Diseases of the Heart

• Pericarditis is the inflammation and/or infection of the pericardium by infectious Coxsackievirus Group B virus when viral, or from other conditions such as thyroid problems, cancers, radiation, connective tissue use, or drug use
• It can cause a pleuritic sharp chest pain, that often puts people into a forward-leaning position to avoid the discomfort when laying or sitting back.
• Pericarditis is characterized by the evanscent fiction rub sound
• Pericarditis can be diagnosed by 2 of 4 ways: hearing the friction rub; by visualizing the ECG, which should should diffuse ST elevation or the depression of the PR; chest pain; and pericardial effusion
• Which medicines can be used to treat pericarditis?

  Nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and corticosteroids.
• pericardial effusion is An acute or chronic accumulation of fluid above 50mL within the pericardial space. There is normally 10-50 mL of serous fluid in the pericardial cavity.
• Some common conditions that cause pericardial effusion can include infections, neoplasms, autoimmune diseases, radiation, and myocardial infarction.
• Beck's Triad includes hypotension, muffled heart sounds, and jugular vein distention
• Cardiac tamponade is heart expansion, stroke volume, and blood flow through the heart is reduced or compromised by increased pericardial cavity pressure
• Fluids that can accumulate in the pericardium include blood, serous fluid, and air.
• Mitral regurgitation: Most common AV valve disease, where blood leaks backwards into left atria.
• Tricuspid regurgitation: Often secondary to left-sided heart problems; blood leaks back into/affecting pressure in the right atrium.
• Mitral stenosis: Narrowing of the mitral valve, causing less blood to left ventricle and increased cardiac workload to compensate.
• Tricuspid stenosis: Less common than mitral stenosis; narrowed tricuspid brings less blood to the right ventricle, causing less blood circulation and enlarged right atrium.
• Aortic regurgitation: Occurs when the aortic valve doesn't close tightly, allowing blood to leak back into the left ventricle.
• Pulmonary stenosis: Less common than aortic stenosis, it involves narrowing of the pulmonary valve opening, hindering blood flow from the right ventricle to the lungs.
• Aortic stenosis: The most common semilunar valve disease, characterized by a narrowed aortic valve opening. This restricts blood flow from the left ventricle to the aorta.
• In atherosclerosis, lipoprotein molecules build up in the intima from Sources like alcohol, fried foods, sweets, dairy, etc.
• In atherosclerosis, oxidative stress + modified LDL induce cytokine attraction to the occluding artery.
• In atherosclerosis, leukocytes and monocytes are called to the scene and promote more scavenge receptor expression
• Foam cells are scavenger cells that have taken up modified LDL into them.
• In atherosclerosis, calcification and fibrosis + necrosis/apoptosis of invaded SMCs occurs, hardens and expands the plaque
• Dyslipidemia (elevated LDL, decreased HDL) is a risk factor for atherosclerosis.
• In unstable angina, there is a partially occlusive thrombus.
• In NSTEMI, there is a partially occlusive thrombus.
• In STEMI, there is a fully occlusive thrombus.
• Chronic RAAS activation stimulates vascular remodeling and cardiac fibrosis.
• Diastolic Heart Failure is when the ventricles are stiff and are unable to fill properly. This means the ejection fraction is above 40%.
• Systolic Heart Failure is when the ventricles are enlarged and push forward a lot of blood, but the atria are unable to eject all of it through. This means that the ejection fraction is below 40%.
• Dilated cardiomyopathy is a cause of systolic HF.
• Restrictive cardiomyopathy is a cause of diastolic HF.
• Orthopnea is a condition in which the patient experiences difficulty in breathing when lying down.
• What sounds might be auscultated in LHF?

  Crackles or rhonci in lung auscultation.
• Edema or JCD is a symptom of RHF.
• HFrEF is systolic HF.
• HFpEF is diastolic HF.
• The S3 sound is heard in HFrEF.
• The S4 sound is heard in HFpEF.
• What does the F in FAILURE stand for?

  Failure to take meds as prescribed.
• What does the A in FAILURE stand for?

  Arrhythmias