pharma test cardio 1.txt

• Inflammation of the heart muscle
• Causes; viral infection (most common), bacterial infection

• ECG (provides evidence of cardiac conduction disturbances)
• Echocardiography (shows enlargement or inflammation of heart muscle
• Blood cultures (shows evidence of infection)
• Cardiac enzymes (elevated levels indicative of myocardial cell damage)

• Antibiotics (if infectious microorganism has been identified)
• Anti-inflammatory medicines (to reduce swelling)
• Diuretics (to remove excess water from the body)
• Low-salt diet (to control fluid volume in the body)
• Reduced activity (to reduce workload on the heart)

• Weakening of or structural changes in heart muscle leading to progressive decrease in cardiac output (CO=HRxSV)
• Three types; dilated (most common), hypertropic, restrictive

• Most common
• Three characteristic features; dilation of the ventricles, contracile dysfunction of ventricular muscle, congestive heart failure

Infection, myocarditis, toxic agents, metabolic disorders, genetic disorders, immune disorders

Rest, medications (beta-adrenegic receptor antagonists), angiotensin coverting enzyme inhibitors (ACE inhibitors), heart transplant

• Due to excessive ventricular growth or thickening of heart muscle (forces heart to work harder)
• Primarily affects young adults
• Most common cause of sudden cardiac death in young - cause of sudden death in athletes (occurs during or just afte physical activity)

Unknown, may have a genetic component

• Medication (beta-adrenergic receptor agonists), Ca2+ channel blockers, antidysrhythmics
• Implantable-cardioverter defibrillator
• Surgery (to remove thickened part of ventricle)
• Alcohol septal ablation (injection of alcohol into the artieries supplying the thickened part of the heart; essentially induces a controlled heart attack by killing the affected area of heart muscle)

• Disorder preventing the heart chambers to fill properly with blood because of stiffness in one or both ventricles
• Heart is of normal size or only slightly enlarged
• Endemic to thrrd world countries

Most common cause is amyloidosis; due to abnormal deposition of protein (amyloid) in heart tissue impairing cardiac function

• Medications (anticoagulants, antidysrhythmics, diuretics)
• Heart transplant

• Used to treat heart failure
• Cardiac glycosides; antidysrhythmics, antiagninals, vasodilators, others

• To improve ventricular contraction or cardiac output and ejection fraction
• To decrease heart rate
• To decrease conduction velocity

To restore normal cardiac rhythm

• To regulate blood flow to the heart muscle
• To increase O2 delivery to and reduce O2 requirement of cardiac tissue

• To reduce cardiac afterload (by decreasing resistance in arteries)
• To reduce cardiac preload (by dilating renal arterioles to improve renal perfusion and increse fluid excretion and by improving cirulation to skeletal muscles)

Angiotensin converting enzyme inhibitors (ACE); diuretics, beta-adrenergic receptor antagonists (contraindicated in heart failure)

Use is contraindicated in heart failure

• In a non-diseased heart, closed valves prevent a backflow of blood; open valves permit blood to move forward
• Normal left atrial pressure is 8-10mmHg
• Two general disorders; stenosis and regurgitation

• Mitral valve stenosis
• Aortic valve stenosis

• Narrowed mitral valve fails to open properly
• Affects valve between the left atrium and left ventricle; mitral valve narrowing causes resistance to blood flow between left atrium and left ventricle
• Causes blood to back up into the left atrium, leading to increased left atrial pressure (>10-30 mmHg)

Increased pulmonary vein pressure, which causes congestion in pulmonary veins, blood flow back into lungs, fluid accumulation or pulmonary edema, difficulty in breathing, congestive heart failure

• Valvuloplasty (small balloon is inserted and inflated to stratch and open a stenosed heart valve)
• Surgical replacement

• Narrowed aortic valve fails to close properly; left ventricular pressure is much greater than aortic pressure during left ventricular ejection
• Aortic valve cusps show evidence of calcified deposits, adherence of cusps and are warty in appearance

• Rheumatic fever
• Congenital heart defect
• Arteriosclerosis

• Left ventricular hypertrophy
• Congestive heart failure
• Inadequate cerebral blood flow

surgical replacement

Mitral valve regurgitation and aortic valve regurgitation

• Mitral valve fails to close completely, so blood flows back (or regurgitates) into the left atrium during ventricular systole
• Two types: sclerosis and retraction of valve cusps (mitral valve calcification) and mitral valve prolapse (connective tissue disorder or papillary muscle dysfunction)

• Reduces net left ventricular stroke volume
• Increased atrial blood volume enlarges left atrial chamber and raised left atrial pressure
• Left artrium compensates by increasing its contractile force to enhance ventricular filling
• Leads to pulmonary congestion and edema

• Aortic valve incompletely closes, causing a backflow of clood into the left ventricle from the aorta closing
• Left ventricular dilation - cardiac muscle weakens and becomes exhausted and congestive heart failure
• I kind of wish that he'd write these notes up in proper English, because figuring out what he's trying to say without punctuation is KILLING me
• On the other hand, I appreciate the notes.

• Inflammation within the heart
• Endocarditis
• Dilated aorta

• Medications: ACE inhibitors, diuretics
• Surgery: repair or replace aortic valve, repair aorta