Systemic disease

Question	Answer
Diseases dealt with in everyday life	Systemic disease
What are some systemic diseases?	Diabetes Mellitus, hypothyroidism, hyperthyroidism, parathyroid disease
If you have diabetes, what will you expect to see?	Coronary artery disease, a form of dilated cardiomyopathy may be noted in late stage
Arteries harden causing increase risk of atherosclerosis to occur	Coronary artery disease
What will you find when a pt has hypothyroidism?	Bradycardia, pericardial effusion/ tamponade, fat deposits in myocardium, decreased LV function
Is a decreased LV function reversible?	Yes
What does a pt with hyperthyroidism generally have?	Increased cardiac output
What does a pt with parathyroid disease generally present with?	Affects calcium metabolism, calcified mitral annulus, hyper or hypo dynamic LV
What are some connective tissue diseases?	Rheumatoid arthritis, lupus, vasculitis, scleroderma, sarcoidosis, mar fans syndrome
What does a pt with rheumatoid arthritis generally have?	Pericardial effusion found in acute stages
A pt with lupus will generally have these developments?	No bacterial wart like lesions on MV that resembles papilloma, pericarditis
Aka libman-sacks	Lupus
Narrowing of the coronary arteries	Vasculitis
Aka takayas	Vasculitis
Coronary artery spasms	Scleroderma
Infiltrative cardiomyopathy	Sarcoidosis
What things will you often see with a pt with mar fans syndrome?	Ascending aortic aneurysm, MVP, AR
What is a hematologic disorder?	Sickle cell anemia
A pt has sickle cell anemia, what will you commonly see in echo?	Cardiomyopathy, LV volume overload, hypertrophied with preserved contractility
With a neoplastic disorder, what will you see in echo?	Pericardial effusion
What are the guidelines for systemic hypertension?	Systolic BP above 140mmhg, diastolic bp above 90 mmhg, or both
What are the causes of primary systemic hypertension?	Unknown
What is the etiology of secondary systemic hypertension?	Renal artery disease, aortic coarctation, endocrine disease, drugs, hx of HTN, DM, IDH, CVA, smoking/alcohol, race and age, obesity/ weight gain
What race are at a higher risk for secondary systemic hypertension?	African Americans
What are the sign and symptoms of systemic hypertension?	Asymptomatic, headaches, dizziness/ blurred vision, palpitations, sweats, anxiety, dyspnea, CP,
What is the classic finding of systemic HTN?	LVH with normal systolic function
What are some echo findings of systemic HTN?	LVH with normal systolic function, LV pressure overload with normal cavity size, reduced LV function - end stage, increased LVEDP causes atrial HTN then increases resistance to pulmonary venous drainage, dilation of the aortic root, LA enlargement due to MR/MAC, pericardial effusion, normal systolic function, AOV sclerotic AR
What do you use Doppler on when there is systemic HTN?	MV, AOV
What will you find when you Doppler the MV when a pt has systemic HTN?	Diastolic dysfunction (reversed e:a), prolonged deceleration, MR
What will you find in Doppler of the AOV when a pt has systemic HTN?	AR common finding, sclerosis
What are some complications of systemic HTN?	Atherosclerotic complications, CHF, Tia/CVA, hypertensive renal disease, HTN encephalopathy, HTN retinopathy, abdominal aortic aneurysm, aortic dissection
What are some atherosclerotic complications?	Angina, MI, acute MI
What is the most common cause of death for HTN?	Atherosclerosis
What are 2 methods of treatment for systemic HTN?	Non pharmacological, pharmacological therapy
What are some examples of a non pharmacological treatment?	Weight loss, exercise, reduction of sodium, cholesterol, alcohol, coffee and tobacco, stress reduction
What are some examples of pharmacologic therapies?	Diuretics, beta blockers, ace inhibitors, calcium channel blockers
What is the first drug of choice with systemic HTN?	Diuretics
What is the cause of primary HTN?	Unknown
What are some examples of secondary HTN?	Increased resistance of pulmonary venous drainage, increased resistance to vascular flow, increased resistance to pulmonary flow through pulmonary artery, hypo ventilation,
What are some miscellaneous examples of secondary pulmonary HTN?	High elevation, anomalous pulmonary vein return, tetralogy of fallot, IV drug abuse, takayasu
What will you see with a increased resistance of pulmonary venous drainage?	Increased LVEDP, la dilation, pulmonary venous obstruction
What will you see with a increased resistance to vascular flow?	COPD, hepatic cirrhosis, portal thrombosis
What will you find with a increased resistance to pulmonary flow through the pulmonary artery?	Pulmonary emboli, pulmonic stenosis
What will you see with hypo ventilation?	Obesity, pharyngeal tracheal obstruction, chest wall disorders
What are some signs and symptoms of phtn?	Dependent on underlying etiology, exertional dyspnea, fatigue, dizziness/ syncope, CP, palpitations, cough/ hoarseness, hemoptysis
What are some echo findings of PHTN?	Dilated pulmonary artery, RV dilation, paradoxical septal motion, septal hyper trophy, RVH, PV motion
What are some examples of PV motion?	Decreased/ absent a dip, mid systolic closure on mode, prolonged RV peak to peak ejection time intervals, premature PV opening with increased RV end diastolic pressures
What will you fin in Doppler with phtn?	Diastolic turbulence in RV outflow, tr, assess for RV systolic pressure
When you Doppler the pulmonary artery flow, what will you see with phtn?	Ejection time and acceleration time should be comparable
What do you treat for secondary phtn?	Treat underlying cause of secondary pulmonary hypertension
What are two methods of treatment for phtn?	Pharmacologically, surgically

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	Created by ecmarchese about 10 years ago