2 Articles - Cardiac Tumors and Cardiac Remodeling Flashcards Preview

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Flashcards in 2 Articles - Cardiac Tumors and Cardiac Remodeling Deck (27)
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1

The signs and symptoms of a cardiac tumor are generally determined by the ________ of the tumor in the heart rather by its ___________.

location

histopathology

2

Some symptoms seen that are caused by tumors. (5)

- obstruction of circulation (most frequent)

- interference with valves

- direct invasion of myocardium

- invasion of adjacent lung

- embolization

3

If a cardiac tumor is suspected, what is the simplest technique for its evaluation? What are two other evaluation techniques that would yield more information?

- echocardiography

- MRI and CT

4

Are the majority of cardiac tumors malignant?

no, they are mostly benign.

5

The majority of tumors are what type?

myxomas

6

The majority of myxomas arise where?

in the left atrium

(most of the remainder are found in the right atrium)

7

Are primary malignant tumors of the heart rare?

yes

(primary malignant tumors of the heart are typically sarcomas)

8

Primary sarcomas arising in the heart generally are rapidly progressive and cause death by doing what? (3)

- infiltrating into the myocardium

- obstructing circulation

- distant metastases

9

Is metastatic involvement of the heart rare? (like, say the tumor originated somewhere besides the heart, but now the heart is involved)

that is actually pretty frequent

10

Patients with smaller excised tumors, minimal cardiac symptoms, and no evidence of mitral regurgitation had lower or higher risk of embolization?

higher risk

11

What is the most serious complication of left atrial tumor embolization?

neurologic symptoms

12

Define cardiac remodeling.

an alteration in the structure and/or function of the heart is response to hemodynamic load and/or cardiac injury

13

Remodeling may be classified as one of two processes. What are they?

adaptive (or physiologic)

maladaptive (or pathologic)

14

What are the three general patterns of remodeling?

1. concentric LV remodeling (response to pressure overload)

2. eccentric LV hypertrophy (response to volume overload)

3. mixed concentric/eccentric hypertrophy

15

The process of cardiac remodeling involves what 4 types of changes to cardiac myocytes and the interstitial collagen matrix?

- structural

- functional

- cellular

- molecular

16

What 3 systemic factors can influence cardiac remodeling?

- changes in hemodynamic load

- neurohormonal activation (causing HTN)

- metabolic status

17

Cardiac dysfunction is defined as an alteration in the relationship between ______ and _______ ________.

preload

stroke volume

(depicted by Frank-Starling curves)

18

The heart can respond to environmental stimuli by growth or shrinkage with a dynamic range of at least ____%.

100%

(that's the reason why the Grinch's heart was able to get so big)

19

What is meant by concentric remodeling?

characterized by increased relative wall thickness (wall thickness as compared to cavity size)

- increased thickness of sarcomeres

20

What is meant by eccentric remodeling?

characterized by increased cardiac mass and chamber volume

- increased length of sarcomeres

21

Are ACE inhibitors and some beta blockers capable of slowing, and in some cases reversing, certain parameters of cardiac remodeling?

yes

22

After an infarct, how long until LV remodeling takes place?

within the first few hours and progresses over time

23

Post-infarction remodeling can be predicted by what change on the EKG?

inverted T waves

24

As the heart undergoes remodeling, it becomes less _______ and more ________.

less elliptical

more spherical

25

What 3 cellular changes are seen with remodeling?

1. myocyte hypertrophy

2. apoptosis of myocytes (or necrosis)

3. fibroblast proliferation and fibrosis

26

What 3 hormones are a part of the neurohormonal activation?

1. renin

2. norepi

3. ADH

27

What is an important factor in the overall extent of remodeling?

the size of the infarct