Path 2 end of midterm

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Path 2 end of midterm
2010-08-19 19:42:02
path 2

End of midterm material for path 2
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  1. Manifestations of ischemic heart disease
    • Angina Pectoris
    • Acute MI
    • Sudden Cardiac death
    • Chronic ischemic heart disease w/ congestive heart failure
  2. Angina pectoris
    • intermittent chest pain caused by a transient, reversible myocardial ischemia
    • Diffuse retrosternal pain (left), not localized-> may spread to inner surface of left arm, left neck, or left scapula (burning/squeezing pain)
  3. Typical/stable/exertional angina pectoris
    Pain that develops after exertion, smoking, exposure to cold, or after a large meal
  4. Prinzmetal/variant angina
    Due to spasms; response to strong emotions; may present as night pain
  5. Unstable/Crescendo angina
    Pain w/o exertion, normally ends w/ MI aka pre-infarction angina (during sleep)
  6. Acute myocaridal infarct
    • aka heart attack
    • Indicates development of an area of myocaridal necrosis caused by local ischemia
  7. Sudden cardiac death
    • Very common, due to coronary artery disease
    • In 50% of ischemic heart disease cases, sudden cardiac death is the first manifestation
  8. Chronic ischemic heart disease with congestive heart failure
    Lack of oxygen-> myofibrils die-> decrease contractility of heart-> congestive heart failure
  9. Congestive heart failure
    Multisystem derangement that occurs when the heart is no longer able to eject blood returning from the venous system
  10. Left sided heart failure
    • #1 cause is LV or LA
    • #1 outcome is pulmonary edema
    • MC causes include: systemic hypertension, mitral or aortic valve disease, ischemic heart disease, primary diseases of myocardium
    • Blood builds up in the LA-> increased hydrostatic pressure-> accumulation of blood in lungs-> pulmonary/lung edema
  11. Heart failure cells
    lung macrophages filled w/ heme/hemosiderin from ingested RBC, found in sputum
  12. Brown induration of the lung
    overall brownish appearance of the lung due to increased blood
  13. Right sided heart failure
    • MC causes: left sided HF or left ventricular failure, cor pulmonale leading to pulmonary vessel hypertension, lung emphysema
    • 1st problem resulting from right sided HF is hepatomegaly from increased pressure in the RV-> hypertrophy-> RA-> increased pressure-> inferior vena cava-> portal veins
  14. Adaptive responses to congestive heart failure
    • Increased sympathetic activity
    • Hypertrophy (concentric v eccentric)
    • Dilation
    • Compensated HF- body can deal w/ the changes & there are no symptoms
    • Decompensated HF- body cannot deal-> symptoms & death
  15. Concentric hypertrophy
    Enlargement of heart muscle w/o enlargement of chambers (due to increase pressure)
  16. Eccentric hypertrophy
    • Hypertrophy of heart muscle w/ increase of heart chamber (mitral stenosis)-> elongation of myofibrils in response to increase fluid in chambers
    • Elongation of fibrils leads to increase contractility
  17. Symptoms of congestive heart failure
    • Dyspnea (difficulty breathing): Exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea
    • Muscle fatigue
    • Enlarged heart
    • Tachycardia
    • Fine rales in the lungs bases
    • High pitched systolic murmur
    • Atrial fibrillation
    • Distended neck veins
    • Hepatomegaly
    • Edema (feet, lower legs)
    • Accumulation of fluid in the body cavities (R sided HF only)
    • Cyanosis
  18. Orthopnea
    Due to a change in position from standing to lying down; lack of gravity when lying down brings blood flowing back to a heart that is already congested
  19. Disorder of the lung that leads to isolated right sided heart failure
    Lung emphysema- enlargement of lung alveoli & rupture of their walls
  20. Cor pulmonale
    heart pathology due to lung pathology
  21. Interstitial lung diseases
    • Replacement of lung tissue by connective tissue
    • Blood vessels obliterated or torn
    • Pneumoconiosis- dust in lungs- industry workers