cardio quiz 5

endocarditis

An infection of the inner lining of the heart, typically involving the heart valves, caused by bacteria or other pathogens.

stenosis

causes increases PRESSURE in UPSTREAM chamber, thick and stiff if VENTRICLE

rheumatic heart disease

A condition resulting from rheumatic fever (STREP) that affects the heart valves and can lead to heart failure.

rheumatic heart disease

leading cause of cardiovascular death in people under age 50

no

is it okay to use cephalexin if a patient has a SEVERE reaction to penicillin

monotherapy (1 medication)

medication treatment of stage 1 hypertension

regurgitation

causes increased VOLUME in UPSTREAM chamber, DILATED

strep veridans

common bacteria of infective endocarditis from dental procedures that affects the LEFT SIDE

poor blood flow, poor wound healing, difficult infections

dental complications of hypertension

mitral

most common valve affected by IE (infective endocarditis) for non-needle users, MOST SUSCEPTIBLE to vegetations

tricuspid

valve most often affected by infective endocarditis in IV DRUG USERS, typically associated with right-sided heart infections

staph aureus

common bacteria of infective endocarditis from IV drug use that affects the RIGHT SIDE

prophylactic antibiotics

what would patients with history of heart lesion or repair likely require

stage 1

stage of hypertension where Bp is : 130-139/ 80-89

cyanotic defects

shunt of blood flow that results in an increase in deoxygenated blood supply to the body, right to left

VSD, ASD, patent ductus arteriosus

examples of acyanotic defects

acyanotic defects

congenital heart defects that DO NOT significantly reduce blood oxygen levels, LEFT-RIGHT

stage 2

stage of hypertension where Bp is : >140/ >90

smoking, diabetes (poorly controlled), medications (ACE and Retin)

risk factors (during pregnancy) for congenital heart failure other than genetic

ventricular septal defect, atrial septal defect, patent ductus arteriosus

3 types of congenital heart defects that result in shunting?

infection

most common cause of endocarditis

thrombus, bacteria, and fibrin/platelets form vegetation

how does endocarditis form after valvular damage

prosthetic heart valve, rheumatic heart disease, IV drugs, immunocompromised

what patients are at increased risk of endocarditis

potential medication reactions

why would you not give patients antibiotics “just in case”?

strep viridans and staph aureus

what bacteria have a high risk of causing endocarditis in patients with predisposing conditions

FEVER (unexplained), embolic spots (palms and soles) ect.

what are the symptom of endocarditis

fever

most common symptom of endocarditis

blood culture, echos (transthoracic and transesophageal)

test used to diagnose bacterial endocarditis

6 weeks

What is the duration of treatment (IV antibiotics) for endocarditis?

antibiotics and/or surgery

treatment options for endocarditis

100%

what is the mortality rate of endocarditis without treatment

Prosthetic heart valve, prior endocarditis, unrepaired cyanotic CHD, recently repaired CHD, incompletely repaired CHD

Who needs to get antibiotic prophylaxis before dental cleaning to prevent infective endocarditis patients at high risk

no longer recommend prophylaxis for moderate risk individuals

how have endocarditis prophylaxis guidelines changed

stenosis

a narrowing of a blood vessel or heart valve that restricts blood flow

regurgitation

the backward flow of blood through a heart valve due to improper closure

yes stage C asymptomatic severe

Can a person have heart valve disease and have no symptoms?

aortic and pulmonic (regurgitation and stenosis)

types of CONGENITAL valvular diseases

degenerative, rheumatic, infection

ACQUIRED causes of valvular diseases

balloon valvuloplasty

A minimally invasive procedure used to treat heart VALVE STENOSIS, where a balloon is inserted and inflated to widen the valve opening.

LV during diastole

where and when does the backflow of blood go in aortic regurgitation

LA during systole

where and when does the backflow of blood go in mitral regurgitation

valve degeneration, infection, and congenital defects.

Potential causes of valvular regurgitation

aortic stenosis

causes left ventricle to thicken and become stiff

aortic regurgitation

causes left ventricle to stretch and become floppy

mitral valve prolapse, rheumatic infective MAC

primary causes of mitral regurgitation

ischemic CM, dilated CM, hypertrophic CM, Afib

secondary causes of mitral regurgitation

congenital heart defects

common cause of pulmonary valve stenosis

RA

What chamber gets dilated in tricuspid regurgitation? 

rheumatic, calcific (degenerative), bicuspid (congenital)

typical causes of AORTIC STENOSIS

left ventricle thickens

change in heart during AORTIC STENOSIS

left atrium, dilates

change in heart during MITRAL STENOSIS

left ventricle dilates

change in heart during AORTIC REGURGITATION

left atrium dilated

change in heart during MITRAL REGURGITATION

rheumatic (RHD)

common cause of MITRAL STENOSIS

trauma, rheumatic (RHD), congenital (bicuspid), age/infection

common causes of AORTIC REEGURGITATION

congenital heart disease

most common type of major birth defect

blood bypasses the lungs

how does fetal circulation differ from circulation after birth?

foramen ovale and ductus arteriosus

what structures change after birth

shunt

aortic or vascular communication that allow mixing of oxygenated and deoxygenated blood 

atrial septal defect

a congenital heart defect characterized by an abnormal opening in the atrial septum, allowing blood to flow between the left and right atria.

left to right

direct of blood flow through most shunts after birth

if right ventricle is stiff (pulmonary hypertension)

when would direction of blood flow through shunt change to right→left

ventricle septal defects

most common type of shunt

RA and RV dilation, exercise intolerance, arrhythmias (atrial), right heart failure, (pulmonary arterial hypertension rarely)

consequences of left to right unrepaired atrial septal shunt/defect

LA and LV dilation, left heart volume overload, pulmonary arterial hypertension

consequences of unrepaired ventricular septal defect/shunt

pulmonary arterial hypertension

consequences of LARGE unrepaired ventricular septal defect/shunt

ventricular

which type of shunt/septal defect is more serious

patent ductus arteriosus

a condition where the ductus arteriosus fails to close after birth, leading to abnormal blood flow between the aorta and pulmonary artery

left heart enlargement, pulmonary hypertension

effects of patent ductus arteriosus

downstream resistance

what determines direction of flow between shunt

ventricular septal defect, over-riding aorta (drains L and R ventricle) , pulmonic stenosis, RV hypertrophy

features of tetralogy of fallot

right to left flow through ventricular septal defect

consequence of pulmonary stenosis in tetralogy of fallot

endocarditis (prosthetic heart valve)

risk associated with repair of tetralogy of fallot

coarctation of aorta

discrete narrowing in proximal descending aorta near ductus arteriosus

transposition of great arteries

a congenital heart defect where the aorta and pulmonary artery are switched, leading to two separate circulations.

no oxygenation of blood, leads to hypoxia and heart failure

why can transposition of the great arteries cause an infant to die quickly after the ductus arteriosus closes

none, asymptomatic

symptoms of hypertension

BP above 130/80

what classifies hypertension

primary hypertension

most COMMON type of high blood pressure WITHOUT KNOWN CAUSE (idiopathic), often linked to genetic factors, lifestyle, and environmental influences.

secondary hypertension

high blood pressure caused by an underlying condition, such as kidney disease or hormonal disorders.

uncontrolled and higher pressures

what worsens the complications of hypertension

diabetes and smoking

factors that exacerbate (worsen) hypertension

remodeling/ thickening of smooth muscle (tunica media)

impact of hypertension on vessels

LV hypertrophy, increase MI risk, heart failure

major CARDIAC complications associated with hypertension

ATHEROsclerosis

primary cause of coronary artery disease, acute coronary syndrome and peripheral artery disease

ARTERIOsclerosis

a condition characterized by the thickening and hardening of arterial walls, often associated with aging and hypertension.

stroke, dementia, vision issues, heart disease, chronic kidney disease, pregnancy complications

health problems caused by high blood pressure

lifestyle modification (exercise bm, smoking cessation, limit alcohol and sodium)

first line treatment of hypertension