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Patho Test 3: 1
Cardiac
Question | Answer |
---|---|
What Causes myocarditis? | Bacteria, fungal, protozoan, and viral infections |
What can also cause myocarditis? | Rheumatic fever, diptheria, heat stroke, and radiation |
WHat is myocarditis? | Inflammation of the myocardium, which is the heart muscle |
Pericarditis? | inflammation of the pericardium |
What can cause pericarditis? | TB, Mycosis, collagen disease, urmeia, fungi, neoplosms, radiation, traum, MI it has a variety of causes |
What are the two main clinical manifestations? | Pain, and a friction rub |
What do you do to diagnose pericarditis? | EKG, Echo CT, MRI |
In Pericarditis what falls and what rises pressure wise? | Falling arterial pressure and rising venous pressure you also have distant heart sounds |
How do you treat Pericarditis | Bedrest, Meds-analgesics, NSAID's helps w/ inflammaiton, corticosteroids, ABT, antipyretics |
Chronic Pericardites | inflammation that has thickened the pericardium, s/s are edema, crackles |
How do you preven Mycocarditis? | Immunizations, increase physiscal activity, avoid competitive sports,gradually increase activity |
what is endocarditis? | attack of organism, gets in body and is a bacterial invasion,can get in through mouth or surgery, in blood stream, |
who is endocarditis common in? | older people and high instance of IV drug use |
how do you diagnose Endocarditis? | H&P blood culture, echo and CT |
what is the first s/s of endocarditis? | Flu like symptoms, splinter hemmorages of under fingernails, roth spots in retina, petechiae in conjunctiva |
Complications of Endocarditis? | Mycardial erosoin, which is bacteria is hanging from heart valves treat with antibiotics before invasive procedures |
What is Pericardial effusion? | fluid in the pericardial cavity, may accompany CHF, Heart surgery, trauma, also renal failure |
S/S of pericardial effusion | sudden or gradual, can result in cardiac tamponade |
What is cardiac Tamponade? | Muffled heart sounds, falling aterial pressure, narrowed pulse pressure, rising venous pressure ect.. these are related to not getting blood out: Dyspnea, pain, anxiety, syncope, distened neck veins, edema |
Pericardial Effusion assessmetn and dx and management | GET TRAY READY, EKG, examine fluid that is withdrawn |
Cardiomyopathies: primary and secondary | Primary: Heart muscle diseases of unknown origin, silent onset, so s/s until disease is well advanced Secondary:OUtside of heart, MI and have complications because of another cardiovascular disease |
There are 3 types of cardiomyopathies list them | dilated, hypertrophic, restrictive |
Hypertrophic | thickend hyper kinetic ventricular muscle mass, uncoordinated contractions and impaired relaxation |
s/s of hypertrophic | A fib is precursor to sudden death, dyspnea is most common, chest pain, fatigue, syncope |
How do you treat hypertrophic? | Beta blockers, ca channel blockers, surgical removal of part of mycardium, have to put in automatic internal defiblilator |
Dilated cardiomyopathy | Most common, dilation of all 4 chambers, cardiac failure, initation is alcohol, cocaine, genetic, pg, and aging, DM or thyroid |
Dilated what happens to heart? | Heart becomes enlarged and the wall becomes thinner |
S/S of dilated | Weakness, fatigue, periphial edema, tachycardia, leads to death |
TX of dilated | releave heart failure adn work laod with digoxin, diuretics, and afterload, reducing drugs, or heart transplant |
Restrictive | rarest form, stiff ventricular impaired diastolic feeling, it gets fibroused and rigid adn non compliant, major diff, is restrictive diastolic feeling, low stroke volume and CHF |
Phase o | rapid depolariztion ions switch side |
Phase1 | early repolarization peak of the action potential stops sodium channels with decrease in socdium permability |
phase 2 | the plateau, caused by the slower calcium sodium channels opening, calcium plays a role in the contractility in the cardiac muscle |
phase 3 | final rapid repolariaztion down slope of action potential, calcium sodium channels close and increase K permebility |
phase 4 | resting, sodium out potassium in |
what are the two catagories of dysrythmia | Superventricular and Ventricular |
EKG | a picture of the electrical conduction of the heart. easy quick 2,3, or 12 leads |
Ejection fraction | amount of blood % beening pumped in the first quarter of systole normal is 60-80 %. |
Cadiac reserve | how much an individual can increase CO as needed |
preload | amount of blood the heart must pump with each beat |
afterload | the pressure needed for the heart to pump blood into the aorta |
Cardiac contractility | heart can change the force of contraction without changing resting |
inotropic | something that can modify the contractility |
heart rate | the frequency the ventricles contract, the blood is ejected , filling time |
dopomine | increases blood pressure and contractility |
arterial circulationq | impairment can lead to echemia and infarction |
what are the three causes of hypercholestrolemia | genetics, nutrition and metobolic disease |
Risk factors of coronary heart disease | nonmodifiable risks-less than 45 for men and 55 for womenlipid risk factors- total chlosterol less than 200, LDL cholestorol is less than 130, Tri- less than 150, HDL greater than 40Nonlipid risk factors- hypertention less than 140/90, cig smoking,DM, |
Probable risk factors | Lipoproteins, small LDL particles, HDL subtypes, apolipoprotein B, Homocysteine, Fibrinogen, High-sensitivity C-reactive protein, Impaired fasting glucose |
CAD | largest killer in the US, great advances in treatment but no decline in death rate |
two types of lesions in CAD | stable and unstable |
stable angina | eschemia r/t athoersclerosis and phasospasms and thrombus |
what brings on stable angina | activity stress and cold |
what relieves angina | rest |
where is the pain located with stable angina | anywhere from the neck to the stomach |
how do you treat stable angina | prevent MI stop activity beta blocker CABG PTCA |
CABG | coronary artery bypass-graft |
Variant angina | caused by vaasospasma with or without the disease looks like Reynolds in heart |
treatment for variant angina | calcium channel or nitrate |
Silent mydocaridial eschmeia | ischemia without angina, common in patients with Dm, old MIS, and elderly |
unstable angina | new angina or recent accelerted angina, caused by plaque distrubtiion or repair |
Diagnosis for unstable angina | EKG, BP, and Cardiac markers |
Segment elevation MI | eschmic death of myo tissue, may or may not have a T wave |
S/S of segment elevation | abrubt onset, extreme pain, SOB, weakness, naseua and vomiting, tachecardia, feelings of impending dome, shock, sudden death due to dysrythmias |
How long do you have to prevent permanent damage to prevent the segment elevation MI | 1 hour (15-20) min is ideal |
Myoglobulins (MB) | cardiac marker; O2 carrier, released 1 hour after MI, not the best indicator |
Creatine Kinese (CK) | released 4-8 hours after MI, |
What are the most specific cardiac markers for MI? | CK and MB |
Troponine | Cardiac specific and peaks later, its the best one to tell how long ago the MI happened, once it gets to this level its pass the level of treatment |
Mitral stenosis | opening being narrowed, obstruction of blood flow from the LA to the LV |
If Mitral stenosis backs up where does it go? | lungs |
Diagnosis of Mitral Stenosis | H/P- Echo, heart cath |
Mitral Regergetation | Rheumatic fever |
Endocarditis | congenital heart defects, diet pills |
Mitral regergetation backs up it goes where? | left atrium |
Aortic Stenosis | calcification of the valves also narrowing of the aortic valve |
What does aortic stenosis cause the left ventrivcle to do? | thicken |
Aortic stenosis is most common with what ages? | 70-90 |
Aortic regergetation | etiology-endocarditis, congenital hear defects, syphllis, aneurysms, aging, Marfins, |
In aortic regergetation it will back up where | LV |
S/S of aortic regergettation | most patients do not have smyptoms, water hammer pulse, visible pulses, murmur, angina, fainting |
Diagnosis of aortic regergetation | Echo, EkG, TEE, Stress test, and heart cath |
Valve replacement: 2 types | Disk Mechanical valves and Ball and socket |
How do you treat Aortic Regurgitation? | Treat CHF and dysthrithmias, also can do aortic valve replacement |