cardio Flashcards

Question

coronary sulcus

Answer 1

Encircles junction of atria and ventricles AV groove

Answer 2

separates atria contains fossa ovalis

Answer 3

remnant of foramen ovale of fetal heart

Answer 4

separates ventricles

Answer 5

returns blood from the body regions above the diaphragm

Answer 6

returns blood from body regions below diaphragm

Answer 7

returns blood from coronary veins

Answer 8

return blood from lungs

Answer 9

project into ventricular cavity Anchor chordae tendineae that are attached to AV valves of the heart

Answer 10

thicker walls than atria left ventricle 3x thicker than right

Answer 11

ensure unidirectional BF through heart open and close in response to pressure changes-> causes normal heart sounds (lub dub) 2 major types- AV and SL

Answer 12

located between atria and ventricles prevent backflow into atria when ventricles contract 2- tricuspid and mitral (bicuspid)

Answer 13

located between ventricles and major arteries exiting the heart prevent backflow from major arteries back into ventricles – Open and close in response to pressure changes – Each valve consists of three cusps that roughly resemble a half moon 2- pulm. and aortic

Answer 14

right AV valve made up of three cusps and lies between right atria and ventricle

Answer 15

left AV valve made up of two cusps and lies between left atria and ventricle

Answer 16

located between right ventricle and pulmonary trunk/artery

Answer 17

located between left ventricle and aorta

Answer 18

Superior vena cava (SVC), inferior vena cava (IVC), and coronary sinus → – Right atrium → – Tricuspid valve → – Right ventricle → – Pulmonary semilunar valve → – Pulmonary trunk → – Pulmonary arteries → – Lungs (to pick up O2 and drop off CO2)

Answer 19

Four pulmonary veins → – Left atrium → – Mitral (bicuspid) valve → – Left ventricle → – Aortic semilunar valve → – Aorta → – Systemic circulation/all tissues (to drop off O2 and pick up CO2)

Answer 20

short low pressure

Answer 21

long high-friction

Answer 22

Functional blood supply and O2 supply to heart muscle itself – Shortest circulation in body – Delivered when heart is relaxed – Left ventricle receives most of coronary blood supply

Answer 23

Both left and right coronary arteries arise from base of the ascending aorta and supply arterial blood to heart – Both encircle heart located in coronary sulcus – Branching of coronary arteries varies among individuals

Answer 24

contain many anastomoses (junctions) * Provide additional routes for blood delivery * Cannot compensate for coronary artery occlusion

Answer 25

receives 1/20th of body’s blood supply

Answer 26

supplies interventricular septum, anterior ventricular walls, left atrium, and posterior wall of left ventricle; has two branches: * Anterior interventricular artery * Circumflex artery

Answer 27

supplies right atrium and most of right ventricle; has two branches: * Right marginal artery * Posterior interventricular artery

Answer 28

striated, short, branched, interconnected – One central nucleus (at most, 2 nuclei) – Contain numerous large mitochondria (25–35% of cell volume) that afford resistance to fatigue – Rest of volume composed of sarcomeres – T tubules are wider, but less numerous – SR simpler than in skeletal muscle no triads

Answer 29

are connecting junctions between cardiac cells that contain: – Desmosomes

Answer 30

hold cells together; prevent cells from separating during contraction

Answer 31

allow ions to pass from cell to cell electrically couple adjacent cells * Allows heart to be a functional syncytium, a single coordinated unit/one organ * Gaps: Intercalated discs

Answer 32

delivery system of dynamic structures that begins and ends at heart Work with lymphatic system to circulate fluids tunica intima, media, externa

Answer 33

carry blood away from heart oxygenated except for pulmonary circulation and umbilical vessels of fetus

Answer 34

direct contact with tissue cells directly serve cellular needs exchange zones for nutrition and waste made up of endothelium (epithelium) with sparse basal lamina

Answer 35

carry blood toward heart deoxygenated except for pulmonary circulation and umbilical vessels of fetus

Answer 36

central blood-containing space surrounded by a wall

Answer 37

Innermost layer that is in “intimate” contact with blood

Answer 38

Middle layer composed mostly of smooth muscle and sheets of elastin * Sympathetic vasomotor nerve fibers innervate this layer, controlling: * Vasoconstriction: decreased lumen diameter * Vasodilation: increased lumen diameter * Bulkiest layer responsible for maintaining blood flow and blood pressure

Answer 39

Outermost layer of wall – called tunica adventitia * Composed mostly of loose collagen fibers that protect and reinforce wall and anchor it to surrounding structures * Infiltrated with nerve fibers, lymphatic vessels * Large veins also contain elastic fibers in this layer

Answer 40

in tunica externa system of tiny blood vessels found in larger vessels * Function to nourish outermost external layer

Answer 41

Elastic arteries give rise to muscular arteries * Also called distributing arteries because they deliver blood to body organs * Have thickest tunica media with more smooth muscle, but less elastic tissue * Active in vasoconstriction

Answer 42

smallest of all arteries: – Larger arterioles contain all three tunics – Smaller arterioles are mostly single layer of smooth muscle surrounding endothelial cells * Control flow into capillary beds via vasodilation and vasoconstriction of smooth muscle * Also called resistance arteries because changing diameters change resistance to blood flow * Lead to capillary beds

Answer 43

Microscopic vessels; diameters so small only single RBC can pass through at a time * Walls just thin tunica intima Supply almost every cell, except for cartilage, epithelia, cornea, and lens of eye * Functions: exchange of gases, nutrients, wastes, hormones, etc., between blood and interstitial fluid drain into postcapillary venule

Answer 44

spider-shaped stem cells help stabilize capillary walls, control permeability, and play a role in vessel repair

Answer 45

allow passage of fluids and small solutes in capillaries

Answer 46

Abundant in skin, muscles, lungs, and CNS * Continuous capillaries of brain are unique * Form blood brain barrier, totally enclosed with tight junctions and no intercellular clefts

Answer 47

Found in areas involved in active filtration (kidneys), absorption (intestines), or endocrine hormone secretion * Endothelial cells contain Swiss cheese–like pores called fenestrations: * Allow for increased permeability * Fenestrations usually covered with thin glycoprotein diaphragm

Answer 48

Fewer tight junctions; usually fenestrated with larger intercellular clefts incomplete basement membranes: – Usually have larger lumens ▪ Found only in the liver, bone marrow, spleen, and adrenal medulla ▪ Blood flow is sluggish—allows time for modification of large molecules and blood cells that pass between blood and tissue ▪ Contain macrophages in lining to capture and destroy foreign invaders

Answer 49

interwoven network of capillaries between arterioles and venules

Answer 50

flow of blood through capillary bed from arteriole to venule

Answer 51

branch off arteriole that further branches into 10 to 20 capillaries (exchange vessels) that form capillary bed: – Exchange of gases, nutrients and wastes from surrounding tissue takes place in capillaries

Answer 52

channel that directly connects arteriole with venule (bypasses true capillaries): - consists of metarteriole and thoroughfare channel

Answer 53

cuff of smooth muscle surrounding each true capillary that branches off metarteriole acts as valve regulating blood flow into capillary bed: - controlled by local chemical conditions (not innervated)

Answer 54

carry blood toward the heart * Formation begins when capillary beds unite in postcapillary venules and merge into larger and larger veins

Answer 55

Capillaries unite to form postcapillary venules: – Consist of endothelium and a few pericytes – Very porous; allow fluids and WBCs into tissues * Have all tunics, but thinner walls with large lumens compared with corresponding arteries * Tunica media is thin, but tunica externa is thick: – Contain collagen fibers and elastic networks * Large lumen and thin walls make veins good storage vessels – Called capacitance vessels (blood reservoirs) because they contain up to 65% of blood supply Blood pressure lower than in arteries, so adaptations ensure return of blood to heart: – Large-diameter lumens offer little resistance

Answer 56

Prevent backflow of blood * Most abundant in veins of limbs

Answer 57

Flattened veins with extremely thin walls * Composed only of endothelium * Examples: coronary sinus of the heart and dural sinuses of the brain

Answer 58

contraction of skeletal muscles “milks” blood back toward heart; valves prevent backflow

Answer 59

pressure changes during breathing move blood toward heart by squeezing abdominal veins as thoracic veins expand

Answer 60

under sympathetic control, smooth muscles constrict, pushing blood back toward heart

Answer 61

the quantity of blood flowing from large veins into the right atrium each minute

Answer 62

1. Skeletal muscle pump: increases VR 2. Pressure drop on inhalation: increases VR 3. Valsalva maneuver: decreases VR 4. Increase blood volume: increases VR 5. Increase venous pressure: increases VR 6. Gravity: decreases VR

Answer 63

dilated and painful veins due to incompetent (leaky) valves * Factors that contribute include heredity and conditions that hinder venous return: – Example: prolonged standing in one position, obesity, or pregnancy; blood pools in lower limbs, weakening valves; affects more than 15% of adults * Elevated venous pressure can cause varicose veins: – Example: straining to deliver a baby or have a bowel movement raises intra-abdominal pressure, resulting in varicosities in anal veins called hemorrhoids

Answer 64

interconnections of blood vessels

Answer 65

provide alternate pathways (collateral channels) to ensure continuous flow, even if one artery is blocked: – Common in joints, abdominal organs, brain, and heart none in retina, kidneys, spleen

Answer 66

shunts in capillaries example: metarteriole–thoroughfare channel

Answer 67

so abundant that occluded veins rarely block blood flow

Answer 68

volume of blood flowing through vessel, organ, or entire circulation in given period: – Measured in ml/min it is equivalent to cardiac output (CO) for entire vascular system directly proportional to blood pressure gradient (ΔP): – If ΔP increases, blood flow speeds up * Blood flow is inversely proportional to peripheral resistance (R): – If R increases, blood flow decreases

Answer 69

force per unit area exerted on wall of blood vessel by blood: – Expressed in mm Hg – Measured as systemic arterial BP in large arteries near heart – Pressure gradient provides driving force that keeps blood moving from higher- to lower-pressure areas

Answer 70

opposition to flow – Measurement of amount of friction blood encounters with vessel walls, generally in peripheral (systemic) circulation more important in influencing local blood flow because it is easily changed by altering blood vessel diameter

Answer 71

1. Blood viscosity 2. Total blood vessel length 3. Blood vessel diameter

Answer 72

The thickness or “stickiness” of blood due to formed elements and plasma proteins: * The greater the viscosity, the less easily molecules are able to slide past each other * Increased viscosity equals increased resistance

Answer 73

The longer the blood vessel, the greater the resistance encountered

Answer 74

Has greatest influence on resistance * Resistance varies inversely with fourth power of vessel radius: – If radius increases, resistance decreases, and vice-versa – Example: if radius is doubled, resistance drops to 1/16 as much

Answer 75

are major determinants of peripheral resistance: * Radius changes frequently, in contrast to larger arteries that do not change often

Answer 76

Abrupt changes in vessel diameter or obstacles such as fatty plaques from atherosclerosis * Laminar flow is disrupted and becomes turbulent flow, irregular flow that causes increased resistance

Answer 77

Fluid close to walls moves more slowly than in middle of tube

Answer 78

derived from Autonomic Nervous System – sympathetic and parasympathetic nerve fibers

Answer 79

between the heart and CNS baroreceptors (stretch/pressure) and chemoreceptors (chemical)

Answer 80

modified by ANS via cardiac centers in medulla oblongata

Answer 81

sends signals through sympathetic trunk to increase both rate and force ▪ Stimulates SA and AV nodes, heart muscle, and coronary arteries

Answer 82

parasympathetic signals via vagus nerve to decrease rate ▪ Inhibits SA and AV nodes via vagus nerves

Answer 83

(cholinergic/muscarinic) Inhibitory

Answer 84

(adrenergic/B1) Excitatory

Answer 85

are linked to the CNS with afferent fibers of the Vagus nerve present in: -Atria – Ventricles – Carotid bodies – Aorta

Answer 86

* Stretch or pressure receptors * Locations: carotid sinus (via CN IX), aortic arch (via CN X), right atria, left atria * Stimulated: by distension of the vessel where they are located * Results: – Increase discharge rate to reverse the stimulus (negative feedback mechanism) will adapt to long term change in BP – will decrease in response to patients with chronic HTN

Answer 87

1. Increased pressure in carotid artery and aorta (increase BP) 2. Stimulates baroreceptors in the carotid sinus and aortic bodies 3. Information travels via the glossopharyngeal (IX) and vagus nerves (X) 4. Processed in the medulla 5. Increase parasympathetic tone (inhibits sympathetic tone) 6. Result: – Decrease HR – Decrease SV (and CO) – Vasodilation (decrease in BP)

Answer 88

Chemoreceptors are sensitive to changes in blood chemistry * Location: carotid bodies, aortic bodies, medulla * Involved in the control of rate and depth of respirations * Main function: – Keep the alveolar pCO2 at a normal level of 40mmHg, which also helps to maintain arterial pO2, PCO2, and pH

Answer 89

Increased CO2 (deceased O2) * Detected by carotid sinus (via CN IX) an aortic bodies (CN X) * Information sent to the medulla * Results: – Stimulates respiratory center: increase rate and depth – Stimulates sympathetic tone: vasoconstriction (increased BP) – Indirectly increases NE release from adrenal medulla: same vasoconstriction (and increased BP)

Answer 90

period of contraction

Answer 91

period of relaxation

Answer 92

blood flow through heart during one complete heartbeat – Atrial systole and diastole are followed by ventricular systole and diastole – Cycle represents series of pressure and blood volume changes – Mechanical events follow electrical events seen on EKG * Three phases of the cardiac cycle (following left side, starting with total relaxation) series of events that occur to complete a heartbeat * Electrical impulses start in the SA node, causing the atria and ventricles to contract and relax * In this cycle: * The heart contracts (systole) – expelling blood (70ml with each contraction) * The heart relaxes (diastole) – filling back up with blood (up to about 120ml when relaxed)

Answer 93

Muscle contraction is preceded by depolarizing action potential – Depolarization wave travels down T tubules; causes sarcoplasmic reticulum (SR) to release Ca2+ (skeletal muscle do not use EC Ca2+) – Excitation-contraction coupling occurs: * Ca2+ binds troponin causing filaments to bind, interact, and slide

Answer 94

responsible for contraction

Answer 95

noncontractile cells that spontaneously depolarize= heartbeat: * Initiate depolarization of entire heart * Do not need nervous system stimulation, in contrast to skeletal muscle fibers

Answer 96

contract as unit (functional syncytium), or none contract * Contraction of all cardiac myocytes ensures effective pumping action * Skeletal muscles contract independently

Answer 97

* Cardiac muscle has more mitochondria than skeletal muscle so has greater dependence on oxygen: * Cannot function without oxygen * Skeletal muscle can go through fermentation when oxygen not present * Both types of tissues can use other fuel sources: * Cardiac is more adaptable to other fuels, including lactic acid, but must have oxygen

Answer 98

initiated by pacemaker cells 1. Pacemaker potential: K+ channels are closed, but slow Na+ channels are open, causing interior to become more positive 2. Depolarization: Ca2+ channels open (around −40 mV), allowing huge influx of Ca2+, leading to rising phase of action potential 3. Repolarization: K+ channels open, allowing efflux of K+, and cell becomes more negative

Answer 99

have unstable resting membrane potentials called pacemaker potentials or prepotentials – KEY: never fully at rest

Answer 100

decrease HR, decrease contractility, decrease conduction velocity = vascular smooth muscle relaxation vascular smooth muscle relaxation = decrease HR, decrease contractility, decrease conduction velocity

Answer 101

Life-threatening, hypermetabolic reaction to anesthesia (halothane-inhaled or succinylcholine – fast acting muscle relaxant) * Cause: AD inherited gene mutation on the RyR1* (ryanodine receptor) found in the SR of skeletal muscles: (RyR2 found in SR of cardiac muscles): – Causes the voltage gates for Ca2+ to remain open/not close in the presence of anesthesia Signs: unexplained tachycardia, unexplained elevation of CO2, hypoxemia, tachypnea, muscle rigidity, and rapid elevation in temperature * Treatment: d/c triggering agent, hyperventilate with 100% O2, and Dantrolene (a muscle relaxant - found in MH carts in surgery)

Answer 102

in malignant hyperthermia use up ATP and O2 increased CO2 increased heat

Answer 103

mechanism of action: inhibits/closes the RyR1 receptor to prevent the further release of Ca2+ * Key: no Ca2+ = no binding of actin and myosin = no expenditure of energy = reduced O2 levels to normal levels

Answer 104

1. atrial systole-> atrial contraction pushes blood into ventricles 2. ventricular systole (1st phase)-> ventricular contraction pushes AV valves closed 3. ventricular systole (2nd phase)-> SL valves open; blood is ejected 4. ventricular diastole (early)-> SL valves closed; blood flows into atria 5. ventricular diastole (late)-> blood fills ventricles passively; chambers relax

Answer 105

2 types: contractile and pacemaker cells

Answer 106

Tetanic contractions cannot occur in cardiac muscles: ▪ Cardiac muscle fibers have longer absolute refractory period than skeletal muscle fibers: – Absolute refractory period is almost as long as contraction itself – Prevents tetanic contractions – Allows heart to relax and fill as needed to be an efficient pump

Answer 107

SA node->AV node->bundle of his->right and left bundle branches->purkinje fibers

Answer 108

– Primary pacemaker of heart in right atrial wall: * Depolarizes faster rate than rest of myocardium firing sites, thus referred to as the primary pacemaker * Generates impulses at average of 75×/minute (normal sinus rhythm). * Average firing rate: 60 – 100 bpm * Impulse spreads across right atria to left atria, and to AV node

Answer 109

In inferior interatrial septum – Delays impulses approximately 0.1 second * Because fibers are smaller in diameter, have fewer gap junctions * Allows atrial contraction prior to ventricular contraction * Average firing rate: 40 – 60 bpm * Inherent rate of 50×/minute in absence of SA node input, thus referred to as the secondary pacemaker

Answer 110

In superior interventricular septum – Only electrical connection between atria and ventricles: * Atria and ventricles not connected via gap junctions

Answer 111

Two pathways in interventricular septum – Carry impulses toward apex of heart

Answer 112

Complete pathway through interventricular septum into apex and ventricular walls * Average firing rate: 20 – 40 bpm * AV bundle and subendocardial conducting network depolarize 30/minute in absence of AV node input * Ventricular contraction immediately follows from apex toward atria * Process from initiation at SA node to complete contraction takes ~0.22 seconds

Answer 113

irregular heart rhythms * Uncoordinated atrial and ventricular contractions

Answer 114

rapid, irregular contractions * Heart becomes useless for pumping blood, causing circulation to cease; may result in brain death * Treatment: defibrillation interrupts chaotic twitching, giving heart “clean slate” to start regular, normal depolarizations

Answer 115

defective SA node abnormal pacemaker that takes over pacing If AV node takes over, it sets junctional rhythm at 40–60 beats/min (inherent firing rate)

Answer 116

ectopic focus of small region of heart that triggers impulse before SA node can, causing delay in next impulse: * Heart has longer time to fill, so next contraction is felt as thud as larger volume of blood is being pushed out * Can be from excessive caffeine or nicotine

Answer 117

defective AV node Few impulses (partial block) or no impulses (total block) reach ventricles – Ventricles beat at their own intrinsic rate (20 – 40 bpm) * Too slow to maintain adequate circulation – Treatment: artificial pacemaker, which recouples atria and ventricles

Answer 118

enlarged ventricles

Answer 119

cardiac ischemia

Answer 120

reveals a repolarization abnormality that increases risk of ventricular arrhythmias

Answer 121

SA node nonfunctional P waves absent AV node paces heart to 40-60 bpm

Answer 122

electrical activities disorganized APs occur randomly throughout ventricles acute HA and electrical shock chaotic, abnormal EKG

Answer 123

amount of blood pumped by each ventricle per min HR*SV

Answer 124

amount of blood ejected from each ventricle w/ each contraction

Answer 125

SNS (NE) venous return (preload) BV SNS (contractility) peripheral resistance (afterload)

Answer 126

volume of blood that leads to ventricular stretch at the end of diastole (venous return)-> EDV more fluid that returns, more the relaxed muscle stretches prior to contracting, results in stronger contractions

Answer 127

amount of resistance heart must overcome to open the aortic valve and push the BV out into the systemic circulation (peripheral resistance)-> ESV Normal aortic pressure: 80mm Hg (normal SV = 70ml results)

Answer 128

end diastolic volume: when diastole (ventricular relaxation) ends, EDV is the volume of blood that has filled the relaxed left ventricle (120ml)

Answer 129

end systolic volume: the amount of blood remaining in the left ventricle after systole (ventricular contraction) is called the ESV (50ml)

Answer 130

EDV-ESV Average SV = 70ml = amount of blood ejected with each beat increased preload=increased SV increased contractility= increased SV increased afterload= decreased SV

Answer 131

average arterial pressure throughout one cardiac cycle = systole, and diastole. * MAP is influenced by cardiac output and systemic vascular resistance, each of which is influenced by several variables

Answer 132

determined primarily by the radius of the blood vessels. Decreasing the radius of the vessels increases vascular resistance. Increasing the radius of the vessels would have the opposite effect

Answer 133

increase in hematocrit will increase blood viscosity and increase systemic vascular resistance

Answer 134

Closure of the aortic semilunar valve

Answer 135

* Positive inotropes can help with heart failure and a slow heart rate * Negative inotropes can help you with high blood pressure and chest pain

Answer 136

can help when your heart can’t get enough blood to your body because it is too weak to pump the amount of blood your body needs * Positive inotropes make your heart muscle contractions stronger, raising your cardiac output to a normal level and increasing the amount of blood your heart can pump out * This helps your organs get the blood and oxygen they need to keep working

Answer 137

Epinephrine (Adrenalin® or Auvi-Q®) *Norepinephrine (Levophed® or Levarterenol®) *Dopamine *Dobutamine *Levosimendan *Milrinone *Digoxin (Cardoxin® or Lanoxin®)

Answer 138

injection medication that treats heart failure and an irregular heartbeat called AFib (atrial fibrillation). It helps your heart beat stronger. It can also stabilize your heart’s rhythm by slowing down overactive electric signals

Answer 139

keep your heart muscles from working too hard by beating with less force * This is helpful when you have high blood pressure, chest pain (angina), an abnormal heart rhythm or a disease like hypertrophic cardiomyopathy

Answer 140

Flecainide. *Verapamil (Calan® or Verelan®). *Cibenzoline. *Clonidine (Catapres® or Kapvay®). *Atenolol

Answer 141

a calcium channel blocker that widens your blood vessels and relaxes your heart muscle. This improves blood flow to your heart and helps it pump more easily. Verapamil is for people with high blood pressure or angina (chest pain). Some people with irregular heart rhythms like SVT also take it.

Answer 142

a description of cardiac hemodynamics as it relates to myocyte stretch and contractility * The Frank-Starling Law states that the stroke volume of the left ventricle will increase as the left ventricular volume increases * Due to the myocyte stretch causing a more forceful systolic contraction

Answer 143

3rd ICS LSB * Clinical significance: where S2 is heard the best * Performed: patient instructed to breath in and hold breath temporarily during auscultation

Answer 144

swishing sound

Answer 145

high-pitched sound or clicking

Answer 146

50-65% can be diagnosed via echo

Answer 147

atherosclerosis HT MI DCM

Answer 148

dilated cardiomyopathy ventricles stretch and become flabby, and myocardium deteriorates drug toxicity or chronic inflammation may play a role

Answer 149

increase levels of intracellular cyclic adenosine monophosphate (cAMP) or cyclic guanosine monophosphate (cGMP), which leads to various physiological effects including smooth muscle relaxation, vasodilation, bronchodilation, and anti-inflammatory effects

Answer 150

stimulated by cAMP regulates heart contraction

Answer 151

stimulated by cGMP and NO regulates SM

Answer 152

pulmonary congestion tachy fatigue cyanosis exertional dyspnea

Answer 153

"col pulmone" fatigue ascites JVD edema

Answer 154

2nd ICS RSB

Answer 155

5th ICS LSB

Answer 156

5th ICS MCL

Answer 157

2nd ICS LSB

Answer 158

supplied by the RCA

Answer 159

supplies the inferior portion of the left ventricle

Answer 160

enzyme elevated very early after MI return to normal after 24 hr (detects recent damage) from muscle breakdown

Answer 161

variant of angina pectoris that occurs at night while the patient is recumbent (lying down)

Answer 162

males= 45 females= 50 father or brother diagnosed with heart disease before age 55 or a mother or sister diagnosed before age 65

Answer 163

peaks 48-72 hrs lactate dehydrogenase

Answer 164

If >50% LDA stenosis Multivessel CAD

Answer 165

most frequent cause of hospitalization in patients older than 65 Rehospitalization rates during the 6 months following discharge are as much as 50%

Answer 166

chronic underlying medical condition with an unusually high demand for blood circulation Hyperthyroidism Pregnancy

Answer 167

reduced EF (HFrEF); LVEF 40% or less (valvular disease or ischemic HD) preserved EF (HFpEF); LVEF 50% or more (HT or hypertrophic cardiomyopathy)

Answer 168

CBC: rule in/out comorbidities, thyroid conditions, reversible causes of HF CMP: electrolyte imbalances (low Na+ poor prognosis), BUN/creatinine BNP: core marker and elevated in CHF (>100pg/ml) Troponin: not a core marker but elevated, indicator of poor prognosis Echocardiogram: single best test – assesses ventricles and valves, estimate EF EKG: ventricular hypertrophy, arrhythmias, ischemia, low QRS

Answer 169

sacubritril (inhibits neprilysin enzymes) valsartan (blocks angiotensin II receptors)

Answer 170

responsible for salt and water balance neprilysin is an enzyme that breaks BNP down prevents them from doing their job

Answer 171

abdominal aorta aneurysm 90% of all AAA occur below the renal arteries >3cm is considered “aneurysmal” Males > females >age of 65 PMH: smoking, hyperlipidemia, obesity, family history

Answer 172

Ultrasound in men age 65 – 75 who have ever smoked more than 100 cigarettes in their lifetime Once detected, CT or MRI evaluation give you more information

Answer 173

Unruptured AAA: back pain, flank pain Ruptured AAA: hypotension and severe “tearing” abdominal pain radiating into the back

Answer 174

Elective repair: when >5.5cm

Answer 175

PMH: hypertension, smoking, hyperlipidemia * Imaging: CT is the best choice for imaging * Prevention of growth: use of Betablockers * Surgical repair when: >5.0 – 5.5cm * Two types: * Type A: involves ascending and arch * Type B: descending aorta distal to subclavian artery

Answer 176

Most common condition associated with the degeneration and worsening of the aneurysm that leads dissection is hypertension * Connective tissue disorders can also lead to dissection: 1. Marfan’s Syndrome: genetic disorder of connective tissue, primary problems with heart and aorta 2. Ehler-Danlos Syndrome: genetic disorder of connective tissue, overflexibility of joints, many different types, problems with vessels being thin and small – rupture easily

Answer 177

Increased QRS = LV hypertrophy * ST segment depression * Asymmetric T wave inversion left atrial enlargement left ventricular hypertrophy

Answer 178

HTN at especially young or old age * Patient with Stage 2 HTN > 140/90 * Abrupt onset of HTN * Drug resistant HTN * Presence of clinical clue (abdominal bruit, low potassium)

cardio Flashcards

(204 cards)