot or transposition of great arteries
42
What is more common, right to left shunts, left to right shunts, or obstructed flow?
Left to right shunts
43
What is the cause of left to right shunts in congenital heart disease?
Pulmonary hypertension
44
What are the cause of obstruction of flow in congenital heart disease?
Valvular stenosis or aortic coarctation
45
In left to right shunts what is the most common abnormality?
VSD
46
What is the tetralogy of Fallot ?
VSD, Right ventricular outflow obstruction, overriding aorta, Right ventricular hypertrophy
47
What is the most common congenital heart Disease to cause cyanosis?
Tetralogy of Fallot
48
A boot shaped heart is associated with what ?
Tetralogy of Fallot
49
What is transposition of the great arteries?
The arteries connect to the wrong locations
50
Where do the arteries connect in the transposition of the great arteries ?
RV------>Aorta and LV------> Pulmonary artery
51
What congenital heart disease is :incompatible with postnatal life" and shunting is required?
Transposition of the great arteries
52
What is the life expectancy of a baby with transposition of the great vessels if it is left untreated?
Less that 1 month
53
What is aortic coarctation?
NARROWING of the aorta
54
Who is aortic coarctation mote common in? (2)
Males, tuner syndrome
55
What kind of aortic coarctation is proximal to a PDA?
Infantile
56
What kind of aortic coarctation is near the ligamentum arteriosum? It is also usually asymptomatic
Adult
57
More than half the people with aortic coarctation also have what?
Bicuspid aortic valve
58
What are the symptoms of aortic coarctation?
Weak lower extremity pulses and cyanosis, systolic murmurs/thrills
59
Balloon dilation is associated with what?
Aortic coarctation treatment
60
Cardiac mooches uses what form ox oxidation in ischemic heart disease?
Oxidative phosphorylation
61
Ischemia produces dysfunction in what amount of time ?
1-2 min
62
Ischemia produces necrosis is what amount of time ?
20-40 min
63
What is common in 90% of all ischemic heart disease?
Coronary artery disease
64
What specifically is the most common cause of Death in the United States?
Ischemic heart disease
65
Cardiac syndromes develop from what?
A decrease in cardiac blood supply
66
Are acute coronary syndromes (cardiac syndromes) medical emergencys?
Yes
67
What are the 4 things that are associated with cardiac syndromes. ?
Angie pectoris, acute myocardial infarction, sudden cardiac death, and Chronic IHD
68
What are the 3 parts of coronary atherosclerosis ?
Inflammation, thrombosis, vasoconstriction
69
At what percent occlusion do you see angina pectoris?
70 or higher
70
What are symptoms of angina pectoris?
Sub-sternal chest pain, and referred pain to the jaw, shoulders, back and LEFT arm
71
What kind of angina pectoris is episodic and exertional and relieved with rest and vasodilators ?
Stable (typical) angina
72
What kind of angina is associated with vasospasm at REST and responds to vasodilators?
Variant (Prinzmetal) angina
73
When do we see unstable angina?
90% or more occlusion
74
What kind of angina is provoked by decreased exertion?
Unstable angina
75
What is it called when there is 70% occlusion causing angina
Critical stenosis
76
In what population is angina pectoris less predictable and my have no angina at all
Woman
77
What are symptoms of angina pectoris is woman?
Lower chest or epi gastric pressure or discomfort, upset stomach
78
What is the most Common case of and MI?
90% are due to an acute thrombosis within a coronary artery
79
What percent of the 1.5 million M.I. Are fatal?
1/3
80
What are risks of MI's?
Males 40-60, posmenapausal woman, smoking, diabetes, sickle cell disease.
81
Where are 40-50% of MI?
Left anterior decending coronal artery
82
What are treatments for MI's ?
CPR, defibrillation, thrombolytic or vasodilator meds, angioplasty, stent, bypass
83
What kind of pain is associated with an MI?
Crushing pain
84
What are the symptoms of chronic ischemic heart disease ?
Contractile dysfunction, myocardium is weak, progressive heart failure
85
Fibrinous inflammation is associated with what kind of heart problem
Chronic ischemic heart disease
86
What is the laboratory diagnosis of a MI?
CK-MB
87
A sustained arrhythmia leading to death is called what?
Sudden cardiac death
88
Are there any symptoms in the previous 24 hours before a sudden cardiac death?
No
89
What is associated with SCD?
Asystole, v fib
90
A 15 year old male with an underdeveloped chest that has no structural damage to his heart could die from what?
Commotio cordis
91
That % of commotio cordis are lethal?
65%
92
Cardiac de compensation is associated with what?
Hypertensive heart disease
93
Systemic hypertensive heart disease produces what?
Left sided heart disease
94
What are complications of systemic hypertensive heart Disease ?
CHF, Arrhythmia, stroke, renal failure
95
Pulmonary hypertensive heart disease produces what?
Right sided heart disease
96
Pulmonary hypertensive heart disease in common in who?
People with CF
97
What kind of pulmonary hypertensive heart disease is associated with a saddle embolism?
ACute (large PE)
98
What kind of valvular heart disease is associated with narrowing and failure to completely open?
Stenosis
99
What kind of valvular heart disease is associated with calcination and fibrosis and is a chronic progression ?
Stenosis
100
What kind of valvular disease is a failure to aropriately close?
Insufficiency
101
What kind of valvular heart Disease is associated with turbulent flow ?
Murmur
102
What is a thrill?
Turbulence leading to palpable vibration
103
What is the most common cause of aortic valve stenosis?
Calcific aortic stenosis
104
In late calcific aortic stenosis what is a symptom?
Left ventricular hypertrophy, Ca++
105
Calcific aortic stenosis is common in who?
Older adults
106
Rheumatic valvular disease is caused by what?
Group A Betta hemolytic strep (GABHS)
107
What are symptoms of rheumatic valvular disease?
Carditis, migratory polyarthritis, Sydenham's chorea, skin rash
108
Where in the heart does most cases of rheumatic valvular disease effect> ?
Mitral valve
109
What is associated with acute rheumatic heart disease?
Aschoff bodies
110
Rheumatic heart disease = ?
Pancarditis
111
Rheumatic mitral stenosis gives what appearance >?
Fish mouth or buttonhole
112
Scarlet fever is a reaction to what?
GABHS
113
Scarlet fever is most common is who?
Kids
114
A pink punctuate skin rash is associated with what?
Scarlet fever
115
What kind of strains of GAGHS are associated with scarlet fever?
Erythrogenic toxin
116
Multiple sandpaper like spots on the neck chest axillary groin and thighs are associated with what ?
Scarlet fever
117
What rash of the face is associated with scarlet fever?
Circumoral pallor
118
What is an infection of the interior heart chambers?
Infective endocarditis
119
What is the most common cause of infective endocarditis?
Bacteria
120
What are symptoms of acute infective endocarditis? And what causes it ?
Destructive, virulent, staph Aureus
121
What causes subacute infective endocarditis?
Step Viridans
122
Where in the heart is infective endocarditis more common?
Aortic and mitral valves
123
What is the most common prosthetic cardiac values?
Mechanical
124
What causes a blender effect?
Thrombosis and hemolysis
125
What is the most common type of cardiomyopathy?
Dilated (90%)
126
What are symptoms of dilated cardio myopathy?
Dilation of all chambers, systolic dysfunction,
127
What is the cause of hypertrophic cardiomyopathy /?
Genetic mutation, most commonly G-myosin
128
What cardio myopathy is associated with a HARSH murmur and a banana like left ventricle
Hypertrophic cardiomyopathy
129
What is the most least common form of cardiomyopathy?
Restrictive
130
What are symptoms of restrictive cardiomyopathy?
Diastolic dysfunction, stiff myocardial, amyloidosis
131
What is the most common form of pericarditis?
Viral
132
Atypical chest pain and friction rub are associated with what?
Pericarditis
133
What is the most common site for chance mets for the heart?
Lung (melanoma)
134
What is the most common primary cardiac neoplasm?
Angiosarcoma
135
What are benign cardiac tumors in adults?
Myxoma is most common, fibroma, lipoma
136
What is the most common benign tumors in kids?
Rhabdomyoma
137
Where are mixomas mc found?
Left atrium
138
What is a cardiac neoplasm that is mobile?
Myxoma
139
What appearance do Myxomas have?
Gelatinous
140
What is the short them pro em with cardiac transplantation ?
Rejection
141
What will happen do a transplanted heart after long enough
Allograft arteriopathy, stenosis of the coronary arteries
142
When one gets a transplant what goes their mortality rate go down to?
20%
