PC705 Pathophysiology #5
Heart Disease - answerLeading cause of death in both men & women
1 in 4 death in US
Mitral Stenosis - answerValve does not open completely >> increased pressure.
Blood flow from L ventricle to L atrium impaired during diastole leading to ATRIAL hypertrophy.
Leads to Pulmonary HTN, R ventricular hyptertrophy, R sided heart failure.
Murmur: Low pitched rumbling diastolic with an opening snap.
Associated with atrial dysrhymias, atrial clots, dyspnea
Mitral Regurgitation - answerValve dose no close completely
Backflow from L ventricle to L atrium, both hypertrophy >>lead to L sided heart failure.
Murmur: High pitched, pansystolic, blowing.
Associated with fatigue and weakness
Mitral Valve Prolapse - answerBallooning or displacement of valve
Most common valve disorder in US
Women>Men
Typically asymptomatic but can present with palpitations, dyspnea, chest pain, rhythm
abnormalities, anxiety, depression & fatigue.
Murmur: Mid-systolic click
Aortic Stenosis - answerCalcified cup obstructs aortic flow
Main cause = age-related Calcium deposits
Results in Left ventricle hypertrophy >> Left sided heart failure/ischemia
Murmur: Crescendo-de crescendo with prominent S4
Clinical manifestations: syncope, fatigue, angina, Left vent. hypertrophy
Aortic Regurgitation - answerIncompetent valve >> leaks into Left ventricle
Causes: abnormal valve (2 instead of 3 cusps), aortic root dilation
, Leads to Left ventricle hypertrophy & Left sided heart failure.
Murmur: High pitched blowing diastolic
Clinical manifestations: Increased SBP, Decreased DBP, palpitations
Rheumatic Heart Disease - answerEtiology: Hummoral Immune (Ig's) response to Group A
Hemolytic Step followed by rheumatic fever. Tx of strep throat within 9 days will prevent
rheumatic fever .
Pathophysiology: Starts as carditis that leads to valve damage (Mitral in 50-60% of cases)
Clinical Manifestations: Polyarthritis, chorea (dysfunctional gait), rash (erithema marginatum)
on trunk, spread outward & center clears up as it expands. No pain, no itching.
Preload - answerPressure created at end of systole.
Is the volume in ventricle after atrial contraction & ventricle filling.
Afterload - answerResistance to ejection during systole.
Tension generated by heart chamber to eject blood
Coronary Heart Disease (CHD) - answerEtiology:Most common form of heart disease
Risk factors: race - whites > blacks, >south, dyslipidemia, HTN, smoking, obesity, DM, sedentary
lifestyle
Pathophysiology: Vascular disorder (narrowed arteries) - atherosclerosis
Sequela include angina, MI, Dysrrhythmias, CHF, sudden cardiac death
Clinical Manifestations
Unstable plaques - answerPlaques have thin cap, sheering force/inflammation/apoptosis lead
to rupture of the plaque. This increases inflammation, releases cytokines, platets are activated,
thrombin produced along with vasoconstriction >>> acute decrease in blood flow & unstable
angine or MI
Stable Plaques - answerArtherclerosis with more collagen & fibers >> stable plaque (less
dangerous)
Stable Angina - answerChest pain with burning, crushing squeezing, choking feeling.
Pulmonary congestion due to decreased cardiac pumping
Rest stop the pain leading to no permanent damage
Predicable, relieved by rest or nitro.
Heart Disease - answerLeading cause of death in both men & women
1 in 4 death in US
Mitral Stenosis - answerValve does not open completely >> increased pressure.
Blood flow from L ventricle to L atrium impaired during diastole leading to ATRIAL hypertrophy.
Leads to Pulmonary HTN, R ventricular hyptertrophy, R sided heart failure.
Murmur: Low pitched rumbling diastolic with an opening snap.
Associated with atrial dysrhymias, atrial clots, dyspnea
Mitral Regurgitation - answerValve dose no close completely
Backflow from L ventricle to L atrium, both hypertrophy >>lead to L sided heart failure.
Murmur: High pitched, pansystolic, blowing.
Associated with fatigue and weakness
Mitral Valve Prolapse - answerBallooning or displacement of valve
Most common valve disorder in US
Women>Men
Typically asymptomatic but can present with palpitations, dyspnea, chest pain, rhythm
abnormalities, anxiety, depression & fatigue.
Murmur: Mid-systolic click
Aortic Stenosis - answerCalcified cup obstructs aortic flow
Main cause = age-related Calcium deposits
Results in Left ventricle hypertrophy >> Left sided heart failure/ischemia
Murmur: Crescendo-de crescendo with prominent S4
Clinical manifestations: syncope, fatigue, angina, Left vent. hypertrophy
Aortic Regurgitation - answerIncompetent valve >> leaks into Left ventricle
Causes: abnormal valve (2 instead of 3 cusps), aortic root dilation
, Leads to Left ventricle hypertrophy & Left sided heart failure.
Murmur: High pitched blowing diastolic
Clinical manifestations: Increased SBP, Decreased DBP, palpitations
Rheumatic Heart Disease - answerEtiology: Hummoral Immune (Ig's) response to Group A
Hemolytic Step followed by rheumatic fever. Tx of strep throat within 9 days will prevent
rheumatic fever .
Pathophysiology: Starts as carditis that leads to valve damage (Mitral in 50-60% of cases)
Clinical Manifestations: Polyarthritis, chorea (dysfunctional gait), rash (erithema marginatum)
on trunk, spread outward & center clears up as it expands. No pain, no itching.
Preload - answerPressure created at end of systole.
Is the volume in ventricle after atrial contraction & ventricle filling.
Afterload - answerResistance to ejection during systole.
Tension generated by heart chamber to eject blood
Coronary Heart Disease (CHD) - answerEtiology:Most common form of heart disease
Risk factors: race - whites > blacks, >south, dyslipidemia, HTN, smoking, obesity, DM, sedentary
lifestyle
Pathophysiology: Vascular disorder (narrowed arteries) - atherosclerosis
Sequela include angina, MI, Dysrrhythmias, CHF, sudden cardiac death
Clinical Manifestations
Unstable plaques - answerPlaques have thin cap, sheering force/inflammation/apoptosis lead
to rupture of the plaque. This increases inflammation, releases cytokines, platets are activated,
thrombin produced along with vasoconstriction >>> acute decrease in blood flow & unstable
angine or MI
Stable Plaques - answerArtherclerosis with more collagen & fibers >> stable plaque (less
dangerous)
Stable Angina - answerChest pain with burning, crushing squeezing, choking feeling.
Pulmonary congestion due to decreased cardiac pumping
Rest stop the pain leading to no permanent damage
Predicable, relieved by rest or nitro.
