Cardiovascular Diseases and Heart Structure
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Questions and Answers

What is the primary function of the Tricuspid and Bicuspids (mitral) valves in the heart?

  • To prevent backflow of blood into the atria (correct)
  • To promote electrical conductivity during heartbeats
  • To assist in oxygen exchange in the blood
  • To regulate blood pressure in the arteries

    • Which sequence of waves on an ECG corresponds to the depolarization and repolarization of the ventricles?

  • T wave followed by QRS complex
  • QRS complex followed by P wave
  • P wave followed by T wave
  • QRS complex followed by T wave (correct)

    • Which electrolyte imbalance is known to prolong the S-T segment on an ECG?

  • Hypercalcemia
  • Hypocalcemia (correct)
  • Hypokalemia
  • Hyperkalemia

    • What is a major risk factor for myocardial infarction (MI)?

    <p>Family history of cardiovascular diseases</p> Signup and view all the answers

    Which condition is primarily caused by the blockage of the coronary arteries?

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

    What role do natriuretic peptides play in cardiac risk assessment?

    <p>They control blood pressure, fluid balance, and electrolyte homeostasis</p> Signup and view all the answers

    What is most commonly associated with the symptoms of chest pain and shortness of breath?

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

    What causes the formation of a thrombus in the context of myocardial infarction?

    <p>Rupture of unstable plaques</p> Signup and view all the answers

    What is the initial deflection seen on an ECG that signifies atrial depolarization?

    <p>P wave</p> Signup and view all the answers

    What is the best method for diagnosing myocardial infarction?

    <p>Troponin level testing</p> Signup and view all the answers

    What is the main characteristic of troponin I in relation to myocardial injury?

    <p>It is the most specific biomarker for myocardial injury.</p> Signup and view all the answers

    Which cardiac biomarker rises earliest after muscle damage?

    <p>Myoglobin</p> Signup and view all the answers

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

    <p>It lacks specificity for cardiac muscle damage.</p> Signup and view all the answers

    What is a key feature of creatine kinase MB regarding its behavior after myocardial infarction?

    <p>It rises within 3 to 4 hours after an MI.</p> Signup and view all the answers

    What does a high level of C-reactive protein (hs-CRP) indicate?

    <p>Presence of atherosclerotic plaque.</p> Signup and view all the answers

    What is the primary utility of measuring troponins in the clinical setting?

    <p>Detecting myocardial cell death.</p> Signup and view all the answers

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

    <p>Around 7-10 days.</p> Signup and view all the answers

    What is the primary role of lactate dehydrogenase in the context of myocardial injury?

    <p>It serves as a non-specific marker of energy metabolism.</p> Signup and view all the answers

    What does a troponin level greater than 0.01 ng/mL indicate in the presence of cardiac symptoms?

    <p>Increased likelihood of cardiac injury.</p> Signup and view all the answers

    What distinguishes troponin C from troponin I and T?

    <p>It is involved in calcium binding.</p> Signup and view all the answers

    Which organism is least likely to be associated with endocarditis?

    <p>Escherichia coli</p> Signup and view all the answers

    What is a primary cause of myocarditis?

    <p>Bacterial infection</p> Signup and view all the answers

    Which of the following is a potential complication of pericarditis?

    <p>Cardiac tamponade</p> Signup and view all the answers

    What is the primary role of imaging techniques in diagnosing myocarditis?

    <p>To confirm the diagnosis</p> Signup and view all the answers

    Which of the following symptoms is most closely associated with congestive heart failure?

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

    What typically triggers bacteria to reach the heart in cases of endocarditis?

    <p>Bloodstream infection</p> Signup and view all the answers

    Which laboratory test is essential for the diagnosis of both myocarditis and endocarditis?

    <p>Blood cultures</p> Signup and view all the answers

    Which of the following conditions is least likely to contribute to congestive heart failure?

    <p>Chronic infection</p> Signup and view all the answers

    What is the significance of Q waves in an Electrocardiogram (ECG) during a myocardial infarction (MI)?

    <p>Suggest a transmural MI</p> Signup and view all the answers

    Which imaging technique is specifically mentioned as useful in myocarditis diagnosis?

    <p>Cardiac MRI</p> Signup and view all the answers

    Why is an echocardiogram not a primary diagnostic tool in diagnosing MI?

    <p>It can indicate heart pumping ability but not diagnose MI directly</p> Signup and view all the answers

    What is a common treatment approach for acute pericarditis?

    <p>Anti-inflammatory medication</p> Signup and view all the answers

    Which cardiac marker appears in the blood first after an MI?

    <p>Myoglobin</p> Signup and view all the answers

    What does the absence of specific changes in an ECG indicate in certain patients with MI?

    <p>The MI is silent and may go unrecognized</p> Signup and view all the answers

    What characterizes unstable angina compared to stable angina?

    <p>It is associated with chest pain at rest</p> Signup and view all the answers

    What procedure utilizes contrast dye and x-ray to detect coronary artery blockages?

    <p>Angiogram</p> Signup and view all the answers

    How does ST-segment depression in an ECG relate to angina episodes?

    <p>It is a temporary and reversible effect during angina</p> Signup and view all the answers

    What is a notable characteristic of ST-segment elevation myocardial infarction (STEMI)?

    <p>It signifies complete blockage of a coronary artery</p> Signup and view all the answers

    Why is cardiac marker testing crucial in diagnosing MI?

    <p>Each marker appears in a unique time frame after an MI</p> Signup and view all the answers

    What does a myocardial ischemia condition lead to?

    <p>Reduced oxygen supply to the heart muscle</p> Signup and view all the answers

    Study Notes

    Cardiovascular Diseases and Evaluation Tests

    • Diseases and tests related to the heart and blood vessels are covered.

    Heart Structure

    • The heart has four chambers (two atria and two ventricles).
    • Tricuspid and mitral (bicuspid) valves are present.
    • Veins and arteries are components of the cardiovascular system.

    Heart Blood Flow

    • Oxygenated blood leaves the heart via the aorta.
    • Deoxygenated blood enters the heart via veins.
    • Coronary arteries supply the heart muscle with blood.

    Electrocardiogram (ECG/EKG)

    • Records electrical changes in the myocardium (heart muscle) during a cardiac cycle.
    • Electrodes are placed on the skin to record these changes.
    • The instrument detects small electrical changes.
    • Deflections indicate time between phases of the cardiac cycle.
    • Baseline measures time between heart beats.

    Electrocardiogram

    • Cells are polarized between heartbeats (resting state).
    • Atrial cells depolarize, triggering the first deflection (P wave).
    • Ventricular cells depolarize, creating the QRS complex (a larger deflection).
    • Ventricular repolarization is represented by the T wave.

    Impact of Electrolytes on ECG

    • Potassium’s fluctuations (hypokalemia/hyperkalemia) affect ECG.
    • Calcium changes (hypocalcemia/hypercalcemia) also alter the ECG.
    • Specific ECG changes, such as QT prolongation or T wave changes, result from electrolyte imbalances.

    Cardiac Risk Assessment

    • Risk factors like age, sex, blood pressure, smoking, and family history are assessed.
    • A lipid profile, including cholesterol levels (total, LDL-C, HDL-C, and triglycerides), is evaluated.
    • Fasting blood glucose or hemoglobin A1c levels are examined.
    • Natriuretic peptides and electrolyte balance are important indicators.
    • Troponin levels are measured to evaluate for myocardial injury (MI). They are used to diagnose MI.

    Myocardial Infarction (MI)

    • MI, also known as a heart attack, is caused by ischemia.
    • Blockage of coronary arteries, responsible for blood flow to the heart muscle, is a common cause.
    • MI symptoms include chest pain, shortness of breath, dizziness, and nausea.

    Pathology of MI

    • Atherosclerosis, an inflammatory process narrowing the arteries, is a frequent cause.
    • Unstable plaques can rupture, leading to clot formation (thrombosis) and artery blockage.
    • Reduced coronary perfusion, causing chest pain, is another symptom of MI.

    Cardiac Biomarkers

    • Troponins, proteins involved in muscle contraction, are useful for detecting myocardial cell death.
    • Highly sensitive troponin assays detect them within hours.
    • Troponin I and T remain elevated for several days/weeks, indicating potential MI.
    • CK-MB and Myoglobin are also used (but less sensitive than troponin) to diagnose MI. Their levels rise earlier than troponins (2-3 hours) after the onset of MI.
    • They remain elevated for a shorter period than troponins.
    • C-reactive protein (CRP) is a marker of inflammation. A highly sensitive form (hs-CRP) can indicate atherosclerotic plaque buildup and MI risk.

    Lactate Dehydrogenase

    • Found in diverse tissues, this enzyme's levels rise after MI, but are not as helpful as troponins, myoglobin and CK-MB for diagnosis.

    MI Diagnosis - Other Tools

    • ECG records the electrical activity of heart, identifying abnormalities like Q waves, ST elevation, and T-wave inversion.
    • Cardiac markers (e.g., troponin, myoglobin, CK-MB) assist in the diagnosis of MI.
    • Echocardiography is an ultrasound of the heart to assess its pumping function.
    • Angiogram is not usually the primary tool but is useful for detecting arterial blockages.

    MI Diagnosis

    • Patient history, ECG, and biochemical markers (troponin, CK-MB, myoglobin) are used to diagnose an MI.
    • Specific ECG changes, like Q waves, ST segment elevation, and T-wave inversion, can indicate MI.

    Angina Pectoris

    • Stable angina is caused by coronary artery narrowing that is relieved by rest or medication.
    • Unstable angina is characterized by chest pain even at rest. ECG changes are temporary (ST-segment depression).

    Acute Coronary Syndrome (ACS)

    • ACS encompasses conditions with reduced blood flow to heart muscle, often from plaque rupture.
    • It includes ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina.
    • STEMI and NSTEMI are more severe than unstable angina.

    Endocarditis

    • Infection of the endocardium, the inner lining of the heart, commonly due to bacteria like streptococci, staphylococcus aureus, or enterococcus sp.
    • Bacteria reach the heart through the bloodstream.
    • Problems with heart valves, previous heart damage, or congenital heart defects predispose individuals. Diagnosis involves blood cultures, echocardiograms, and clinical evaluation.

    Myocarditis

    • Myocarditis is inflammation of the heart muscle.
    • Some causes include infections (viral, bacterial, parasitic, fungal) and autoimmune diseases.
    • Severe myocarditis can lead to heart problems called MI or stroke.

    Pericarditis

    • Inflammation of the pericardium (outer layer of the heart) can be acute or chronic.
    • Causes include heart attack, trauma, viral infection, fungus, cancer, and kidney failure or use of certain drugs.
    • Chronic pericarditis and cardiac tamponade (heart compression) are complications that can arise.

    Endocarditis, Myocarditis, and Pericarditis - Diagnosis

    • Diagnosis relies on specific tests: blood cultures, white blood cell count, troponin/myoglobin levels, and antibody titers, imaging techniques like echocardiography, Cardiac MRI.

    Congestive Heart Failure (CHF)

    • CHF results in decreased heart pumping ability over time.
    • Causes include MI, hypertension, heart valve disease, and cardiomyopathies.
    • Fluid buildup in lungs and extremities are common symptoms.

    Congestive Heart Failure (CHF) - Diagnosis

    • Diagnosis involves echocardiogram, chest x-ray, ECG, measurement of blood volume, assessing for fluid buildup, biochemistry tests (BNP), electrolyte and kidney function tests.

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    Lecture 9 Cardiovascular Disease PDF

    Description

    Explore the complexities of cardiovascular diseases and the essential tests used for evaluation. This quiz covers the anatomy of the heart, blood flow dynamics, and details about the electrocardiogram (ECG/EKG) process. Test your knowledge on the heart's structure and its critical functions.

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