Cardiovascular Disorders Overview

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Questions and Answers

What are common clinical manifestations of acute pericarditis?

Anorexia and shortness of breath

Fever, myalgias, and severe chest pain (correct)

Murmur and swelling in the limbs

Fatigue and exercise intolerance

Which treatment is NOT typically associated with constrictive pericarditis?

Surgical excision if other treatments fail

Antibiotics for underlying infection (correct)

Dietary sodium restriction

Diuretics to improve cardiac output

What is the main characteristic of pericardial effusion?

Accumulation of fluid in the pericardial cavity (correct)

Weakening of the heart muscle leading to stretching

Scarring of the myocardium

Thickening and rigidity of the pericardium

Which of the following disorders is associated with the heart muscle making it harder to pump blood?

Cardiomyopathy Signup and view all the answers

What describes the condition of dilated cardiomyopathy?

Weakening and stretching of the heart muscle Signup and view all the answers

In a child with a ventricular septal defect, blood flow is shunted from the:

left ventricle to the right ventricle Signup and view all the answers

What is the correct treatment timing for an Atrial Septal Defect to improve health outcomes?

Before school age Signup and view all the answers

Which of the following best describes a Coarctation of the Aorta?

Narrowing of the lumen of the aorta Signup and view all the answers

Which clinical manifestation is typically associated with Ventricular Septal Defect?

Poor weight gain Signup and view all the answers

What is a possible treatment for Coarctation of the Aorta?

Surgical intervention Signup and view all the answers

What is a common clinical manifestation of an Atrioventricular Canal Defect?

Murmur Signup and view all the answers

What is the expected anatomical defect in Atrioventricular Canal Defect?

Nonfusion of the endocardial cushions Signup and view all the answers

In treating Coarctation of the Aorta, what is the initial intervention suggested for infants?

Bring babies' knees to chest Signup and view all the answers

What is the most common type of Truncus Arteriosus?

Type I Signup and view all the answers

Which treatment is typically administered for Hypoplastic Left Heart Syndrome?

Prostaglandin administration Signup and view all the answers

What is a significant clinical manifestation of Truncus Arteriosus?

Cyanosis that worsens with activity Signup and view all the answers

What is the outcome of untreated obstructed lesions in congenital heart conditions?

Worsening cyanosis Signup and view all the answers

Which of the following procedures is part of the treatment for Truncus Arteriosus?

Modified Rastelli procedure Signup and view all the answers

What is the result of the closure of the ductus in Hypoplastic Left Heart Syndrome?

Decreased systemic perfusion Signup and view all the answers

What defines the conduction system of the heart?

Presence of pacemaker cells and conduction pathways Signup and view all the answers

Which manifestation indicates a potential myocardial ischemia during an ECG?

ST segment depression Signup and view all the answers

What characterizes a Non-ST-Elevation Myocardial Infarction (Non-STEMI)?

ST segment depression and T wave inversion Signup and view all the answers

Which presentation is typically seen in a Transmural Infarction (STEMI)?

ST segment elevation on ECG Signup and view all the answers

What is the typical heart rate associated with Atrial Flutter?

300 bpm Signup and view all the answers

Which of the following is a common cause of Atrial Fibrillation?

High blood pressure (HTN) Signup and view all the answers

In Atrial Fibrillation, which of the following is typically not observed on an ECG?

Visible P-waves Signup and view all the answers

What is the primary risk associated with patients who experience STEMI?

Increased risk for serious complications Signup and view all the answers

What type of myocardial damage occurs in Subendocardial Infarction?

Partial wall thickness damage beneath the endocardium Signup and view all the answers

Which of the following describes a key feature of arrhythmias?

Can vary from missed beats to severe disturbances Signup and view all the answers

What characteristic pattern is observed in atrial flutter on an ECG?

Sawtooth pattern Signup and view all the answers

What is a typical ventricular rate when experiencing frequent atrial impulses in atrial flutter?

70 bpm Signup and view all the answers

Which condition features an extra P-wave with abnormal morphology?

Premature Atrial Contractions Signup and view all the answers

How can monomorphic ventricular tachycardia be characterized in terms of QRS complexes?

Same shape and symmetrical Signup and view all the answers

What is a significant feature of polymorphic ventricular tachycardia?

Variable QRS shape Signup and view all the answers

What is often the result of a premature ventricular contraction?

Compensatory pause Signup and view all the answers

When should atrial flutter be suspected in a patient based on heart rate?

When resting HR is 150 bpm Signup and view all the answers

What occurs when only some of the atrial impulses are conducted to the ventricles?

Ventricular rate lower than atrial rate Signup and view all the answers

Study Notes

Disorders of the Pericardium

Acute Pericarditis: Inflammation of the pericardium causing chest pain, fever, muscle aches, and malaise. Treated with rest, salicylates, NSAIDs, and possibly colchicine.
Constrictive (Restrictive) Pericarditis: Fibrous scarring and calcification of the pericardium restrict heart function, leading to exercise intolerance, dyspnea, fatigue, and anorexia. Treatment includes dietary sodium restriction, diuretics, anti-inflammatory drugs, and potentially surgical excision.
Pericardial Effusion: Fluid accumulation in the pericardial cavity, a life-threatening condition. Assessment may reveal a murmur and chest pain. Treatment involves pericardiocentesis (fluid removal).

Disorders of the Myocardium

Cardiomyopathies: Diseases affecting the myocardium, impairing the heart's pumping ability. Often idiopathic, and may result from neurohumoral responses to ischemia or hypertension.
Dilated Cardiomyopathy: Weakening and stretching of the heart muscle, hindering blood pumping. Treatment may involve surgical closure techniques.

Congenital Heart Defects

Atrial Septal Defect (ASD): Abnormal opening between atria, shunting blood from left to right. Often asymptomatic, diagnosed by murmur. Three types: ostium primum, ostium secundum, and sinus venosus. Surgical closure is recommended before school age.
Ventricular Septal Defect (VSD): Abnormal opening between ventricles, shunting blood from the high-pressure left side to the low-pressure right side. Clinical manifestations vary with age and defect size, potentially causing heart failure, poor weight gain, murmur, and systolic thrill. Treatment ranges from minimal intervention to surgical repair. Blood flows from the left ventricle to the right ventricle.
Atrioventricular Canal Defect (AVC): Results from incomplete fusion of endocardial cushions, affecting atrial and ventricular septa and AV valves. Manifests with murmur, heart failure, and respiratory infections. Complete repair is usually done between 3 and 6 months of age.

Obstructive Defects

Coarctation of the Aorta: Narrowing of the aorta impeding blood flow. Commonly found near the ductus arteriosus but can occur elsewhere. Newborns may present with heart failure; older children might exhibit upper extremity hypertension, lower extremity pulse weakness, cool mottled skin, and leg cramps during exercise. Treatment includes prostaglandin administration, mechanical ventilation, inotropic support, and surgery.
Truncus Arteriosus: Failure of the embryonic artery to divide into the pulmonary artery and aorta. The truncus straddles a VSD. Four types, with varying pulmonary artery origins. Clinical manifestations include cyanosis (worsening with activity) and murmur. Treatment involves surgical procedures like the modified Rastelli procedure.
Hypoplastic Left Heart Syndrome: Underdevelopment of left-sided cardiac structures, obstructing left ventricular outflow. The left ventricle, aorta, and aortic arch are underdeveloped; mitral atresia or stenosis may be present. Clinical manifestations include decreased systemic perfusion leading to hypoxemia, acidosis, and shock. Treatment involves prostaglandin administration, acidosis correction, inotropic support, ventilatory manipulation, surgery, and potentially cardiac transplantation.

ECG Interpretations: The Cardiac Cycle and Conduction System

The cardiac cycle has five phases.
The heart's conduction system facilitates coordinated heartbeats.
Electrocardiography (ECG) and Holter monitoring are used to assess myocardial ischemia, infarction, conduction defects, and dysrhythmias. The baseline is isoelectric.

ECG Interpretation: Myocardial Infarction (MI)

Subendocardial Infarction (Non-STEMI): Involves only the inner myocardium. ECG shows ST segment depression and T-wave inversion.
Transmural Infarction (STEMI): Involves the entire myocardial wall thickness. ECG shows ST segment elevation. STEMI patients require urgent intervention.

Arrhythmias/Dysrhythmias

Disturbances in heart rhythm, ranging from occasional missed beats to severely impaired pumping. Caused by abnormal impulse generation or conduction.

Specific Arrhythmias

Atrial Fibrillation: The most common arrhythmia. Rapid, irregular atrial activity (400-600 bpm) causing fibrillatory waves on ECG. No visible P-waves, irregularly irregular QRS complexes, and often a high ventricular rate.
Atrial Flutter: Rapid, regular atrial contractions (usually 300 bpm), creating a "sawtooth" pattern on ECG. Ventricular rate is slower than atrial rate (e.g., 70 bpm if every fourth atrial impulse is conducted).
Premature Atrial Contractions (PACs): Extra, premature P-wave with abnormal morphology, followed by a compensatory pause. May appear as atrial bigeminy.
Premature Ventricular Contractions (PVCs): Wide, abnormal QRS complexes out of sequence with the normal rhythm, followed by a compensatory pause.
Ventricular Tachycardia: Rapid ventricular rate (>100 bpm). Can be monomorphic (uniform QRS complexes) or polymorphic (variable QRS complexes). May require immediate medical intervention (code blue).

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Description

Explore the disorders affecting the pericardium and myocardium, including acute pericarditis, constrictive pericarditis, and various cardiomyopathies. This quiz will test your knowledge on symptoms, treatments, and complications associated with these conditions.