Patho-Heart Disease

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Patho-Diseases of the Heart

What has the ability to accelerate atherosclerosis and most other cardiac disease?

High BP.

What is a mechanical failure of the heart to eject blood delivered to it?

Congestive heart failure CHF.

These are one way gates for blood flow and are susceptible to obstruction (stenosis) and regurgitation (incompetence).

Cardiac Valves

Define arrhythmias.

Abnormal heartbeat patterns that can cause cardiac dysfunction or death and can complicate any heart condition.

What part of the heart is described as the "pace-maker" of the heart. Why?

SA Node. It controls when the AP gets fired and allows the heart to contract in a rhythmic manner. They send the signal that goes to the AV node and than it takes the signal from the atria and delays it from contracting the ventricles.

What is the purpose of the delay that the AV node causes?

Chambers are filling up with blood, the ventricles are pushing it out. This is a passive process. At the end they contract to squeeze the last bit out through the ventricles.

When blood is being pushed out it is defined as _________ and when it is being pushed in filling the ventricles it is __________.

Systole.
Diastole.

____________ is a low heart rate below ______BPM. __________ is a high heart rate above ________BPM.

Bradycardia <60.
Tachcardia >100.

This is described as an organized atrial contractions at 3000/min leading to ventricular tachycardia. This would caused decreased blood, making the patient at risk for a fall.

Atrial Flutter

This is describe as unorganized atrial contractions at 200.min leading to an irregular ventricular tachycardia and large drop in cardiac output. In long term, puts patient at risk for thrombi.

Atrial Fibrillation (A-Fib)

Define Asystole

State of no cardiac electrical activity, no contractions, no CO.

A heart block is defined by 3 degrees. List and describe.

1st: AV signal delayed, but no missed ventricular contractions.
2nd: Beats are missed.
3rd: Many beats are missed, bradycardia ~40BPM decreased CO. Can lead to syncope or Asystole.

This is described as unorganized, no cardiac output, associated with ischemia and myocardial infarcts, Fatal unless rhythm is re-established.

Ventricular Fibrillations

What can cause Arrythmias?

MI or Myocardial Ischemia.
Potassium electrolyte imbalance.
Stress, that releases catecholamines.
Congenital defects.
CHF myocardial remodeling.
Drugs such as caffeine or cocaine.

This is defined as the endpoint for many CVDs. Decreased CO and increased symp input and plasma volume. Increased blood volume and myocardial contractibility compensate for awhile, but eventually the volume overlad typically leads to dialated cardiomyopathy.

Chronic Heart Failure

CHF can be __________ or _____________. Describe each.

Forward: Lack of oxygen and dyspnea.
Backward: Congestion and Edema.

What are the risk factors for ischemic heart disease? What is the most risky behavior?

Typically overweight/obese, eats a diet high in animal fats, big belly, lack of exercise and has dyslipidemia and either diabetes or hypertension. Smoking is the biggest risk behaviour.

Why does having a big belly pose as a health risk?

Visceral adipose makes people predisposed for heart diseases and diabetes.

What are some causes of coronary ischemia?

Young atheromas more likely to rupture. Obstruction. Occlusion. Platelet aggregation forms a thrombosis which typically leads to angina, which is the first symptom of a full blow thrombosis, indicating a heart attack. Reversible obstruction, get to hospital immediately in order to save tissue from dying.

This is described as when the inner wall of the heart tissue dies first and expands out from there. It can be confirmed by enzymes in the blood such as troponin and creatine kinase and takes 3-6 hours for full evolution.

Myocardial Infarction

This is described as a pericardial sack the heart sits in rupturing causing blood to leak in and build up pressure making the heart unable to beat.

Cardiac Tamponade.

What are 4 complications of myocardial Infarctions?

Intramural Thrombi (embolism and stroke) Valve dysfunction Arryhtmias in 80% Sudden Death

This is described as leading for the heart to have increased stiffness, poor filling, decrease cardiac output, increased oxygen demand, and leads to increased risk or CHF and arrythmias.

Hypertensive Heart Disease

This is described as inflammation that can to to fused valve leaflets that produce stenosis or regurgitation.

Valvular Heart Disease

This is described as an autoimmune disease that occurs in some gases of group A streptococcal pharynitis produced against strep antigens also attack similar self antigens that are found in the heart and joints.

Rheumatic Heart Disease.

What does Rheumatic Heart disease cause the heart to appear like?

Inflammation produces a stiff, thick valve and short thick chrodae tendinae. These valves may be stenotic or incompetent.

This is described as typically havint to do with a bacterial infection on the inner layer of the cell walls within the heart.

Endocarditis.

There are four classifications of heart disease. Describe.

Dilated: viruses, alcholism, chemotherapy, ischemic CAD. Can be idiopathic. Hypertrophic: Genetic or idiopathicHyper tension cause forceful contractions but leads to CHF, arrythmias. Restricted: Rare, stiff myocardium with weak contractions. Cardiomyopathies: heart muscle diseases.

Which of the four classifications of heart disease is most likely to cause a young athlete to drop dead?

Hypertrophic.

This is described as a shunt that tends to go from right to left because the pressure on the left side tends to be higher. It predisposed the right ventricle for cardiomyopathy and the chamber the blood came from will often have to work harder which may change it into a hypertrophied chamber anything that flows blood into a chamber will tend to dilate it.

Congential Heart Disease

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