Heart Quiz

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Questions and Answers

What characterizes left ventricular dysfunction in heart failure?

Stenosis of the right atrium

Hypertrophy and dilation of the left ventricle (correct)

Enhanced valvular competence

Increased myocardial perfusion

Which of the following is a common consequence of left ventricular diastolic dysfunction?

Elevated oxygen demand

Reduced risk of thrombus formation

Increased cardiac output

Secondary dilation of the left atrium (correct)

Which term best describes the microscopic changes seen in a failing heart?

Distinctive calcific deposits

Specific inflammation and necrosis

Prominent angiogenesis

Nonspecific changes with myocyte hypertrophy and interstitial fibrosis (correct)

What is a typical effect of neurohumoral stimulation in heart failure?

Increased sympathetic activity leading to arrhythmias Signup and view all the answers

Which factor is NOT associated with pulmonary congestion in heart failure?

Decreased pulmonary perfusion Signup and view all the answers

Which type of tumor is most commonly found in the heart?

Myxoma Signup and view all the answers

Which condition is characterized by the accumulation of fluid in the pericardial cavity?

Pericardial Effusion Signup and view all the answers

Which type of cardiomyopathy is characterized by a thickened left ventricle without an obvious cause?

Hypertrophic Cardiomyopathy Signup and view all the answers

Which valvular heart disease complication is associated with significant retrograde flow due to high-pressure gradients?

Aortic Stenosis Signup and view all the answers

Which class of drugs is often used to manage hypertension, which is a major risk factor for heart failure?

Calcium channel blockers Signup and view all the answers

What is the primary symptom of ischemic heart disease that warrants immediate clinical intervention?

Angina Pectoris Signup and view all the answers

Which congenital heart defect is characterized by a ventricular septal defect and pulmonary stenosis?

Tetralogy of Fallot Signup and view all the answers

What is the most common cause of left-sided heart failure?

Coronary Artery Disease Signup and view all the answers

What is the primary consequence of a heart rupture or major vessel injury?

Massive blood loss Signup and view all the answers

What is indicated by a reduction in ejection fraction (EF) in a patient?

Deterioration of myocardial contractile function Signup and view all the answers

Which factor is NOT typically involved in the pathogenesis of congenital heart defects?

Dietary imbalances Signup and view all the answers

What is the role of genes in the development of heart disease?

Genes control cardiac response to injury Signup and view all the answers

Which term describes the changes in the heart following injury or altered loading?

Remodeling Signup and view all the answers

What does hypotensive shock following a major vascular injury often signify?

Impaired blood flow and potential organ failure Signup and view all the answers

How is systolic dysfunction expressed in clinical terms?

Decreased ejection fraction Signup and view all the answers

What can overwhelm the adaptive mechanisms meant to preserve cardiac output during stress?

Genetic polymorphisms Signup and view all the answers

In the context of cardiovascular diseases, what might molecular diagnoses help identify?

Underlying genetic abnormalities Signup and view all the answers

What can changes in contractility due to genetic factors affect in the heart?

Myocyte survival after injury Signup and view all the answers

Which of the following is a primary cause of left-sided heart failure?

Myocardial infarction Signup and view all the answers

What is the consequence of pressure overload in the myocardium?

Increased oxygen demand Signup and view all the answers

Which factor contributes to the development of myocardial hypertrophy in valvular heart disease?

Increased wall stress Signup and view all the answers

What characterizes left-sided congestive heart failure?

Passive congestion in the pulmonary circulation Signup and view all the answers

Which of the following conditions is NOT a contributor to hypertensive heart disease?

Hematological disorders Signup and view all the answers

What is a consequence of volume overload in the myocardium?

Dilation of the heart chambers Signup and view all the answers

Which of the following best describes arrhythmias that can be caused by valvular heart diseases?

Atrial fibrillation Signup and view all the answers

What is a significant consequence of stasis of blood in left-sided heart failure?

Pulmonary congestion Signup and view all the answers

Which of the following is a term used to describe the increase in heart mass due to prolonged pressure overload?

Concentric hypertrophy Signup and view all the answers

Which of the following conditions is least likely to directly cause left-sided heart failure?

Telangiectasia Signup and view all the answers

What primarily characterizes left-sided heart failure?

Inadequate cardiac output resulting in congestion Signup and view all the answers

Which of the following factors is most commonly linked to left-sided heart failure?

Ischemic heart disease Signup and view all the answers

Which embryonic period is crucial for the development of congenital heart defects (CHD)?

Gestational weeks 3 to 8 Signup and view all the answers

What role do specific micro-RNAs play in cardiac development?

They coordinate patterns and levels of transcription factor expression. Signup and view all the answers

What is a key characteristic of congenital heart disease (CHD)?

Abnormalities present at birth in the heart or great vessels Signup and view all the answers

How do transcription factors related to inherited heart defects typically inherit?

Autosomal dominant pattern Signup and view all the answers

Which condition is specifically associated with increased venous congestion?

Left-sided heart failure Signup and view all the answers

What is the role of mechanical ventricular assist devices (VADs) in treating heart failure?

They assist cardiac output in severe cases. Signup and view all the answers

What is the main outcome of chronic heart failure?

Inadequate perfusion to meet metabolic needs Signup and view all the answers

Which growth factors are involved in cardiac pathology other than transcription factors?

Bone morphogenetic protein and fibroblast growth factor Signup and view all the answers

Study Notes

The Heart

The human heart is a vital organ, pumping blood through the body, crucial for oxygen and nutrient delivery.
Worldwide, cardiovascular disease is the leading cause of deaths, with over 610,000 deaths annually in the United States alone.

Cardiac Structure and Specializations

Heart weight varies with body habitus, normally 0.4% to 0.5% of body weight.
Increased heart weight or ventricular thickness indicates hypertrophy.
Enlarged chamber size implies dilation.
Cardiomyocytes are responsible for heart's pumping function.
Atrial cardiomyocytes contain granules storing atrial natriuretic peptide.
Ventricular cardiomyocytes contain B-type natriuretic peptide.
These hormones promote arterial vasodilation and renal salt/water removal.

Cardiac Valves

Four valves (tricuspid, pulmonary, mitral, and aortic) maintain unidirectional blood flow.
Atrioventricular valves (tricuspid and mitral) depend on leaflets, tendinous cords, and papillary muscles.
Semilunar valves (aortic and pulmonary) depend on cuspal attachments.

Cardiac Conduction System

Electrical impulses initiate cardiac contraction via specialized myocytes.
SA node (sinoatrial node) is the pacemaker (60-100 beats/min).
AV node (atrioventricular node) acts as a gatekeeper by delaying impulse transmission to ventricles.

Blood Supply

Myocardial energy production relies heavily on oxidative phosphorylation.
Coronary arteries supply oxygenated blood to myocardium.

Cardiac Regeneration

Potential exists to regenerate damaged myocardium by inducing cardiac regeneration in vivo or implanting stem cells.
However, adult mammalian myocardium has a limited replicative potential.

Effects of Aging on the Heart

Several changes occur with age, including changes to chamber sizes and valves.
Increased subepicardial fat, brown atrophy and decreased cardiomyocyte number, and accumulation of amyloid in the elderly heart.
These changes contribute to cardiovascular diseases more prevalent in the aging population.

Overview of Cardiac Pathophysiology

Heart failure (CHF) is a condition where the heart cannot adequately pump blood to meet body's demands.
CHF often arises from prior chronic overload (e.g., valve disease or hypertension) or acute events (e.g., MI).
Main mechanisms of a "broken" heart include: pump failure, obstruction to flow, regurgitant flow, shunted flow, conduction disorders, and rupture.

Heart Failure

Over one-half of patients with CHF die within 5 years of diagnosis.
One out of every nine deaths in the United States is directly linked to CHF.
CHF is characterized by inadequate cardiac pumping to meet peripheral tissue demands, coupled with increased venous congestion.

Left-Sided Heart Failure

Is most commonly caused by ischemic heart disease, hypertension, and valvular diseases.
Passive congestion and resultant blood backing-up in the pulmonary circulation are hallmark signs of left-sided heart failure.

Right-Sided Heart Failure

Is frequently a consequence of left-sided heart failure.
Primarily occurs in conditions/disorders affecting the lungs and/or pulmonary vasculature.

Ischemic Heart Disease

IHD is a group of diseases resulting from an imbalance between myocardial oxygen supply and demand.
Atherosclerosis is the main cause in over 90% of cases.
Clinically significant plaques in coronary arteries limit blood flow, leading to myocardial ischemia.

Angina Pectoris

Recurrent chest discomfort resulting from transient myocardial ischemia.
Different forms exist, distinguished by provocation factors and time course.

Acute Myocardial Infarction (MI)

Ischemia sufficient to cause cell death, often triggered by a superimposed thrombus.
Most patients experience crushing chest pain, radiating pain to the left arm, jaw, or back; other symptoms include profuse sweating, nausea, and shortness of breath.
Early diagnosis and intervention can improve outcomes.

Myocardial Response to Ischemia

Early Biochemical Changes, involving ATP depletion, lactate accumulation, and progressive loss of myocardial viability.
Cellular/structural changes follow, mirroring loss of energy.

Infarct Modification by Reperfusion

Restoration of blood flow, using therapies like thrombolysis, angioscopy, or bypass surgery, can salvage some ischemic myocardium.
Reperfusion may, however, induce secondary harm.

Clinical Features of MI

Diagnosis uses clinical symptoms, laboratory tests, and specific ECG changes.
Early intervention plays a key role in limiting infarct expansion and cellular/tissue damage.

Other Causes of Myocardial Disease

Many conditions, such as cardiotoxic drugs, radiation exposure, and infections (myocarditis), result in myocardial damage.

Pericardial Disease

Pericardial disease involves problems with the pericardial sac, which surrounds the heart.
Fluid accumulation (effusion), inflammation (pericarditis), and fibrous scar formation (constrictive pericarditis) are key markers.

Tumours of the Heart

Primary heart tumors (e.g., myxomas, lipomas, fibromas, rhabdomyomas) are rarely malignant.
Metastatic tumors (likely starting from other locations) are more common.

Cardiac transplantation

Cardiac transplantation is a life-saving therapy for end-stage heart failure, but complicated by risks like rejection and vasculopathy.

Cardiac Devices

Ventricular assist devices (VAD) allow for short- or long-term mechanical support in individuals with advanced heart failure, awaiting a transplant.

Arrhythmias

Arrhythmias are abnormal cardiac rhythms, varying from slow (bradycardia) to fast (tachycardia) to erratic rhythms.
Several genetic causes (including channelopathies) are implicated.
IHD can produce abnormal myocardial electrical conduction patterns.

Cardiomyopathies

Cardiomyopathies are heart muscle diseases, categorized as dilated (predominantly systolic dysfunction), hypertrophic (predominantly diastolic dysfunction), and restrictive (mainly impaired diastolic filling).
Genetic factors are often responsible.

Myocarditis

Inflammation of heart muscle triggered by infections (most commonly viral).
Clinical presentation varies from asymptomatic to severe heart failure.

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Description

Test your knowledge on the characteristics and complications of heart failure and various forms of cardiomyopathy. This quiz covers essential concepts including left ventricular dysfunction, neurohumoral stimulation, and common heart diseases. Challenge yourself with questions related to diagnosis and management in cardiovascular health.