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Cards A&P and Exam


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