Week 6b:

Question 1

the accumulation of fluid in the pericardial cavity

Answer 1

pericardial effusion

Question 2

slow or rapid compression of the heart due to the accumulation of fluid, pus or blood in the pericardial sac

Answer 2

cardiac tamponade

Question 3

an acute inflammatory process of the pericardium that can be acute, chronic or constrictive

Answer 3

pericarditis

Question 4

the result of calcified scar tissue that develops between the visceral and parietal layers of the serous pericardium. Cardiac output and cardiac reserves become fixed

Answer 4

constrictive pericarditis

Question 5

what is friction rub associated with?

Answer 5

pericarditis

Question 6

what is beck’s triad and what is it associated with?

Answer 6

1. Elevated JVP
2. Hypotension
3. Decreased heart sounds (with narrowing pulse pressure)
   associated with cardiac tamponade

Question 7

chronic stable angina

Answer 7

associated with a fixed coronary obstruction that produces a disparity between coronary blood flow and metabolic demands of the heart

Question 8

stable angina

Answer 8

the initial manifestation of ischemic heart disease in approximately half of people with CAD. Mostly starts with exertion or stress. relieved by rest.

Question 9

unstable angina (acute coronary syndrome)

Answer 9

unexpected chest pain that can occur while resting or is not relived by rest

Question 10

what are the 3 characteristics of pain with unstable angina?

Answer 10

1. occurs at rest and lasts more than 20 minutes
2. severe pain described as frank pain with new onset
3. pain is more severe, prolonged and or frequent than previously experienced

Question 11

what are the 3 causes of unstable angina?

Answer 11

1. atherosclerotic plaque disruption
2. platelet aggregation
3. secondary hemostasis

Question 12

what 3 types of drugs are used to prevent MIs?

Answer 12

1. aspirin
2. Ticlopidine and clopidogrel (ADP inhibitors)
3. platelet receptor antagonists (abciximab)

Question 13

what is the preferred anti platelet agent for preventing platelet aggregation in persons with CAD?

Answer 13

aspirin

Question 14

what preventive medications may be used when aspirin is contraindicated?

Answer 14

Ticlopidine and clopidogrel

Question 15

what are some of the manifestations of a ST-segment elevation MI?

Answer 15

• abrupt onset
• severe crushing pain, usually substernal. radiating to the left arm, neck or jaw
• GI complaints
• fatigue and weakness
• tachycardia, anxiety, restlessness, feeling of impending doom,
• pale, cool and moist skin

Question 16

what populations present with atypical MI symptoms?

Answer 16

elderly, women, heart failure, diabetes

Question 17

transmural infarcts

Answer 17

• involve the full thickness of the ventricular wall

- occurs when there is an obstruction of a single artery

Question 18

Subendocardial infarcts

Answer 18

• involve the inner one third to one half of the ventricular wall
• occur more frequently in the presence of severely narrowed but still patent arterial ductus

Question 19

What is the treatment for MI?

Answer 19

M: Morphine
O: Oxygen
N: Nitrates
A: Aspirin/Antiplatelets

Question 20

Persons with evidence of infarction (i.e., cardiac biomarker) should receive immediate reperfusion therapy with a fibrinolytic agent within?

Answer 20

30 minutes

Question 21

Persons with evidence of infarction (i.e., cardiac biomarker) should receive immediate percutaneous coronary intervention within?

Answer 21

90 minutes

Question 22

How is pain with MIs managed?

Answer 22

combination of nitrates, analgesics (morphine), oxygen, and beta blockers

Question 23

myocarditis

Answer 23

inflammation of the heart muscle and conduction system without evidence of myocardial infarction

Question 24

primary cardiomyopathies

Answer 24

heart muscle diseases of unknown origin

Question 25

secondary cardiomyopathies

Answer 25

conditions in which the cardiac abnormality results from another cardiovascular disease such as MI

Question 26

a heterogenous group of diseases of the myocardium associated with mechanical and/or electrical dysfunction that usually exhibit inappropriate ventricular hypertrophy or dilation and that are due to a variety of causes that are frequently genetic

Answer 26

cardiomyopathies

Question 27

which type of cardiomyopathy involves disproportionate thickening of the ventricular septum and intermittent left ventricular flow obstruction?

Answer 27

hypertrophic cardiomyopathy

Question 28

what medications are used for hypertrophic cardiomyopathy?

Answer 28

beta adrenergic blockers to prevent outflow obstruction

Question 29

what are the symptoms of hypertrophic cardiomyopathies?

Answer 29

dyspnea, chest pain during exertion, exercise intolerance, syncope and palpitations. Can also be asymptomatic

Question 30

colonization of heart valves and the mural endocardium by a microbial agent

Answer 30

infective endocarditis

Question 31

what type of infections cause infective endocarditis?

Answer 31

staphylococcal and streptococcal infections

Question 32

What are the signs and symptoms of infective endocarditis?

Answer 32

fever, signs of systemic infection, anemia, a change in the character of an existing heart murmur and evidence of embolic distribution of the vegetative lesions

Question 33

a complication of the immune mediated response to group A hemolytic streptococcal throat infection

Answer 33

rheumatic fever

Question 34

acute stage of rheumatic fever

Answer 34

- history of an initiating strep infection | - involves mesenchymal connective tissue of the heart, blood vessel, joints and subcutaneous tissues

Question 35

recurrent phase of rheumatic fever

Answer 35

extension of the cardiac effects of the disease

Question 36

chronic phase of rheumatic fever

Answer 36

permanent deformity of heart valves

Question 37

radiographic signs for PE are?

Answer 37

not a specific or a sensitive test for PE

Question 38

stenosis

Answer 38

narrowing of the valve opening so it does not open properly

Question 39

incompetent or regurgitant valve

Answer 39

distortion of the valve so it does not close properly. permits backward flow to occur when the valve should be closed.

Question 40

what occurs as mitral valve stenosis progresses?

Answer 40

symptoms of decreased cardiac output which occur during extreme exertion

Question 41

what happens in the late stages of mitral valve stenosis

Answer 41

pulmonary hypertension

Question 42

mitral valve stenosis may eventually lead to?

Answer 42

right sided heart failure

Question 43

mitral valve regurgitation can occur...?

Answer 43

After MI, valve perforation in IE, or ruptured chord tendinae in mitral valve prolapse

Question 44

mitral valve regurgitation leads to?

Answer 44

a rapid rise in left atrial pressure and pulmonary edema

Question 45

what happens to the left ventricular wall in aortic valve stenosis?

Answer 45

the left ventricular wall becomes thicker (hypertrophy) but a normal chamber volume is maintained

Question 46

incompetent aortic valve that allows blood to flow back to the left ventricle during diastole

Answer 46

aortic valve regurgitation

Question 47

what can result due to aortic valve regurgitation?

Answer 47

pulmonary edema

Question 48

congenital defects that increase resistance to aortic outflow increase?

Answer 48

left to right shunting

Question 49

congenital defects that obstruct pulmonary outflow increase?

Answer 49

right to left shunting

Question 50

an opening in the atrial septum permitting free communication of blood in the atria.

Answer 50

atrial septal defect

Question 51

patent ductus arteriosus

Answer 51

persistence of the normal fetal vessel that joins the pulmonary artery to the aorta

Question 52

what happens as a result of higher aortic pressure and PDA?

Answer 52

blood shunts left to right through the ductus from the aorta to the pulmonary artery

Question 53

PDA leads to increased ______ _____ disease

Answer 53

pulmonary vascular disease

Question 54

a narrowing of the aorta at varying points anywhere from the transverse arch to iliac bifurcation

Answer 54

coarctation

Question 55

what are the 4 characteristics of the tetralogy of fallot?

Answer 55

1) ventricular septal defect 2) right ventricular outflow tract obstruction 3) overriding aorta 4) right ventricular hypertrophy