Cardiology
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| CHF effect on risk of sudden heart failure death: | increases risk x8
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| lifetime risk devt of A-fib | 1 in 4
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| Most common causes of heart failure: | Ischemic cardiomyopathy; Valvular cardiomyopathy; Hypertensive cardiomyopathy (diastolic non-compliant CHF more common in hypertension than Systolic (end stage hypertensive dz))
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| Structural causes of heart dz | myocardial dz; pericardial dz
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| Types of myocardial dz | Cardiomyopathy; myocarditis
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| 3 functional categories of cardiomyopathy | dilated; hypertrophic; restrictive
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| 3 types of myocarditis | infectious; toxic; idiopathic
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| 3 types of pericardial dz | Pericarditis; Pericardial effusion / tamponade; Pericardial constriction
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| CHF risk factors | Age; Hypertension; Tobacco abuse; Diabetes mellitus; Obesity; ETOH/Substance abuse
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| CHF precipitators | Coronary artery dz/MI; Valvular or congenital heart dz; Hypertension….diastolic dysfn; ETOH/substance abuse; Viral Infxns; PG; Idiopathic
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| Most common causes of heart failure: | Ischemic cardiomyopathy; Valvular cardiomyopathy; Hypertensive cardiomyopathy
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| Which type of non-compliant CHF is more common in HTN? | Diastolic more than Systolic (end stage hypertensive dz)
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| What precipitates conduction system problems? | Coronary artery dz/MI (ischemia induced); congenital; anything that causes CHF
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| Deoxygenated blood draining from the heart itself enters the right atrium via: | the coronary sinus & thebesian veins
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| Second most common cause of sudden death in young adults | Anomalous coronary arteries (4-15% of young people with sudden cardiac death); 1-2% of population
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| Which valves do/do not have chordae/papillary mx? | AV valves do; semilunar valves do not
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| period of ventricular contraction | systole
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| period of ventricular relaxation | diastole
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| the load that stretches the cardiac muscle prior to contraction | preload
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| the resistance against which the left ventricle must contract | afterload
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| ability of cardiac muscle to shorten, when given a load | myocardial contractility
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| myocardial contractility is increased by: | sympathetic stimulation/action
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| myocardial contractility is decreased by: | myocardial injury
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| afterload comprises: | blood volume/viscosity; resistance in aorta & other peripheral vessels
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| Preload is increased by: | inspiration or increasing venous return to right heart)
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| Amount of blood remaining after ejection: | end systolic volume
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| In diastole, _____% of ventricular filling occurs before atrial contraction | 80
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| SV= | EDV (end diastolic volume) – ESV (end systolic volume)
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| CO = | HR x SV (normal about 5 L/min)
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| Adult normal cardiac blood volumes: | SV=70ml, EDV=135ml, ESV=65ml, CO=5L total blood
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| volume of blood ejected from each ventricle during one minute | Cardiac output
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| volume of blood ejected with each heartbeat | Stroke volume
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| Starling’s Law: | SV increases as the EDV increases
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| Ejection Fraction formula: | EF% = SV/EDV
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| A quantitative measure of contractility | Ejection Fraction
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| Normal EF | 67% (at DUMC: >55%)
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| Annulus: | fibrous ring surrounding each of the 4 cardiac valves; fn: to provide structural support to the heart
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| narrowing or obstruction to forward flow while valve is open | Stenosis
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| backward leakage during time when valve is closed | Regurgitation / Insufficiency
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| S1 = _____ valve closing | Mitral (Systole)
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| S2 = _____ valve closing | Aortic valve closing (diastole)
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| S3 may indicate: | CHF (sounds like: Ken-Tuc-Key)
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| S4 may indicate: | HTN or CAD (sounds like: Tenn-es-see)
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| Which heart sound is always pathological? | S4
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| Left & right coronary arteries arise from what part of the aortic root? | Sinuses of Valsalva
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| Branches off the left main coronary artery | LAD; Left circumflex
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| Right Dominant: Septum supplied by: | Distal branches from RCA (supply the septum 70%)
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| Left Dominant: Septum supplied by: | Distal branches from LCx (supply the septum 20%)
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| SA Node is supplied by: | RCA 60% of the time & by LCX 40% of the time
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| AV node supplied by: | dominant artery (RCA or LCx)
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| small vascular channels that interconnect the normal coronary arteries | Collateral Vessels
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| Function of collateral vessels in normal myocardium | Nonfunctional because no pressure gradient is present
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| S/S of conduction problems | palpitations; dizziness; presyncope/ syncope
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| Myocardial dz categories | Cardiomyopathy; Myocarditis
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| DM increases risk/incidence of: | Diffuse dz; small vessel dz; CHF & death rates post MI; death or MI post CABG & PCI
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| Recommended for sedentary lifestyle | Devoted exercise 30 min/day, 5 d/wk; initially under med supervision
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| Causes of noncardiac CP | Pericarditis; myocarditis; MVP; chostocondritis; C- or T-spine dz/thoracic outlet; GI/gall bladder; PE; pneumonia; pneumothorax
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| Pericardium anatomy | complex = outer fibrous layer (flask-shaped tough outer sac connected at diaphragm, sternum, and costal cartilage) and inner serous layer
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| Pericardial friction rub is pathognomonic for: | acute pericarditis
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| Coronary artery at left lateral wall | left marginal
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| Coronary artery at posterolateral surface | left circumflex
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| Coronary artery at posterior heart, AV node | right coronary
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| Coronary artery at anterior wall of LV, anterior2/3 of intraventricular septum | LAD
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| RCA supplies: | sinus node, AV node, bundle of His
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Created by:
Abarnard
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