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Patho chap 16
ischemic heart disease
| Question | Answer |
|---|---|
| three layers of the heart are | epicardium, myocardium, and endocardium |
| systole | when the heart muscle contracts and the pressure is highest in the blood vessels |
| diastole | when the heart muscles relax, and pressure is lowest in the blood vessels |
| the pulmonary circuit | a low pressure system where the blood moves towards the lungs for gas exchange |
| the systemic circuit | a high pressure system where blood moves towards the heart |
| blood flow through the heart | IVC/ SVC -> RA -> tricuspid valve -> RV -> pulmonary valve -> pulmonary arteries -> pulmonary veins -> LA -> mitral valve -> LV -> aortic valve -> aorta |
| which coronary artery supplies the left ventricle and is most commonly involved in an MI? | left anterior descending artery (LAD) |
| what is the LAD nickname? | widow maker |
| components in the conduction system | SA node, AV node, left & right bundle of HIS, perjunkie fibers |
| average heart rate if the impulse originates in the SA node | 60 - 100 bpm, pacemaker of the heart |
| average heart rate if the impulse originates in the AV node | 40- 60 bpm |
| average rate if the impulse originates at the bundle of HIS and perkinjie fibers | 30-40 bpm |
| 3 main ions involved in cardiac muslce action potential are | sodium, potassium and calcium |
| depolarization | contraction -- when Na enters and electrical impulse begins |
| repolarization | relaxation -- when K exits the cell as electrical impulse goes to initial resting state |
| what occurs when an action potential is interrupted by a second impulse? | a dysrhythmia (abnormal rhythm) occurs - enables heart to relax without being reactivated and enables the heart to fill with blood |
| what are symptoms of decreased cardiac output observed with dysrhythmias? | sleepiness, shortening of breath, weak pulses, low urine output |
| P wave | atria depolarization |
| QRS wave | ventricle depolarization and atria repolarization |
| T wave | repolarization of the ventricles |
| U wave | not visible unless low K |
| a flattened T wave noticed on an EKG indicates | hypokalemia |
| if SA impulse fails to be conducted, what takes over? | AV node |
| atrial fibrillation | the most common arrhythmia in the clinical setting and can cause blood clot formation |
| 3 main casues of myocardial ischemia | 1. coronary thrombosis <- can block perfusion to pulmonary artery 2. atherosclerotic plaque <- plaque can shrink & obstruct all sizes of arteries 3. coronary artery vasospasm <- spasm stops blood flow |
| stable angina | consistent, chronic chest pain that often occurs with physical or emotional stress and it is relived by rest or vasodilators |
| unstable angina | a medical emergency as it could progress to an MI |
| prinzmetal's angina | a variant of angina that occurs during from vasospams |
| most common sign of Levine's sign | fist over sternum |
| classic signs of angina | chest pain w/ exertion, crushing pain on left side of chest, may radiate to shoulder arm, jaw or back, diaphoresis, dyspenia, pallow |
| common anginal equivalents | signs of myocardial ischemia that differ from classic chest pain |
| who most commonly experiences the symptoms of anginal equivalents | women and elderly |
| amount of damage from an MI depends on what 3 factors | locaiton, length of time, collateral circulation |
| 3 zones of an Mi | zone of infarction, zone of injury, zone of ischemia |
| NSTEMI | partial coronary artery occlusion |
| STEMI | complete coronary artery occlusion |
| why is STEMI occlusion most serious? | because it's infarcting all the way through |
| changes on an EKG with a NSTEMI | ST depression and T inversion |
| changes on an EKG with a STEMI | ST elevation, T wave inversion, pathologic Q waves |
| 2 diagnostic tests are used together to confirm an MI | myoglobin & CK- MB with a cardiac troponin |
| reperfusion injury | ischemic myocardial tissue that is damaged by normalized levels of oxygen and nutrients following an MI |
| endocarditis location affected | valves |
| endocarditis causes | IV drugs, prosthetic valves, staph and GABHS |
| endocarditis symptoms | new / worsening heart murmur, osler's nodes, roth spods |
| myocarditis location affected | myocardium |
| myocarditis causes | viral |
| myocarditis symptoms | arthralgia, palpations |
| pericarditis location affected | pericardium or epicardium |
| pericarditis causes | MI, infection, radiation or surgery |
| pericarditis symptoms | pericardial friction rub, chest pain worsens with deep breathing |
| what can be a worsening complication of a pericardial effusion | cardiac tamponade |
| what does Beck's triad indicate | acute cardiac tamponade |
| 3 symptoms of Beck's triad | distention of jugular veins, low blood pressure, muffled heart signs |
Created by:
sammy.e7
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