Cardiovascular Diseases and Heart Evaluation Tests
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Questions and Answers

Which bacteria are commonly associated with endocarditis?

  • Escherichia coli
  • Viridans Streptococci (correct)
  • Corynebacterium diphtheriae
  • Clostridium perfringens

What is a common complication of pericarditis?

  • Valvular prolapse
  • Cardiac tamponade (correct)
  • Arrhythmia
  • Pulmonary embolism

What is typically used to confirm a diagnosis of myocarditis?

  • Blood cultures
  • Echocardiogram
  • Electrocardiogram (ECG)
  • Cardiac MRI (correct)

Which of the following is NOT a cause of congestive heart failure (CHF)?

<p>Asthma (B)</p> Signup and view all the answers

What is the primary mechanism that leads to damage in myocarditis?

<p>Lymphocyte infiltration (C)</p> Signup and view all the answers

Which of the following diagnostic tests is essential for diagnosing endocarditis?

<p>Blood cultures from 2 separate sites (D)</p> Signup and view all the answers

What is a characteristic symptom of congestive heart failure (CHF)?

<p>Shortness of breath (A)</p> Signup and view all the answers

Which condition is primarily indicated by inflammation of the endocardium?

<p>Endocarditis (C)</p> Signup and view all the answers

What is the primary function of troponins in the context of cardiac biomarkers?

<p>Proteins involved in muscle contraction (B)</p> Signup and view all the answers

How long do troponins I remain elevated after myocardial injury?

<p>7-10 days (D)</p> Signup and view all the answers

Which cardiac biomarker rises early, generally within 2-3 hours after cardiac muscle damage?

<p>Myoglobin (C)</p> Signup and view all the answers

Which cardiac biomarker is known to be the most specific for myocardial injury?

<p>Troponin I (C)</p> Signup and view all the answers

What is the primary limitation of myoglobin as a cardiac biomarker?

<p>It has low specificity for cardiac muscle damage (D)</p> Signup and view all the answers

Which biomarker is considered a marker of inflammation and indicates the presence of atherosclerotic plaque?

<p>C-reactive protein (C)</p> Signup and view all the answers

What is the main characteristic of lactate dehydrogenase as a cardiac biomarker?

<p>Non-specific and rarely used to diagnose myocardial infarction (B)</p> Signup and view all the answers

What is a distinguishing feature of creatine kinase MB compared to troponins?

<p>It can be useful for diagnosing reinfarction (C)</p> Signup and view all the answers

What is the role of the tricuspid and bicuspid (mitral) valves in the heart?

<p>They prevent backflow of blood. (B)</p> Signup and view all the answers

Which component is primarily measured by an electrocardiogram (ECG)?

<p>Electrical changes in the myocardium. (B)</p> Signup and view all the answers

What does the QRS complex represent in an ECG?

<p>Ventricular depolarization. (B)</p> Signup and view all the answers

How does hypocalcemia affect an ECG reading?

<p>It lengthens the S-T segment. (A)</p> Signup and view all the answers

What is the primary purpose of an electrocardiogram (ECG/EKG) in diagnosing myocardial infarction (MI)?

<p>To record the electrical activity of the heart (D)</p> Signup and view all the answers

Which of the following is a major risk factor for myocardial infarction (MI)?

<p>Smoking and family history. (B)</p> Signup and view all the answers

Which of the following statements about cardiac markers is true?

<p>Troponins I and T are specific markers for MI diagnosis. (C)</p> Signup and view all the answers

What is the primary cause of myocardial infarction?

<p>Blockage of coronary arteries. (D)</p> Signup and view all the answers

What feature is characteristic of stable angina pectoris?

<p>Typically triggered by physical exertion and stress (C)</p> Signup and view all the answers

What happens to the heart during the resting state of cardiac cells?

<p>Cells remain polarized. (B)</p> Signup and view all the answers

What is a common consequence of unstable plaques in coronary arteries?

<p>Formation of clots leading to thrombosis. (D)</p> Signup and view all the answers

What describes the role of an echocardiogram in myocardial infarction diagnosis?

<p>It provides insights into heart's pumping ability. (A)</p> Signup and view all the answers

Which type of myocardial infarction is characterized by ST-segment elevation?

<p>ST-segment elevation myocardial infarction (STEMI) (B)</p> Signup and view all the answers

Why might an angiogram be used in the diagnosis of myocardial infarction?

<p>To detect blockages in the arterial system (A)</p> Signup and view all the answers

During an angina episode, what typical ECG change may be observed?

<p>ST-segment depression (A)</p> Signup and view all the answers

What differentiates unstable angina from stable angina?

<p>Unstable angina is a medical emergency with chest pain at rest. (B)</p> Signup and view all the answers

What is the significance of the P wave in an electrocardiogram (ECG)?

<p>It indicates atrial depolarization. (D)</p> Signup and view all the answers

Hypokalemia can cause which of the following changes in an electrocardiogram?

<p>Flattened T wave. (C)</p> Signup and view all the answers

Which of the following factors is NOT typically included in cardiac risk assessment?

<p>Duration of exercise routine. (C)</p> Signup and view all the answers

What is the primary role of natriuretic peptides in cardiac function?

<p>To control blood pressure and fluid balance. (C)</p> Signup and view all the answers

Which of the following correctly describes the QRS complex in an electrocardiogram?

<p>It shows ventricular depolarization. (B)</p> Signup and view all the answers

What is the consequence of unstable plaques in coronary arteries?

<p>Increased risk of thrombosis. (D)</p> Signup and view all the answers

Which of the following best describes myocardial infarction?

<p>It results in the death of cardiac muscle due to ischemia. (A)</p> Signup and view all the answers

Which electrolyte imbalance is associated with a prolonged S-T segment on an ECG?

<p>Hypocalcemia. (C)</p> Signup and view all the answers

What is a common triggering factor for endocarditis in individuals with pre-existing heart conditions?

<p>Congenital heart defects (C)</p> Signup and view all the answers

Which type of inflammation primarily affects the myocardium?

<p>Myocarditis (B)</p> Signup and view all the answers

What serious complication can arise from severe myocarditis?

<p>Myocardial infarction (MI) (B)</p> Signup and view all the answers

What is a common diagnostic method for pericarditis?

<p>Echocardiography (D)</p> Signup and view all the answers

Which condition is characterized by fluid accumulation in the lungs and extremities?

<p>Congestive heart failure (CHF) (C)</p> Signup and view all the answers

Which of the following is NOT commonly associated with myocarditis?

<p>Congenital heart defects (C)</p> Signup and view all the answers

Which diagnostic test is useful for assessing inflammatory conditions such as myocarditis?

<p>White blood cell count (B)</p> Signup and view all the answers

What is a consequence of stasis of blood in the context of congestive heart failure?

<p>Fluid retention (A)</p> Signup and view all the answers

What is the primary role of an electrocardiogram (ECG) in the diagnosis of myocardial infarction (MI)?

<p>Record the electrical activity of the heart (D)</p> Signup and view all the answers

Which cardiac marker appears in the blood first following a myocardial infarction?

<p>Myoglobin (D)</p> Signup and view all the answers

Which of the following statements is true regarding an echocardiogram as a diagnostic tool for myocardial infarction?

<p>It provides valuable insights but is not the primary diagnostic tool. (C)</p> Signup and view all the answers

Which type of myocardial infarction is associated with ST-segment elevation?

<p>ST-segment elevation myocardial infarction (STEMI) (C)</p> Signup and view all the answers

What is a common misconception about the presence of ECG changes during a myocardial infarction?

<p>30% of patients may not exhibit ECG changes during an MI. (D)</p> Signup and view all the answers

What would an angiogram typically be used to identify in the context of coronary artery disease?

<p>The arterial blockages in the coronary arteries (B)</p> Signup and view all the answers

Which characteristic symptom is commonly associated with myocardial infarction?

<p>Severe crushing central chest pain (B)</p> Signup and view all the answers

In the context of myocardial ischemia, what commonly occurs during unstable angina?

<p>Chest pain at rest, signaling a medical emergency (D)</p> Signup and view all the answers

What does an elevation of troponins I or T levels greater than 0.01 ng/mL indicate when accompanied by cardiac symptoms?

<p>Myocardial injury (C)</p> Signup and view all the answers

How long can troponin T remain elevated after a myocardial injury?

<p>7-10 days (D)</p> Signup and view all the answers

Which cardiac biomarker is associated with inflammation but lacks specificity?

<p>C-reactive protein (CRP) (A)</p> Signup and view all the answers

What is a key characteristic of myoglobin as a cardiac biomarker?

<p>Its elevation indicates damage proportional to the muscle affected. (D)</p> Signup and view all the answers

Which enzyme is predominantly found in the myocardium and can indicate myocardial infarction when elevated?

<p>Creatine kinase MB (B)</p> Signup and view all the answers

What is the primary function of troponins in myocardial cells?

<p>Facilitating skeletal muscle contractions (C)</p> Signup and view all the answers

Which cardiac biomarker rises early, typically within 2-3 hours after muscle damage but is not specific to cardiac tissue?

<p>Myoglobin (C)</p> Signup and view all the answers

What is the typical rise time of creatine kinase MB levels after a myocardial infarction?

<p>Within 3-4 hours (A)</p> Signup and view all the answers

Flashcards

ECG/EKG Definition

An ECG/EKG plots the electrical activity of the heart over time. It shows heart rhythm and identifies potential problems.

Heart Chambers

The heart has four chambers: two atria and two ventricles. They work together to pump blood.

Myocardial Infarction (MI)

A heart attack, where blood flow to the heart muscle is blocked, causing cell death.

ECG Waves

ECG waves depict depolarization and repolarization of heart cells. P, QRS, and T waves represent specific phases.

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Atherosclerosis Cause

A gradual buildup of plaque in artery walls causing reduced blood flow (ischemia) and potentially a heart attack (MI).

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Troponin Levels

Blood tests for proteins (Troponin I/T) released if heart muscle is damaged, often used to confirm heart attack.

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Cardiac Risk Factors

Factors increasing chances of heart disease include age, high blood pressure, smoking, family history, etc.

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Coronary Artery Blockage

Obstruction of the arteries supplying oxygen to the heart muscle, potentially leading to a heart attack (MI).

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ECG (Electrocardiogram)

A test that records the heart's electrical activity.

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Troponin

A blood marker used to diagnose a heart attack.

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Angina Pectoris

Chest pain caused by reduced blood flow to the heart.

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STEMI (ST-segment elevation MI)

A serious heart attack with ECG changes.

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NSTEMI (Non-ST-segment elevation MI)

Less severe heart attack, without specific ECG changes.

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Acute Coronary Syndrome (ACS)

Conditions indicating low blood supply to heart muscle.

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Echocardiogram

Ultrasound of the heart used to assess pumping ability.

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Troponin I/T elevation

Indicates potential cardiac event in 30-60 days - a rise in Troponin I or T (greater than 0.01 ng/mL with symptoms).

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Myoglobin

Cardiac muscle damage marker, rises early (2-3 hours).

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Creatine Kinase MB (CK-MB)

Enzyme found in myocardium, used to diagnose MI, rising within 3 to 4 hours; not elevated long-term.

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Cardiac Biomarkers

Substances used to detect myocardial cell death.

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MI Diagnosis

Diagnosis of a heart attack using biomarkers like Troponins, CK-MB, and myoglobin levels.

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Useful Cardiac Biomarkers

Troponins (I/T) - Precise, elevated for a while. CK-MB - Quick rise, short elevation. Myoglobin - High sensitivity, early rise.

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Endocarditis

Infection of the inner lining of the heart (endocardium).

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Myocarditis

Inflammation of the heart muscle (myocardium).

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Pericarditis

Inflammation of the heart's outer lining (pericardium).

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Congestive Heart Failure (CHF)

A progressive condition where the heart struggles to pump blood efficiently.

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Endocarditis diagnosis

Diagnosing endocarditis involves blood cultures, CRP, and echocardiograms.

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Myocarditis diagnosis

Myocarditis diagnostic methods include blood tests, antibody levels, and imaging like echocardiography and MRI.

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CHF Causes

Congestive heart failure is often caused by heart attack, high blood pressure, valve problems, or cardiomyopathies.

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CHF Symptoms

CHF symptoms include shortness of breath, fatigue, and swelling of limbs.

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What does an ECG record?

An ECG captures electrical changes in the heart muscle (myocardium) during each heartbeat cycle.

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ECG Wave: P Wave

The P wave on an ECG represents atrial depolarization, the electrical signal that triggers atrial contraction.

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ECG Wave: QRS Complex

The QRS complex represents ventricular depolarization, the electrical signal that triggers ventricular contraction.

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What is a 'heart attack' medically called?

A heart attack is medically known as a myocardial infarction (MI).

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Cause of Myocardial Infarction (MI)

A heart attack occurs when a coronary artery becomes blocked, preventing oxygen-rich blood from reaching the heart muscle.

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What is Troponin?

Troponin is a protein released into the bloodstream when heart muscle cells are damaged, often used to diagnose a heart attack.

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What is Atherosclerosis?

Atherosclerosis is a condition where plaque builds up inside arteries, gradually narrowing the passage for blood flow, potentially leading to a heart attack.

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What is ECG used for?

An ECG (Electrocardiogram) helps diagnose heart rhythm problems, detect heart attacks, and evaluate the overall health of the heart.

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Troponin I vs. T

Both are cardiac biomarkers. Troponin I is more specific to the heart muscle, while Troponin T is present in both skeletal and heart muscle.

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C-reactive Protein (CRP)

A protein produced by the liver that indicates inflammation in the body. It's associated with atherosclerosis, a condition that can lead to heart attacks.

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Lactate Dehydrogenase

An enzyme found in many tissues, including the heart. Levels rise later after a heart attack, making it less useful for diagnosis.

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High Sensitivity CRP (hs-CRP)

A test that measures very low levels of CRP, which can indicate an increased risk for heart disease.

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ECG/EKG

Records electrical activity of the heart. It's the most important test to diagnose heart attacks (MIs). Changes are evident even at the onset of an MI.

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Q Waves, ST Segment Elevation, T Wave Inversion

These are abnormal ECG findings that indicate a heart attack. Q waves appear in transmural MIs, ST elevation points to blockage, and T wave inversion shows ongoing injury.

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Echocardiogram for MI

Not primary diagnostic tool, but valuable in assessing heart's pumping ability and complications. Uses ultrasound to look at heart's muscle movement.

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Angiogram for MI

Not primary diagnostic tool, but reveals blockages in the arteries. Uses contrast dye and x-rays.

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Troponin (I/T)

Cardiac biomarker (protein) released when heart muscle is damaged. Elevated levels confirm heart attack.

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STEMI vs. NSTEMI

STEMI is a more severe heart attack with specific ECG changes (ST elevation). NSTEMI is less severe and doesn't have those specific ECG changes.

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Cardiac Tamponade

A dangerous complication of pericarditis where fluid buildup compresses the heart, restricting its ability to pump blood.

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Study Notes

Cardiovascular Diseases and Evaluation Tests

  • This presentation covers various cardiovascular diseases and the tests used to evaluate them.

Heart Structure

  • The heart has four chambers: two atria and two ventricles.
  • Tricuspid and mitral (bicuspid) valves regulate blood flow.
  • Veins carry blood to the heart.
  • Arteries carry blood away from the heart.

Heart Blood Flow

  • Blood flows through the heart in a specific pathway, involving the atria and ventricles.
  • Coronary arteries supply blood to the heart muscle itself.
  • Specific coronary arteries are named, like the left coronary artery and its branches (circumflex, left anterior descending, obtuse marginal arteries) and right coronary artery and its branches (acute marginal artery).

Electrocardiogram (ECG/EKG)

  • An ECG records electrical changes in the myocardium (heart muscle) during a cardiac cycle.
  • These changes are detectable on the body's surface, using electrodes placed on the skin.
  • The ECG instrument measures small electrical changes and shows deflections (electrical impulses) in the heart.
  • The time between deflections represents phases in the cardiac cycle.
  • The baseline is the time between heartbeats.

Electrocardiogram (Detailed)

  • Heart cells remain polarized between cardiac cycles – their resting state.
  • A triggered impulse causes atrial cells to depolarize, first shown as a P wave.
  • Depolarization of ventricular cells is shown as a large QRS complex.
  • Repolarization of ventricular cells is associated with a T wave.

Impact of Electrolytes on ECG

  • Potassium imbalances (hypokalemia and hyperkalemia) affect the ECG.
  • Calcium imbalances (hypocalcemia and hypercalcemia) also affect the ECG, specifically the S-T segment.

Cardiac Risk Assessment

  • Risk factors (age, sex, blood pressure, smoking, and family history) influence cardiac risk.
  • Lipid profiles (cholesterol, LDL-C, HDL-C, triglycerides) are assessed.
  • Fasting blood glucose (or hemoglobin A1c) levels are crucial.
  • Natriuretic peptides indicate heart function and fluid balance.
  • Troponin levels help diagnose myocardial infarction (MI).

Myocardial Infarction (MI)

  • Also known as a heart attack.
  • Occurs due to necrosis from ischemia, characterized by blockage in coronary arteries.
  • Symptoms include chest pain, shortness of breath, dizziness, and nausea.
  • A primary cause is coronary artery blockage.

Pathology of MI

  • Atherosclerosis (inflammatory process) is a common cause of MI.
  • Progressive narrowing of arterial lumen reduces coronary perfusion, causing chest pain.
  • Unstable plaques can rupture, causing clot formation (thrombosis).
  • Sudden occlusion of the artery results in myocardial infarction.

Cardiac Biomarkers

  • Useful for detecting myocardial cell death.
  • Troponins, proteins involved in muscle contraction, rise within hours of cardiac injury and remain elevated for days.
  • Troponin I is often used as a more specific marker than Troponin T.
  • Myoglobin is another cardiac biomarker that rises early but is not as specific.
  • Creatine kinase MB (CK-MB) is also used but is less specific than troponins.
  • Lactate dehydrogenase (LDH) rises later. The highly sensitive troponin assays are available earlier to detect a cardiac event and troponins I or T reference is < 0.01 ng/mL.
  • C-reactive protein (CRP) measures inflammation, which may be connected with atherosclerosis and increased risk of MI.

MI Diagnosis - Other Tools

  • Electrocardiogram (ECG) records the heart's electrical activity and is useful to diagnose MI (ST-segment elevation or Q-waves).
  • Echocardiogram is an ultrasound technique used to assess heart function.
  • Angiogram detects arterial blockages using contrast dye and x-rays.

MI Diagnosis

  • History (symptoms) informs the diagnosis.
  • ECG changes (ST-segment elevation, Q waves) can indicate MI.
  • Blood markers (troponins, CK-MB, myoglobin) help diagnose MI and quantify muscle damage.
  • Each marker (troponin, CK-MB, myoglobin, etc.) appears in the blood at a different time from onset of MI, so a comprehensive assessment is key for diagnosis.
  • A patient may not show specific ECG changes (30%).

Angina Pectoris

  • Stable angina is chest pain due to reduced coronary blood flow, often triggered by physical activity or stress.
  • Symptoms may subside with rest or medication.
  • Unstable angina presents with similar symptoms but may occur at rest and is a medical emergency.
  • ECG changes associated with angina typically show ST-segment depression.

Acute Coronary Syndrome (ACS)

  • ACS encompasses conditions where myocardial ischemia is possible (lack of blood flow to the heart).
  • ST-segment elevation myocardial infarction (STEMI) is a severe type of ACS, often indicating a complete blockage.
  • Non-ST-segment elevation myocardial infarction (NSTEMI) is a less severe type of ACS.
  • Unstable angina is also a possibility.

Endocarditis

  • Infection of the inner lining of the heart chambers and valves (endocardium).
  • Commonly caused by bacteria (streptococci, staphylococcus aureus, enterococcus).
  • Diagnosis involves clinical evaluation, blood cultures, CRP, and echocardiography to confirm the infection.

Myocarditis

  • Inflammation of the heart muscle (myocardium).
  • Often associated with viral infections, drugs, and autoimmune diseases.
  • Can lead to heart damage and possibly MI or stroke.

Pericarditis

  • Inflammation of the pericardium (the outer lining of the heart).
  • Common causes include infection, trauma, cancer, and medications.
  • Complications can include cardiac tamponade (fluid buildup compressing the heart).

Diagnosis of Endocarditis, Myocarditis and Pericarditis

  • Blood cultures, white blood cell count, troponin and myoglobin levels, antibody titers, and imaging techniques (like echocardiograms and cardiac MRIs) to potentially aid in diagnosis.

Congestive Heart Failure (CHF)

  • Progressive disease where the heart loses its ability to efficiently pump blood.
  • Causes include hypertension, heart valve disease, and cardiomyopathies. Ultimately, blood can not be effectively pumped to tissues.
  • Stasis (stagnation) in blood vessels and fluid accumulation in the body (lungs, extremities) lead symptoms like shortness of breath, fatigue, and swelling (edema).

Congestive Heart Failure (CHF) - Diagnosis

  • Diagnosis involves symptoms evaluation, echocardiography (a detailed study of heart's electrical activity), chest X-ray for fluid status, ECG for electrical activity, and biochemical tests of blood pressure measurements, electrolytes (Na and K), natriuretic peptide (BNP) levels, and kidney function (BUN, creatinine).

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Lecture 9 Cardiovascular Disease PDF

Description

This quiz explores various cardiovascular diseases alongside the evaluation tests used to diagnose them. Key topics include heart structure, blood flow pathways, and the role of electrocardiograms in assessing heart health. Test your knowledge on the anatomy and functions of the heart, along with the tools for monitoring cardiovascular health.

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