Human Disease Ch 13

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1

coronoary circulation

main blood supply of the heart

myocardium is too think for the diffusion of nutrients

venous blooded collected by cardiac veins

empties blood into the RA

2

normal sinus rhythm

controls heart beat

makes it one contraction

3

sinus node

makes heart beat as one contraction

acts as the bus driver

4

congenital heart disease

atrial and ventricular septal defets

hole between chambers doesn't close, oxygenated blood mixes with deoxygenated blood

5

manifestations of congenital heart disease

murmurs

easily fatiuged

heart failure

6

tetralogy of Fallot

rare 1:2000

four heart defects

VSD-ventral septal defect

pulmonary stenosis-pulm valve narrows heart pushes harder

right ventricle hypertroph

overriding aorta-opens right next to right ventricle

7

manifestations of tetralgy of Fallot

cyanosis

slow growth

heart failure

variable life expectancy

8

treatment of TF

surgery soon after birth

9

valvular dysfunctions

valvular stenosis

valvular regurgitation

mitral valve prolapse syndrome

10

valvular stenosis

aortic or mitral stenosis

(narrowing)

11

valvular regurgitation

aortic, mitral, or tricuspid

valves don't close tightly and blood flows backwards

12

mitral valve prolapse syndrome

valves open all the way back

13

aortic stenosis

leaflets undergo connective tissue degeneration

ie fibrotic calcifie rigid- restricts valve mobility

14

clinical outcomes of aortic stenosis

increases strain leads to LV hypertrophy and eventually heart failure

15

rheumatic fever

aka scarlet fever

common in children

bacteria strain of streptococcal

is due to hypersensitivity not bacteria

antibodies injure connective tissue and causes fever

16

clinical outcomes of rheumatic fever

healing with scarring of tissues (heart valves)

death from severe inflammation and acute heart failure

can recur if another streptococcal infection reactivates hpersensitivity and tissue damage

17

rheumatic heart disease

scarring of heart valves following rhejmatic inflammation

primarily affects mitral and aortic valves

18

clinical outcome of rheumatic heart disease

valve regurgitation or stenosis-impairs cardiac function, increases strain on heart, eventually leads to heart failure

19

mitral valve prolapse

common but creates few functional problems

benign growths on valve leaflets

genetic or connective tissue disease

leaflets may not fit together tightly-blood leaks back into LA (mitral regurgitation)

on auscultation-faint systolic murmur from reflux of blood in between closed valve leaflet

20

atherosclerosis pathogenesis

endothelial injury

fatty streak lipid accumulation

influx of SMC and macrophages

young or old atheroma (plaque)

21

atherosclerosis occurs in ____

any artery, not veins or capillaries

22

atherosclerosis creates what that causes a heart attack

thrombus

23

causes and consequences of atherosclerosis

lifetime development

begins early in life

asymptomatic for many years

clincal after 6 decades

24

myocardial infarction

necrosis of heart muscle fom severe ischemia (lack of blood flow)

25

basic mechanisms that trigger a heart attack

sudden blockage of a coronary artery from thrombus or atheromatous debris

hemorrhage into atheromatous plaque

arterial spasm

sudden greatly increase myocardial oxygen requirements (vigorous physical activity)

26

symptoms of acute myocardial infarction

angina

gi distress, nausea, vomitting

tachycardia and vasoconstriction

anxiety, reslessness

hypotension and shock

weakness in arms and legs

27

angina pectoris

chest pain due to ischemia

28

stable angina

most common type

pain when hearts oxygen demand increases

may not necessarily lead to heart attack

29

variant angina

no pattern

meical emergency, heart attack may follow

30

silent myocardial ischemia

myocardial ischemia without pain

31

unremitting angina

chest pain never goes away

32

features of myocardial infarctions

50% are without warning

50% preceded by angina

80-90% of patients arrive at ER alive

33

when heart attack sufferers die it is usually due to ____ (10-20%)

cardiac arrhythmia

34

long term complications of myocardial infarctions

heart failure

cardiogenic shock

pericarditis (heart cell necrosis)

thrmboemboli

heart rupture-increased pressure against weakened walls

ventricular aneurysms

35

most important risk factors for heart disease

high blood lipids and blood pressure

cigarette smoking

diabetes

36

myocardial infarction diagnosis

medical history

physical examination

laboratory data

37

myocardial infarction treatments

thrombolytic therapy-convers plasminogen to plasma, reduces blood coagulability which dissolves clots

angioplasty favored for restoring coronary blood flow

38

asprin and reduced CVD risk

interferes with platelet function by permanently inactivating thromboxane A2 that causes platelets to aggregate and start clotting process

39

myocardial infarction medical treatment

medical treatments-control/eliminate risk factors

cessation of smoking

control hypertension

anti-coronary diet-low cholesterol and fat

weight reduction

exercise program

40

cocaine induce arrhythmias and infarcts

cocaine prolongs and intensifies effets of sympathetic nervous system

41

dysrhythmias (arrhthmias)

disturbances of heart rhythm-irregular heart beat

range from occasional missed or rapid beats to severe disturbances that affect the pumping ability of the heart

42

types of dysrhythmias

premature

atrial fibrillation

ventricular

43

premature dysrhythmia

extra beats

flutters

premature atrial or ventricular contraction

44

atrial fibrillation

HR doesn't originate in SA node, disorganized heart beat

incomplete emptying of ventricles leads to blood clots

45

ventricular dysrhythmia

tachycardia-increased heart rate

fibrillation-worse of the two, ventricle flooded

46

hypertension

140/90-only needs to be one of the two raised

damages walls of systemic blood vessels

smooth muscles undergo hypertrophy and hyperplasia with fibrosis

arteriosclerosis-artery scarring

47

complications of hypertension

cardiovascular

neurologic

renal failure

48

heart failure

heart fails as a pump

two types: left and right heart failure

49

Left heart failure

pulmonary edema

50

right heart failure

blood back flows into veins, increases veinous pressure

51

cardiomyopathy caused by

inflammation and intrinsic factors

52

types of cardiomyopathy

dilated

hypertrophic

restrictive

53

dilate cardiomyopathy

congestive cardiomyopathy

weakened enlarged chambers, poor pumping

54

hypertrophic cardiomyopathy

leading cause of death in young athletes

no immediate cause

can be genetic or acquired

55

restrictive cardiomyopathy

heart is rigid, restricted from stretching

56

complications of cardiomyopathy

heart failure

blood clots-pulmonary embolism

valve problems

cardiac arrest

sudden death

57

aneurysms

weakening of a vessel wall or cardiac chamber

can balloon and burst

aorta is most susceptible

58

vascular dissecting

longitudinal tearing within wall-false lumen

can occur in-carotid, vertebral, coronary

59

causes of dissection

hypertension

trauma

60

symptoms of dissection

severe back and chest pain

risk factor for stroke

pooling of blood

61

when damage occurs to heart...

it cannot be repaired

62

sudden cardiac death

natural death from cardiac causes within one hour of acute symptoms

not necessarily a heart attack

63

sudden cardiac death may be due to

arrythmia

myocardial infarction

aortic aneurysm

electrocution

drugs ie cocaine