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72 Cards in this Set
- Front
- Back
ischemic heart disease:
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-disorder of myocardial blood flow due to coronary atherosclerotic plaques
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What disease is the #1 cause of death in the U.S.?
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cardivascular disease
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5 factors that affect coronary perfusion:
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1. coronary atherosclerosis
2. platelet aggregation and thrombus formation 3. coronary spasm 4. nonatherosclerotic coronary disease 5. hemodynamic alterations |
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What are the 2 types of CAD?
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chronic ischemic heart disease and actue coronary syndrome
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What are the 3 types of chronic ischemic heart disease?
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1. stable angina
2. variant angina 3. silent myocardial ischemia |
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Causes of nonatherosclerotic coronary disease:
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1. SLE
2. polyarteritis nodosa 3. cocaine vasospasm (can cause hole in septum) |
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polyarteritis nodosa:
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-a serious blood vessel disease
-Small and medium-sized arteries become swollen and damaged when they are attacked by rogue immune cells |
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SLE:
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= Systemic Lupus Erythematosus
-an inflammatory disease of connective tissue -primarily in women -characterized especially by skin rash, arthritis and inflammation of different organs |
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List the 4 ischemic syndromes:
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1. angina pectoris
2. myocardial infarction 3. chronic ischemic heart disease 4. sudden cardiac death |
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angina pectoris:
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-chest pain form intermittent myocardial ischemia
-no cell death occurs -referred pain is felt-neck, jaw, arm |
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What are the 3 patterns of angina pectoris?
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1. stable angina
2. Prinzmetal's variant angina 3. unstable angina |
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stable angina:
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-most common
-stenosed arteries dilate poorly -occurs during stressed situation Tx: rest and nitroglycerin |
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Prinzmetal's variant angina:
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-unpredictable attacks
-unrelated to emotion -significant atherosclerosis Tx: Ca channel blockers |
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unstable angina:
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-increasing frequency and severity
-close to causing death of myocaridal tissue |
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What is the risk of a myocardial infarction in males?
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> 1 in 5 by age 65
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What is the risk of a myocardial infarction in females?
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the risk gradually equalizes to males after menopause
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Describe the morphology of a myocardial infarction?
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1. occlusion of left (40-50%) or right (30-40%)anterior descending artery occurs
2. changes are generally not detectable for 6-12 hrs 3. fibrous scar tissue in 6 wks |
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Causes of a myocardial infartion:
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1. coronary atherosclerosis
2. plaque usually has caused at least 75% obstruction prior to MI 3. plaque rupture causing a thrombus |
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Symptoms of an MI:
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1. pain and shortness of breath
2. ECG wave and location changes 3. can also be known as "silent MI" 4. does not dertermine extent of injury 5. enzyme indication |
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What enzymes are indicated with an MI?
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SGOT and SGPT (nonspecific), AST, CK, LDH
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Why do most pts with MI die prior to the hospital?
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pt has either V-fib or a severe heart attack
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List the 5 main complications of an MI.
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1. arrhythmias
2. CHF 3. cardiogenic shock 4. ventricular ruture 5. thromboembolism |
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What is the mortality rate of MI's?
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35% mortality within one year
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Tx for an MI:
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-rest and pain relief (morphine), oxygen, sympathetic antagonists and nitrates, thrombolytics, balloon angioplasty (w/in 90 minutes), or CABG
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sudden cardiac death:
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-caused by a lethal arrhythmia
-ischemia, fibrosis and scarring, and electrolyte imbalance |
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What is a pt with chronic ischemic heart disease most likely to die from?
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CHF
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endocardial diseases:
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-causes inflammation and scarring and calcification
-congenital -mainly affects mitral and aortic valves (mostly left side) -common with stenosis and regurgitation |
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List the disorders of the mitral valve.
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1. stenosis
2. insufficiency 3. prolapse |
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mitral stenosis:
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-Rh fever
-increases LA pressure -causes pulmonary HTN, LA hypertrophy, atrial arrhythmias, diastolic murmurs -decrease of stroke volume dt inadequate filling |
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mitral valve insufficiency:
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-S/S similar to mitral stenosis
-LV dilates and hypertrophies trying to compensate |
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mitral valve prolapse:
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-valve balloons into LA during systole
-mainly in women ages 20-40 -usually asymptomatic -sometimes assoc with regurgitation |
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Name the (rare) complications of a mitral valve prolapse:
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endocarditis
regurgitation arrhythmias |
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What are the 2 aortic valve disorders?
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stenosis and insufficiency
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aortic stenosis:
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-high LV systolic pressure
-left hypertrophy -SYSTOLIC murmur -surgery needed for this condition -age related calcification |
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aortic insufficiency:
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-left heart failure
-DIASTOLIC murmur |
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Rheumatic heart disease:
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aka Rh fever
-caused by an infection of beta-hemolytic streptococcus -an auto-immune disease -antibiotic therapy -can also affect joints and kidneys |
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infective endocarditis:
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-vegitations found on endocardium and valves
-embolus formation -strep and staph -invasion of bloodstream by organisms (causes sepsis) |
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Which form of endocarditis has a high mortality rate?
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acute endocarditis
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What are some causes of infective endocarditis?
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overt infection
surgical and dental precedures IV drugs |
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subacute endocarditis:
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-more insidious (spreadable)
-organisms less virulent -occurs in hearts with preexisting cardiac disease |
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Diagnosis for endocarditis:
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-positive blood cultures
-results vary according to the type and location of the damage |
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treatment for endocarditis:
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-antibiotics
-valve replacement thereafter |
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myocarditis:
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-inflammation of heart muscle
-dilation of all chambers occur -caused mostly by viral infections and in immunosuppressed pts |
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cardiomyopathy:
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-noninflammatory disorder, effects heart muscle
-primary or secondary |
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3 types of primary cardiomyopathies:
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1. dilated or congestive
2. hypertrophic 3. restrictive (fibrosed, rigid) |
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dilated cardiomyopathy:
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-decreased pumping ability of ventricles due to dilation
-slowly progressive heart failure -heart transplantation may be necessary |
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4 causes of dilated cardiomyopathy:
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1. alcohol toxicity
2. genetics 3. pregancy complications 4. postviral myocarditis |
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3 causes hypertrophic cardiomyopathy:
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1. genetic
2. asymptomatic or outflow obstruction 3. uneven hypertrophy |
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Tx for hypertrophic cardiomyopathy:
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-little cardiac change to CHF
-Rx: Ca channel blockers and beta-adrenergic antagonists |
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secondary cardiomyopathy:
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-many known origins
-clinically similar to dilated type of primary |
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pericardial effusion:
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-accumulation of fluid in the pericardial cavity
-compresses heart chambers -generally indicates underlying disease process |
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cardiac tamponade:
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-life threatening type of pericardial effusion
-systemic venous congestion that reduced SV -aspiration is necessary for removal of fluid, pus, blood |
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2 types of pericarditis:
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acute and chronic
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chronic pericarditis:
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-increase in inflammatory exudates longer term than acute
-adhesive, constrictive -pericardiectomy may be necessary |
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exudates:
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-fluid released from the body with a high concentration of protein, cells, or solid debris
-classified as catarrhal, fibrinous, hemorrhagic, serous |
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acute pericarditis:
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-sudden increase in inflammatory exudates
-accompanied by chest pain, pericardial friction rub, ECG changes |
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How does an ECG change with an acute pericarditis?
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ST elevation
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causes of congenital heart disease:
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1. pregnant mother develops rubella w/in first trimester
2. drug and alcohol use by pregnant woman 3. genetic |
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List 6 types of acyanotic defects:
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1. atrial septal defects
2. ventricular septal defects 3. patent ductus arteriosis 4. coarctation of aorta 5. pulmonary stenosis or atresia 6. aortic stenosis or atresia |
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congenital heart defects:
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-produce their effects through abnormal shunting of blood and alterations in pulmonary blood flow
-classified as either acyanotic or cyanotic defects |
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acyanotic defects:
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-generally asymptomatic as long as flow is from left to right
-requires surgical repair Ex: left-to-right shunts |
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cyanotic defects:
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-sufficient unoxygengated blood mixes with oxygenated blood in the left side of the heart
Ex: right-to-left shunts with obstruction |
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ventricular defects:
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-most common
-frequently associated with other defects -S/S depend on the size of the defect and shunting -surgical repair is needed if it does not close |
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patent ductus arteriosis:
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-shunts from pulmonary artery to aorta beyond prenatal period
-spontaneously closes within 24-72 hrs of birth -systolic murmur (sounds like machinery) |
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Which are more likely to have coarctation of aorta-males or females?
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males are 3-4 times more likely than females
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Which acyanotic defect is associated with "notched ribs"?
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coarctation of aorta
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atresia:
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-the absence or closure of a normal body orifice or tubular passage such as the anus, intestine, or external ear canal
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2 types of cyanotic defects:
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1. tetralogy of fallot
2. transposition of great arteries |
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truncus arteriosis:
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-the arterial "trunk" frm the embryonic heart
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tricuspid atresia:
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-closure of the tricuspid valve
-congenital |
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Tetralogy of fallot consists of 4 congenital heart defects:
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1. ventricular septal defect
2. overriding aorta 3. pulmonary stenosis 4. RV hypertrophy |
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What is the treatment for tetralogy of fallot?
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surgery
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