Cardiovascular System 3, Heep, Survey of Western Clinical Sciences, Bastyr
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| Describe Coronary Heart Disease: | show 🗑
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| show | cardiac angina, MI, cardiac arrhythmias, heart failure and sudden death.
Risk factors for CHD:
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| Describe CHD: | show 🗑
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| show | ECG, Stress test, nuclear imaging and cardiac catheterization.
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| show | Ischemic heart diseases. Cardiac angina
Myocardial infarction
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| Define Ischemia: | show 🗑
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| show | can be due to: atherosclerosis, vasospasm, thrombosis.
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| show | Cardiac ischemia can be symptomatic (angina pectoris) or silent (more risk for MI and sudden death).
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| show | means “to choke”
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| show | Chest pain or pressure on chest due to myocardial ischemia.
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| What are the qualities of Pain of Angina: | show 🗑
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| show | can radiate to jaw, shoulder, arm, abdominal area.
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| show | Pain is brief, less than 5 minutes.
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| show | Classic
Unstable
Variant
Describe Classic Angina:
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| show | pre-infarction angina, usually significant CHD present, risk for MI and heart failure is high.
Pain with any position/level of exertion
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| Describe Variant (Prinzmetal angina): | show 🗑
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| Contributing factors for Angina: | show 🗑
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| show | Nitroglycerin* (vasodilator) and Ca channel blockers ariant/Prinzmetal
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| What are the Medication groups for Angina: | show 🗑
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| Describe β blockers: | show 🗑
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| Which β blocker works on heart muscle: | show 🗑
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| Which β blocker works on Bronchial Systemand peripheral vascular system: | show 🗑
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| Define Myocardial Infarction: | show 🗑
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| show | 1.5 million new or recurrent cases per year. 1/3 of them die within the first hour.
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| Primary cause of MI: | show 🗑
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| show | 3 times more common in early morning to noon.
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| Describe Pain Manifestation of MI: | show 🗑
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| Describe Other Sx of MI: | show 🗑
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| show | MI Pain lasts longer than angina,
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| Describe Heart damage over time after an MI: | show 🗑
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| show | Dx: need ECG, Lab tests
ECG: ST elevation, ST depression, T inversion, Q wave formation
Labs: CK-MB and LDH increase. Cardiac troponin and myoglobin levels go up in blood.
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| show | 1 hour after the attack of MI, after that hour cell death is irreversible.
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| show | Fatal dysrhythmia specially ventricular tachycardia
Heart failure, cardiogenic shock
rupture of heart or other anatomical elements
thrombo-emboli
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| show | REFER TO MD for EKG to rule out heart problems. If Cold sweat, call 911
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| Tx for Pt w/chronic HT trouble has angina episode: | show 🗑
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| What is a common mistake of cardiac pain? | show 🗑
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| Tx for Pt who has “chronic acid reflux” but TCM interview reveals palpitation & nausea: | show 🗑
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| show | DO NOT TREAT – Refer to MD for assessment.
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| Define Myocarditis: | show 🗑
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| show | Fatigue, dyspnea, palpitation, fever
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| Define Cardiomyopathies: | show 🗑
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| show | Hypertrophic cardiomyopathy
Dilated cardiomyopathy
Restrictive cardiomyopathy
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| show | Thickening of intraventricular septum and left ventricle.
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| show | genetic, HTN, obstructive valvular disease, thyroid disease
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| What heart disease kills young athletic people? | show 🗑
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| Define Dilated cardiomyopathy: | show 🗑
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| show | infections, HTN, ischemic heart dz, drugs, EtOH, peripartum cardiomyopathy
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| show | Left ventricular hypertrophy and endocardial fibrosis
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| Define Infectious and immunologic disorders of the heart: | show 🗑
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| show | The bacteria enters blood stream directly
Most common: Staph aureus, Strep pneumonia.
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| show | malaise, fatigue, fever low grade, petechia and splinter hemorrhages, arthritis and arthralgia, and sometimes diarrhea.
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| show | lungs, kidneys, spleen, CNS
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| show | – rheumatic heart disease
Rheumatic fever: acute inflammatory disease that follow a throat infection with group A β-hemolytic streptococci.
Incidence mostly in age range 5-15 y.old.
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| Complications of Immunologic disorders of the heart: | show 🗑
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| Describe Rheumatic Fever: | show 🗑
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| show | Hx of sore throat present – sore throat is exudative and pus producing. Can see white coat back of the throat most of the times.
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| show | : migratory polyarthritis, fever, HA, abdominal pain, nausea and swollen lymph nodes.
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| Complications of Rheumatic Fever: | show 🗑
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| What would labs positive for Rheumatic Fever show: | show 🗑
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| Treatment for Rheumatic Fever: | show 🗑
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| Define Kawasaki’s disease: | show 🗑
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| show | Valvular opening decreases in size (stenosis) or valves don’t close properly.
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| show | Congenital, trauma, IHD, degenerative changes, and inflammation.
RF is a common cause for valvular problems.
They produce blood flow turbulence
Mostly chronic conditions
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| show | (stenotic valvular problems):Decrease of blood flow through a valve, resulting in impaired emptying and increased work demand on the heart chamber that empties blood across the diseased valve
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| Ex of Stenosis: | show 🗑
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| Define Regurgitation of Valves: | show 🗑
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| Describe Mitral valve prolapse (MVP): | show 🗑
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| Is valvular heart disease more prevalent in men or women? | show 🗑
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| show | chest pain (non-exertional), weakness, fatigue, dyspnea, palpitation, anxiety, lightheadedness.
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| show | Use of β-blockers to treat autonomic manifestations.
Antibiotics for preventive infective endocarditis before dental work.
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| show | Failure of the heart as a pump, to eject blood out and into the systemic and pulmonary systems
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| Describe the impact of Heart Failure in America: | show 🗑
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| show | Mortality is high even with appropriate and aggressive treatment (more than 50%).
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| Define Preload: | show 🗑
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| Define Afterload: | show 🗑
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| show | In a range, an increase in the preload will increase the stroke volume meaning the more blood enters the heart the more leaves the heart, as the heart does not like to keep the blood in it
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| Describe Heart failure: | show 🗑
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| Types of Heart failure: | show 🗑
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| show | Impaired Cardiac function, Excess work demand
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| show | Myocardial diseases: Myocarditis, CAD, MI and Cardiomyopathies.
Valvular heart disease: Stenosis in the valves or regurgitation in the valves.
Congenital heart diseases
Constrictive pericarditis
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| Describe Excess work demand: | show 🗑
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| Describe Heart Failure Classes: | show 🗑
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| What are symptoms show increased chance of heart failure? | show 🗑
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| show | Increased sympathetic nervous system activity
Renin-Angiotensin-Aldosterone
Reabsorption of fluids in kidney (Na and ADH)
Increase systemic vascular resistance
Atrial Natriuretic Peptide
Myocardial hypertrophy
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| Tx for Heart Failure: | show 🗑
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| Meds for Tx of Heart Failure: | show 🗑
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| Definition of Congestive heart Fiailure: | show 🗑
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| Sx of Congestive Heart Failure: | show 🗑
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| Describe Rt Heart Failure symptoms: | show 🗑
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| Describe Lt Heart Failure symptoms: | show 🗑
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| Describe Acute pulmonary edema: | show 🗑
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| show | Dyspnea and gasping for air, rapid pulse, cool moist skin, cyanosis, confusion and stupor. Cough and bloody sputum. Crackles in the lungs.
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| Tx of Acute pulmonary edema: | show 🗑
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| show | Failure of the heart to pump the blood in the systemic circulation, no O2 and nutrients provided to tissues and organs due to impaired perfusion.
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| show | MI
Arrhythmias (especially after MI)
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| show | hypotension, cyanosis….
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| Tx of of Cardiogenic Shock: | show 🗑
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| show | Disturbance in impulse generation
Disturbance in impulse conduction
Normal heart Rhythm is called sinus rhythm and there is physiologic dysrhythmia with respiration
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| show | Sinus bradycardia:<60 bpm
Sinus tachycardia:>100 bpm
Sinus arrest: asystole, no impulse coming
Sick sinus syndrome (SSS) brady- and tachy- cardia alternatively.
Atrial dysrhythmias usually asymptomatic unless they get transferred to AV and to ventric
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| Are dysrhythmias in heart more serious in ventricle or atrium? | show 🗑
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| show | PVC (premature ventricular contraction) is usually caused by an ectopic pacemaker in heart.
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| Describe Ventricular tachycardia: | show 🗑
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| Describe Ventricular fibrillation: | show 🗑
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