Myocardial Perfusion Handout

Question 1

Cardiac muscle contains _______ but _______ t-tubules

Answer 1

fewer, larger

Question 2

True/False: Cardiac muscle cannot regenerate

Answer 2

False: It can regenerate, but only 1% per year

Question 3

True/False: Cariac muscle contains intercalated discs, but skeletal muscle does not.

Answer 3

True

Question 4

Normal lab values: Whoopee!

1. pH
2. PCO2
3. PO2
4. HCO3
5. %Sat

Answer 4

1. 7.35-7.45
2. 40 mmHg
3. 97 mmHg
4. 24 mEq/L
5. 95-98%

Question 5

What is the most commonly occluded coronary artery? What does it supply

Answer 5

LAD. It supplies the left ventricle

Question 6

What artery is the most common one to supply the AV and SA nodes?

Answer 6

RCA

Question 7

True/False: In angina, women tend to have left shoulder blade pain and men tend to have left arm pain.

Answer 7

True

Question 8

What is Levine’s sign

Answer 8

pt clenches fist over sternum

Question 9

What are the 2 things that relieve angina (if it is stable angina)?

Answer 9

rest and nitro

Question 10

What is prinzmetal angina

Answer 10

angina that only occurs at rest because of vasospasm

Question 11

What is the main important distinction between stable and unstable angina?

Answer 11

stable: happens at predictable rate pressure product (RPP)
unstable: doesn’t happen at a predictable RPP

Question 12

What is the most frequent cause of MI?

Answer 12

atherosclerotic heart disease with thrombus formation.

Question 13

The following symptoms occur most often in males or females?

1. SOB
2. weakness
3. heartburn
4. pain in arm
5. L shoulder blade pain
6. extreme fatigue

Answer 13

1. men
2. men
3. women
4. men
5. women
6. women

Question 14

True/False: The preload is the amount of blood in the ventricle before contraction and the afterload is the amount of resistance in the system.

Answer 14

True

Question 15

What will the central zone of infarct show on an ECG?

Answer 15

larger Q wave

Question 16

What will the zone of injury show on the ECG?

Answer 16

elevated ST segment in leads over this area

Question 17

What will the zone of ischemia show on an ECG?

Answer 17

as an inverted T wave

Question 18

What are the 3 main causes of valvular heart disease?

Answer 18

1. Congenital deformities
2. infection
3. disease

Question 19

When valve leaflets don’t close completely, resulting in regurgitation of blood behind the valve, this is termed…

a. stenosis
b. insufficiency
c. prolapse

Answer 19

b. insufficiency

Question 20

When there is a narrowing so that the valve will not fully open, causing the chamber behind the valve to push more forcefully, this is termed…

a. stenosis
b. insufficiency
c. prolapse

Answer 20

stenosis

Question 21

When mitral valve leaflets bulge back into left atrium, this is called…

a. stenosis
b. insufficiency
c. prolapse

Answer 21

c. prolapse

Question 22

True/False: Valve issues happen more on the left side than the right side of the heart.

Answer 22

True

Question 23

What are 2 compensatory mechanisms for valvular heart diseases?

Answer 23

ventricular hypertrophy

peripheral changes such as vasodilation

Question 24

True/False Dilated cardiomyopathy is an increase in heart size without an increase in chamber volume while hypertrophic cardiomyopathy is an increase in chamber volume without an increase in wall thickness.

Answer 24

False: Hypertrophic cardiomyopathy is an increase in heart size without an increase in chamber volume while dilated cardiomyopathy is an increase in chamber volume without an increase in wall thickness.

Question 25

What is the part of the heart damaged during restrictive cardiomyopathy and how is is damaged? What does it cause as a result?

Answer 25

The ventricles are damaged in that the compliance of the muscle is compromised and the walls become rigid. This causes backflow throughout the system.

Question 26

What is acute myocarditis often caused by? | What condition will it often follow? What condition is often concurrent with it?

Answer 26

caused by Streptococcal infection. | Often follows upper respiratory infection, often concurrent with pericarditis

Question 27

What is pericarditis? How are symptoms often relieved from it?

Answer 27

Acute inflammation of the pericardium. Symptoms can often be relieved with all fours position (unlike MI)

Question 28

What serious condition can a pericardial effusion cause? What kind of heart sound can it cause?

Answer 28

tamponade. Can hear a pericardial friction rub often.

Question 29

What disease does rheumatic heart disease often follow? What part of the heart does it usually affect?

Answer 29

strep throat. It affects the mitral valve usually and sometimes another valve.

Question 30

Infective endocarditis is caused by what agent(s)? | What is the primary cause?

Answer 30

bacterial or fungal. | Most often happens when infection is introduced directly into the blood stream.