IPHY 2400 Cardiology

Cardiology

The medical specialty that studies the anatomy and physiology of the cardiovascular system

Cardiovascular System

A continuous circuit that moves blood throughout the body

O2, CO2, Nutrients, Wastes

What does blood transport (carries these substances to and from the tissues throughout the body)

Blood

The transport medium of the cardiovascular system

Mounds

The external surface irregular shape that reflects the locations of the heart’s internal chambers

• Correspond to the chambers underneath

Grooves

The external surface irregular shape that contain fat, blood vessels, and nerves

• Correspond to spaces between spaces between chambers + vessels/nerves/fat

Atrium

Each small upper chamber of the heart is an…

Ventricle

Each large lower chamber of the heart is a….

Right atrium (abbv)

RA

Left atrium (abbv)

LA

Right ventricle (abbv)

RV

Left ventricle (abbv)

LV

Septum

The central muscular wall that divides the heart into left and right sides

Myocardium

The muscular middle layer lies beneath the epicardium responsible for contraction

Endocardium

The thin innermost layer that lines the heart’s chambers and valves

My/o-

Muscle prefix

-cardi/o-

heart combining form

end/o-

inside prefix

-um

structure suffix

Tricuspid valve

The _____ has three cusps and lies atrioventricular (AV) between the right atrium (RA) and right ventricle (RV)

Pulmonary valve (semilunar)

The semilunar valve that has three cusps and lies between the right ventricle (RV) and the pulmonary arteries

Mitral valve (bicuspid valve)

The atrioventricular valve that has two cusps and is located between the left atrium (LA) and the left ventricle (LV)

Aortic valve (semilunar valve)

The semilunar valve that has three cusps and is located between the left ventricle (LV) and the aorta.

Pulmonary circulation, systemic circulation

Each time the heart beats, it pumps blood from the right ventricle through the ____(1)_____ and from the left ventricle through the ______(2)______

Acute Coronary Syndrome

Sudden reduction in blood flow to the heart muscle

Usually results from

Atherosclerotic plaque —> blood clot —> reduced coronary blood flow —> ischemia

• Results in ischemia (blocking of blood flow and tissue oxygenation) to the heart muscle

• May result in a myocardial infarction (heart attack)

(Diseases of the heart)

Angina pectoris

Chest pain caused by reduced blood flow and oxygen to the heart muscle (myocardial ischemia).

• Involves crushing, squeezing, or pressure-like pain in the chest that may extend to the jaw, teeth, neck, back, or left arm

• Often accompanied by extreme sweating and a sense of dread

• Considered a warning sign for impending heart attack

(Diseases of the heart)

Angin/o-

Strangling prefix

pector/o-

chest prefix

Cardiomegaly

Enlargement of the heart, usually due to congestive heart failure (CHF)

(Diseases of the heart)

-megaly

Enlargement suffix

Cardiomyopathy

Condition of the heart muscle that can weaken the heart and impair its ability to pump blood effectively. Includes cardiomegaly and heart failure (Diseases of the heart)

Congestive Heart Failure (CHF)

Heart failure occurs with inability of the heart to pump sufficient amounts of blood

• Caused by coronary artery disease (CAD) or hypertension (HTN)

• Involves cardiac hypertrophy, reduced contractility, and progressive loss of cardiac function

(Diseases of the heart)

Coronary artery disease (abbv)

CAD

Hypertension (abbv)

HTN

Endocarditis

Infection and inflammation of the endocardium that lines a heart valve; occurs in patients who have a structural defect of the valve

Commonly caused by

• Bacteria that enter the bloodstream and attach to damaged heart tissues

Occurs in patients

• With a structural defect of the valve

(Diseases of the heart)

Mitral valve prolapse

Structured abnormality in which the leaflets of the mitral valve do not close tightly and bludge into the left atrium during ventricular contraction

• Often develops from changes in the valve tissue: may be congenital or the result of infection

• The valve might not close completely, allowing some blood to leak backward into the left atrium (mitral regurgitation)

(Diseases of the heart)

Murmur

An abnormal heart sound caused by turbulent blood flow through the heart or the valve.

Described by

• Volume: Loudness, intensity

• Timing: When it occurs during a heartbeat

• Quality: Its sound

(Diseases of the heart)

Pericarditis

Infection or inflammation of the pericardial sac

• May cause chest pain and irritation of the pericardial layers

• In some cases, involves an increase in the amount of pericardial fluid (pericardial effusion)

• Pressure from this fluid may compress the heart and prevent it from pumping (cardiac tamponade)

(Diseases of the heart)

Peri

Around prefix

Myocardial infarction (MI)

Death of tissue in the myocardium due to severe lack of oxygen

• AKA heart attack

• Occurs when blood flow in a coronary artery is blocked by a clot or atherosclerosis

• May be accompanied by angina, indigestion-like symptoms, or no symptoms at all

• If area of dead tissue is small, the heart keeps contracting and scar tissue develops

• If area of dead tissue is large, the heart may not be able to contract and death will result

(Diseases of the heart)

Arteries

Blood vessels that carry blood away from the heart

Capillaries

Blood vessels that connect arteries and veins

Veins

Blood vessels that carry blood toward the heart

Aneurysm

An area of dilation and weakness in the wall of an artery that buldges or widens outward

• Weakened areas balloon with each heartbeat and can rupture without warning

• If it ruptures, it can cause severe internal bleeding and become life-threatening

• __ is Greek for widening out (dilatation)

(Diseases of the blood vessels)

Hypotension

Decreased blood pressure (BP) of <90/60 mm/Hg

• Usually caused by loss of blood volume

• Orthostatic ____ is a sudden, temporary decrease in systolic BP upon standing (often feel dizzy)

(Diseases of the blood vessels)

Arteriosclerosis

A progressive degenerative disease that produces narrowed, hardened artery walls

• Occurs as the arteries become hard and inflexible with age

(Diseases of the blood vessels)

Arteri/o-

Artery prefix

Scler/o-

Hardening prefix

Coronary artery disease (CAD)

Arteriosclerosis that occurs in coronary arteries.

• May cause angina pectoris

• With blockage, MI may occur

(Diseases of the blood vessels)

Peripheral artery disease

Arteriosclerosis in the legs

May cause

• Intermittent calf pain (claudication)

• Cyanosis of the toes and feet

(Diseases of the blood vessels)

Atherosclerosis

A buildup of fatty, cholesterol-rich deposits (plaques) in the walls of arteries that can restrict blood flow

• Is a specific type of arteriosclerosis that begins with a small tear in the arterial endothelium

• Cholesterol builds up in the tear, leading to formation of an atheromatous plaque

• Growth of the plaque narrows the arterial lumen and may eventually block blood flow

(Diseases of the blood vessels)

Ather/o-

Soft, fatty substance prefix

Hyperlipidemia

Presence of elevated fat levels in the blood

• Hypercholesterolemia: High cholesterol levels

• Hypertriglyceridemia: High triglyceride levels

(Diseases of the blood vessels)

Hypertension (HTN)

Elevated blood pressure (BP) of > 120/80 mm/HG

• Diagnosis requires multiple BP readings

(Diseases of the blood vessels)

Tens/o-

Pressure prefix

Phlebitis

Infection or inflammation of a vein

• Causes pain and possible red streak on skin over the vein

• Thrombophlebitis involves presence of a bloodclot

(Diseases of the blood vessels)

Thrombophlebitis

Phlebitis with a clot (Diseases of the blood vessels)

Raynaud disease

Sudden, severe vasoconstriction of arterioles in the fingers and toes, causing them to turn white or cyanotic

• Usually triggered by cold or emotional stress

(Diseases of the blood vessels)

Varicose veins

Condition in which damaged valves in a vein allow the backflow of blood, causing the vein to become distended and twisted

• May lead to pain and heaviness in the legs

• Often caused by phlebitis, injury, long periods of sitting or standing, and pregnancy

(Diseases of the blood vessels)

Varic/o-

Enlarged, tortuous vein prefix

Systole

The period when the heart contracts

Diastole

The resting period between heart contractions

Normal sinus rhythm (NSR)

When the SA node controls heart rate, the heart is in ____

Conduction system

The system that controls a person’s heartbeat by initiating and transmitting electrical impulses throughout the heart

SA node, AV node, Bundle of His, Bundle Branches, Purkinje Fibers

The (1) Initiates an electrical impulse that travels through the (2), the (3), the left and right (4), and then to the (5), causing the atria and then the ventricles to contract

Electrocardiogram (ECG, EKG)

An ___ reflects the electrical activity of the heart

• The “waves” illustrate the depolarization (excitation) and repolarization (resting) of heart muscle

Depolarization

Excitation of the heart muscle

Repolarization

Resting of the heart muscle

P wave

Atrial depolarization

QRS complex

Ventricular depolarization

T wave

Ventricular repolarization

Arrhythmia

Any type of irregular rate or rhythm of the heart (Diseases of the Conduction System)

Bradycardia

An arrhythmia in which the heart beats too slowly (Diseases of the Conduction System)

Fibrillation

An arrhythmia in which there is a very fast, uncoordinated quivering of the myocardium (Diseases of the Conduction System)

Fibrill/o-

Muscle or nerve fiber prefix

Flutter

Arrhythmia that involves a rapid but organized rhythm of the atria or ventricles (up to 250 bpm)

• Atrial rate may reach 250-350 bpm

• May be felt as palpitations or “fluttering” in the chest

(Diseases of the Conduction System)

Tachycardia

Arrhythmia in which there is a fast but regular rhythm (up to 200 bpm)

Asystole

Complete absence of a heartbeat

• Known as cardiac arrest

(Diseases of the Conduction System)

-systole

Process of contraction suffix

Bradycardia

60 bpm or less

Normal sinus rhythm

Normal HR at rest at 80 bpm

Ventricular tachycardia

Faster than normal heart rate at 150 bpm

Ventricular fibrillation

Ventricles are contracting unrhythmically

Cardiac enzymes

Blood test that measures levels of two enzymes released when myocardial cells die (Laboratory Tests)

C-reactive protein (CRP)

Elevated high-sensitivity CRP (hsCRP) is associated with increased cardiovascular risk

Blood test that measures the level of inflammation in the body; presence of inflammation increases the risk of clots and myocardial infarction

(Laboratory Tests)

Homocysteine

Blood test that measures levels of the amino acid homocysteine; elevated levels increase the risk of arteriosclerosis, clots, heart attack, and stroke (Laboratory Tests)

Lipid profile

Blood test that measures levels blood lipids, including cholesterol, triglycerides, and lipoproteins (HDL, LDL, and VLDL)

(Laboratory Tests)

Troponin

Blood test that measures levels of two proteins released when myocardial cells die:

• Levels rise 4-6 hours after myocardial infarction (MI) and remain elevated for 1-2 weeks

(Laboratory Tests)

Epicardium

The outermost layer of the heart wall, also called the visceral pericardium

isch/o-

block, keep back prefix

Cardiac catheterization

Procedure to study anatomy and pressures in the heart

• A thin catheter is inserted into the femoral or brachial vein and threaded to either side of the heart to evaluate heart function and blood flow

Used to

• Examine the heart and coronary arteries

• Measure pressures

• Diagnose certain conditions

(Diagnostic procedures)

Catheter/o-

Catheter prefix

-ization

process of inserting, or creating suffix

Cardiac exercise stress test

Procedure to evaluate the heart’s response to exercise in patients with chest pain, palpitations, or arrythmias

• patient walks on a treadmill or a stationary bike while an electrocardiogram (ECG) is performed

• Helps detect abnormal heart rhythms and signs of reduced blood flow to the heart

(Diagnostic procedures)

Electrocardiography (ECG, EKG)

Noninvasive procedure that records the heart’s electrical activity

• Electrodes are placed on the limbs and chest tracings of each pattern are used to create it

• The signals are recorded as an electrocardiogram

(Diagnostic procedures)

Holter monitor

Procedure to document intermittent or infrequent arrhythmias; involves use of a portable ECG monitor to continuously track a patient’s heart rate and rhythm for 24 hours

(Diagnostic procedures)

Telemetry

Procedure to continuously monitor a patient’s heart rate and rhythm in the hospital (for hospitalized patients)

• The patient wears electrodes that transmit ECG tracings to a central monitoring station

• A nurse at the station watches multiple patients’ tracings simultaneously

(Diagnostic procedures)

tele/o-

Distance prefix

Angiography

Procedure in which contrast dye is injected into a blood vessel to outline it on an x-ray. The resulting image is an ____gram

• When done in an artery, the procedure is an arteriography and the image is an arteriogram

• When done in a vein, the procedure is a venography and the image is a venogram

(Radiologic procedures)

Echocardiography

Procedure in which ultra high-frequency sound (ultrasound) waves are bounced off the heart to create an image called an _____gram

(Radiologic procedures)