45 terms

Cardiac Pathologies

Mitral stenosis tx
Drugs that slow the heart rate (beta-blockers, CCB's) to increase LV filling time, anticoagulants to decrease thromboembolytic risk.
Pharmacotherapeutic tx for CHRONIC (but not acute) Mitral Regurgitation or Aortic Insufficiency
IV vasodilators (reduce peripheral vascular resistance and favour forward flow.
Four right-to-left shunts in Congenital Heart Disease
Tetralogy of Fallot, Transposition of great arteries, Truncus arteriosus, Tricuspid valve atresia
Tricuspid Valve Atresia
Complete absence of the tricuspid valve w/ undersized or absent right ventricle
Ventricular Septal Defects
Wall between the L & R ventricles defective, allowing blood to move left to right
Atrial Septal Defects
Wall between the L & R atria defective, allowing blood to move left to right
ASD & VSD effects
Volume & Pressure overloads on R heart
Acute rheumatic fever findings
Fever, arthritis, acute carditis, erythema marginatum
Most common causes of mitral stenosis
Calcification of valve or chronic rheumatic disease is the etiology
Associated w/ dental work in pt w/ cardiac deformity
Bacterial endocarditis
Mitral valve prolapse dx
Midsystolic click, palpitations, panic attacks, depression
Four etiologies of vegetative endocarditis
Rheumatic fever, Lupus, Bacterial Ix, Thrombotic dz
Most common benign cardiac tumor in adults
Atrial myxoma
Most common benign cardiac tumor in ped.s
Three measurements of aortic stenosis
Flow rate, cross-sectional area, pressure
Acute mitral regurgitation progression
MR --> High LV EDV --> CHF
Aortic valvular insufficiency progression
LV Volume overload --> LV Pressure overload -->LVH --> LCHF
Mitral Stenosis progression
Left atrial enlargement --> pulmonary edema --> RVH
Cardiac defects resulting in A-fib
All valvular disease --> Left Atrial Enlargement --> A-fib
Aortic stenosis worst case
Sudden death (LVH --> V-fib --> MI)
Most common cause of Mitral Regurgitation
Mitral valve prolapse
Mitral valve prolapse anatomical indicator
Hollow at the lower part of the breastbone, called pectus excavatum
Clinical presentations of Aortic Stenosis
SAD + 1 Angina, syncope, dyspnea & CHF
Auscultation of Aortic Stenosis
Slurred upstroke, delayed peak
An S4 gallop may indicate these 3 diseases
Disease associated with sudden cardiac death in athletes
Hypertrophic obstructive cardiomyopathy (HOCM)
An S3 gallop may indicate this
Decompensated CHF
Cardiac pressure effects of Mitral Regurgitation & Aortic Stenosis
Aorta: down, LA: up, LV: up, Systemic BP: down
Chronic Aortic insufficiency pulse findings
Bounding pulse, wide pulse pressure.
Auscultatory findings in Mitral Stenosis
Opening snap, then a rumbling diastolic murmur ending with presystolic crescendo
Three clinical presentations of HCM & AS
SAD: Syncope, Angina, & Dyspnea
Common etiologies of acute aortic insufficiency
Dissection, syphilis
Common etiologies of chronic aortic insufficiency
Marfan's, congenital bicuspid aortic valve, chronic rheumatic heart dz
Atrial septal defects induce what overloads on which side of the heart, and with what result?
Both volume & Pressure on the right--> RVH & pulmonary edema--> CHF
Site of 90% of VSDs
Membranous septum
Complications associated with VSD's
Unrepaired: Aortic insufficiency/CHF, Repaired: RBBB
Ventricular, systemic & pulmonary BP effects of VSDs
LV: increased preload, RV: pressure overload, Systemic BP drops, pulmonary BP rises
Four defects in Tetralogy of Fallot
Pulmonary trunk stenosis, Overriding aorta, VSD & RVH
Truncus Arteriosus
A single artery from the two ventricles gives rise to both the aorta and pulmonary trunk
Tricuspid Valve Atresia
Complete absence of tricuspid valve w/ undersized or absent right ventricle
Failure of coronary circulation to supply adequate circulation to cardiac muscle
CAD: Coronary Artery Disease --> CHD Coronary Heart Disease
Aortic insufficiency signs and symptoms
SAD, also Bounding pulse, low diastolic pressure and increased pulse pressure, De Musset's sign (head nodding in time with the heart beat), Quincke's sign (pulsation of the capillary bed in the nail)
Coronary Heart Disease s/s
STAR: ST depression, angina, response to nitro
Tetralogy of Fallot dx
"Coeur-en-sabot" (boot-like) heart on X-ray, low blood O2 saturation, cyanosis
Tricuspid valve atresia dx maneuver
Carvallo's Maneuver : Deep inhalation increases right ventricle filling, prolonging ejection time