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Pathophysiology - Diseases > Cardiovascular Diseases > Flashcards

Cardiovascular Diseases Flashcards

1
Q

Main function of the circulatory system

A

transport of oxygen, nutrients, waste products,
electrolytes, leukocytes, and hormones among the
tissues and organs of the body

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2
Q

What does the circulatory system comprises them?

A

heart, bv and blood

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3
Q

What are the chambers of the heart?

A

right and left atrium

right and left ventricle

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4
Q

how does the heart work

A

collect body from body and lungs and pass it through ventricles which ejects the blood through the body and the lungs

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5
Q

muscles in the heart

A

myocardium - cardiac muscles that consists of the chamber walls
endocardium - internal lining of the heart
pericardium - double layer membrane enclosing the heart within the pericardial cavity (split into visceral pericardium or epicardium (inner serous layer) and parietal pericardium (outer fibrous layer))

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6
Q

What are the function of valves?

A

make sure blood only flows in one direction

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7
Q

where is the mitral valves

A

on left side between the left atrium and left ventricle (has 2 flaps called cusps)

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8
Q

where is the tricuspid valve?

A

between right atrium and right ventricles named for 3 cusps

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9
Q

What is the pulmonary semilunar valve

A

between right ventricle to pulmonary artery (one way flow)

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10
Q

Where is the aortic semilunar valve

A

controls blood flow from the left ventricle to the aorta

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11
Q

What are the pumping cycle of the heart?

A

diastole (diastolic phase) where the chambers r filling

systole (systolic phase) where the chambers r contracting

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12
Q

How lojng does the cardiac cyle take?

A

0.8 sec

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13
Q

L coronary artery

A

L coronary artery begins at aorta (front) and divides into the anterior interventricular coronary artery and circumflex artery (around to the back of heart)

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14
Q

R coronary artery

A

R Coronary artery branches from the front of the aorta and divides to the right

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15
Q

What is the sinoatrial node (SA node)

A

the pacemaker of the heart (initiates the impulse for contraction) and passes to ventricles via atrioentricular node

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16
Q

What does the vagus nerve do?

A

slows heartrate during rest and sleep by secreting acetylcholine

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17
Q

how does the nervous system increase heart rate + when?

A

during periods of stress, strenuous physical activity, and excitement

releases epinephrine and norepinephrine to excite heart

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18
Q

what is systemic circulation?

A

distribute oxygenated blood from left ventricle from aorta to the all arteries in body then back to veins to the right atrium (this blood is deoxygenated)

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19
Q

What is pulmonary circulation?

A

carries deoxygenated blood from the R ventricle, beginning at pulmonary trunk and continuing through smaller arteries to the lungs to be oxygenated and returns the blood through pulmonary veins to the left atrium

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20
Q

What are the partitions known?

A

interatrial septum and interventricular septum

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21
Q

What are the subdivisions of arteries?

A

arterioles and the capillaries

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22
Q

What are the smallest veins?

A

venules

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23
Q

what do arteries, arteroiles, and capillaries look like ?

A

Arteries - musculsr, thick,strong, elastic, lined with endothelium
Arterioles - smaller, thinner walls, smooth muscle fibers, lined with endothelium, change diameter by constricting or dilating
Capillaries - has lumen as wide as red blood cell, layer of endothelium

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24
Q

Veins look like?

A

thinner than arteries but lumens r larger

less muscle and elasticity in walls = veins collaspe when empty

have valves to help return blood upward to heart against gravity (particularly in legs)

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25
Q

What is auscultation?

A

listening for sounds through a stethoscope

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26
Q

what is an electrocardiogram?

A

electric recording of heart action and aids in diagnosing coronary artery disease, MI, valve disorders, congenital heart diseases, arrhythmias, and heart block

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27
Q

what is echocardiography?

A

uses high-frequence sound waves to examine size, shape, and motion of heart structures to record heart walve moveet, measure heart chambers and changes in heart chambers

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28
Q

Doppler echocardiography

A

explore blood-flow patterns and changes in velocity of blood flow within heart and great vessels

allows cardiologist to evaluate valve stenosis or insufficiency

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29
Q

exercise tolerance test

A

used to diagnose coronary artery disease and other heart disoers (monitors ECG and blood perssure during exercise)

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30
Q

What is cardiac catheterization?

A

where catheter is passed into the heart through blood vessels to sample blood in each chamber for O2 content and pressure

helps diganose valve disorders or abn shunting of blood

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31
Q

What is an angiocardiogrpahy?

A

a contrast indicator (dye) is injected into the cardiovascular system which can detect blockage in vessles

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32
Q

what is a coronary arteriography?

A

employs an injected contrast material that permits imaging of blood vessel function.

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33
Q

What is the leading cause of death in US and world ______ ppl die from it yearly in us

A

cardiovascular diseases, abt 700,000 ppl yrly

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34
Q

What is hyperlipidemia?

A

elevated lipids (fats) in the blood

lipids include cholesterol, phospholipids, and triglycerides

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35
Q

What is cholesterol transported by?

A

lipoproteins

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36
Q

What is low-density lipoprotein (LDL)

A

major cholesterol carrier in the blood
known as bad cholesterol bc if it accumulates it = a plaque that narrows arteries and impedes blood flow

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37
Q

An estimated ___% of adults older than 20 years of
age in the United States have high levels of LDL.

A

35

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38
Q

an increase in levels of blood LDL =

A

increase in risk for heart disease

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39
Q

What are high-density lipoprotein (HDL)

A

carries abt 1/4 to 1/3 cholesterol

known as good cholestrol bc it carries cholesterol away from arteries and to liver to be eliminated

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40
Q

higher HDl levels =

A

lower risk of coronary heart disease

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41
Q

fat in the human body is called:

A

triglycerides

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42
Q

What is hypercolesterolemia + etiology?

A

abn high levels of blood cholesterol

many types of hyperchoelsterolia have a genetic basis

can also be bc of obesity and diabetes mellitus, high cal diets

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43
Q

diets high in triglycerides and saturated fats =

A

increased cholesterol syntheisis and ingibit removal of cholesterol from blood

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44
Q

What is arteriosclerosis, etiology, and types?

A

artery walls thicek and become hard and inflexible bc of calcium deposition = not being able to response to pressure of blood

leads to hypertension

most common cause is atherosclerosis in which fatty material accumuulates within the walls of the artery (smoking can also cause it)

3 tpes: atherosclerosis, Monckeberg arteriosclerosis, arterioscelrosis

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45
Q

What is atheroscleorisis + risk factors + s/s?

A

the thickening, narrowing, and hardening of arteries

occurs when plaques of cholesterol and lipids form in arterial tunica intima

risk factors: high lipids blood levels, hypercholesterolemia, smoking, hypertension, obesity, and diabetes

responsible for most MIs, cerebral infarction, most r asymptomatic, first symptoms angina pectoris, dizziness, elevated bp and SOB

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46
Q

What are fatty streaks

A

simplest form of atherosclerosis r thin flat discolorations in arteries that can enlarger and become thicker as they grow in length (present in children and increase in size and number till abt 20)

47
Q

What are a fibrous atheromatous plaque?

A

medically important feature of atherosclerosis, charcterized by accumulation of lipids and the formation of scar tissue

begins as a whitish-gray thickening of the innerlinig of an artery (may have a lipd core covered by plaque)

48
Q

What are the leading risk factors for arterial disease?

A

cigarette smoking, high blood lipid and cholesterol levels, and hypertension

49
Q

What is thrombosis?

A

a clot within a bv that formed bc of ulceration and tubulent blood flow in the region ofthe plaqye

50
Q

what t is occlusion

A

when the interior of the artery is narrowed

may result i nchest pain and SOB

51
Q

what can blocakage of the cartiod arteries result in?

A

reduce blood supply to brain and cause stroke

52
Q

WHat is peripheral vascular disease?

A

hardening of arteries in legs which leads to pain in the muscles of the leg (may even lead to ulcers and infections)

53
Q

How do diagnose atherosclerosis?

A

elevated cholesterol, triglyceride, lipid level, hypertension, doppler studies of major vessels show reduced blood flow, ECG, coronary angiography, CT

54
Q

treatment for atherosclerosis?

A

controlling bp, reducing blood cholesterol and lipids and exercise, change in diet to reduce saturated fats and foods high in cholesetorl and lipids

antihypertensive and cholesterol-lowering medication (hyperlipidemic)m niacin and lovastatin combo and ezetimibe

55
Q

What is an important cause for peripheral arterial disease?

A

atherosclerosis

56
Q

peripheral arterial disease is most common in which gender and age?

A

men 70-80 yrs of age

57
Q

risk factors of peripheral arterial disease

A

heredity, high-fat diet, smoking, and physical inactivity

58
Q

most common arteries affect by peripheral arterial disease

A

femoral and popliteal arteries

59
Q

What is ischemia?

A

a loss of blood and oxygen supply

60
Q

What is Raynaud’s disease?

A

disorder of arteries in finger and toes where arteries uddenly contract (vasospasm)

s/s r cold and causes white discoloration (blanching), followed by blue discoloration as venous blood remains, finally red or purple, in stressful events, more in women

61
Q

s/s of peripheral arterial disease

A

intermittent claudication (primary sign of peripheral artery disease, pain with walking)
thinning of skin and subcutaneous tissue of the lower leg
foot may feel cool to touch, a lower leg pulse may be faint or absent

62
Q

What can reduced blood flow lead to?

A

pain, impaired fucntion and tissue necrosis

63
Q

what is diagnosis for peripherial arterial disease

A

uses ultrasound and angiography to confirm diagnosis and pintpoint location

64
Q

how to treat peripheral vascular disease

A

aimed at prevention of further complication:

walking slowly
avoid injury
blood-thinning agents
severe cases = surgical bypass around clot

65
Q

risk factors for raynaud symptom + cause

A

sex, age, stress (highest among young women)

cause is unknown but occurs when exposed to cold or emotional stress (vasospams of small peripheral arteries and arterioles supplying fingers, hand, feet)

66
Q

what are symptoms of vasospasm

A

pallor or cyanosis and cold, numb or tingling fingers (color is most notable in fingertips)

may result in nails becoming brittle, skin over fingers becoming thicker, arthritis, ulcers and infection

67
Q

diagnosis and treatment for raynaud

A

phyiscal exam + pt histroy of s/s

treatment is aimed at reducing triggers for symptoms and protecting hands from trauma (stop smoking, protect hands from cold, avoid emotional stress, med can help), warmth to affected area, vasodilators, alpha-adrenergic blockers, CCBs

68
Q

What is aortic aneurysm?

A

abnormal dilation of the aorta that results from weakness in the aorta wall that can be caused by an inherited disorder, hypertension, atherosclerosis, or inflammation and infection of the artery

69
Q

How are aneurysms described?

A

by their location, size, shape and origin

70
Q

what r the shape of aortic aneurysms known as and what are they?

A

fusiform - uniform shaped, tapered at both ends, symmetrical dilation

saccular - appears as an outpouhcing of a portion of the aoritc wall

71
Q

where do aneurysms usually occur

A

in abd below kidney (abdominal aortic aneurysm)

in chest cavity (thoracic aneurysm)

cereberal (brain) aneurysm is less common

72
Q

what is the danger of an aneurysm?

A

the tendency to increase in size and rupture = hemorrphage

73
Q

how to diagnose and treat an aneurysm?

A

diagnose - bruit heard on ausculation, rupture, ultrasound imaging, ECG, CT, MRI

treat - surgical repair before they leak or rupture, catheter-based stent grafts (after integrity of aortic wall has been breached, immediate surgical intervention to repair the rupture, usually with synthetic graft)

74
Q

What is hypertension?

A

high bp (arterial bp is measure of force of blood against the arterial walls)

75
Q

What is the highest ideal pressure for healthy adullts

A

(systolic) less than 120
(diastolic) less than 80

76
Q

What is the blood pressure for hyper tension?

A

greater than 140/90 in at least 3 measures

77
Q

what is prehypertension??

A

120-139
80-89

78
Q

Abt __% of adult population world wide has hypertension

A

most common CV disorder with abt 20%

79
Q

Risk factors for hypertension?

A

advancing age, sedentary lifestyle, excess weight, and
excessive dietary salt and alcohol consumption, family histroy of Hypertension, AA ancestery

80
Q

What is essential hypertension?

A

primary hypertension which is a sustained increase in systolic and diastolic bp

81
Q

what is secondary hypertension?

A

elevated bp as a result from some other disease likekidney disease

82
Q

What are the s/s of hypertensions

A

headache, dizziness, agitation
epistaxis
lightheadness
syncope
development of CV disease

83
Q

What are common symptoms in pt with CV disease?

A
  • chest pain
  • dyspnea on exertion
  • tachynpean
  • palpitaitons
  • cyanoisis
  • edema
  • fatigue
  • synocope
84
Q

What is coronary artery disease?

A

0 involving arteries supplying myocardiam (arteries become narrowed bc of atherosclerotic deposits over tiem, causign temporary cardiac ischemia and eventually MI)
- casued by fat-containing plaque in lumen of coronary arteries resultin in atherosclerosis and subsequent narrowing of lumen (myocardium must ahve an adequate blood supply to function)

85
Q

s/s of coronary artery disease?

A
  • 1st symtpom is pain of angina pectoris
  • if advanced: severe pain of MI as burning, squeezing, crushing, radiating to arm, neck or jaw as result from diminsiehd blood flow and lower oxygen saturation
  • nausea and vomiting
  • weakness
  • changes r often on pt ECG
  • pt may be asymptomatic
86
Q

ppl at high risk for CAD:

A
  • those with genetic predisposition
  • older than 40
  • men (slightly more than women0
  • postmenopausal women
  • Caucasians
  • history of smoking
  • residence in urban society
  • presence of hypertension
  • dabetes
  • obesity
  • history of elevated serum cholesterol
    -reduced HDL
  • sedentary lifestyle
  • stress
87
Q

how to diagonse coronary atery disease

A

diagnose -usually no chest pain from atherosclerosis until coronary arteries r about 75% occluded
- collateral circulation often develops to suply tissue with needed Oxygen and nutrients
- ECG = ischemia and possibly arrhytmias
- treadmill testing, thallium or Cardiolite scanning, CT, stress echocardiography, cardiac catheterization, angiography, electron bean computerized testing

88
Q

how to treat coronary artery disease

A
  • aimed to restore adequate blood flow to myocardium
  • vasodilators
  • angioplasty w/ balloon or stention
  • hyolipidemic drugs
  • angiotensin- converting enzyme (ACE) inhibitor
  • angiotensin receptor blockers (ARBs)
  • calcium channel blockers (CCBs)
  • thiazide diuretics
  • vasodilators
  • beta-blockers and anticoagulants
  • CABG (coronary artery bypass surgery)
89
Q

What is cardiac arrest + etiology?

A
  • sudden, unexpected cessation of cardiac activityy
  • pt is unresponsive w/ no respiratory effort and no palpable pulse
  • caused by anoxia (absnece of oxygen to tissue) or interruption of electrical stimuli (can be caused by respiratory arrest, arrhythmias, MI, electrocution, drowning, severe trauma, massive hemorrhage, drug overdose)
90
Q

how to diagnose and treat cardiac arrest/

A

diagnose - absnece of respiratory effort and lack of palpable pulse, ECG = ventricular fibrillation or asystole

treat - ZCPR within 4-6 min of cardiac arrest, AEC, epinephrine, isoproterenol or dobutamine, antiarrhytmic drugs

91
Q

What is therapeutic hypothermia?

A
  • after cardiac arrest pt often have bad outcome howevere studies ahve shown cooling pt immediately after cardiac arrest can improve neurologic outcome and quite possibly decrease mortality
  • cool to 91F w/ cooling blankets, ice, caardiopulmonary bypass for 18-24 hrs and then rewarming slowly by less than 1 degree an our
92
Q

What is broken heart syndrome?

A
  • aka takotsubo cardiomyopathy
  • occur when heart’s pumping function is abnormal (can result when there is a temporary problem in a single area or region of heart)
  • indv experience chest pain and SOB after stressful or exciting even
  • thought to be caused by surge of stress hormones (preceded by powerful emotional or physical incident)
  • left ventricle temproarily enlargesand doesnt pump properly
93
Q

how to diangose and treat broken heart syndrome?

A

diagnose- arteries arent obstructed, blood flow may be reduced, chest xray may not show abn size or shape, ECG (changes from normal rhythm) and echocardigraphy may show enlarged left ventricle, coronary angiography to rule out arterial blockage, lungs will be evaluated for pulmonary edema, bp, blood tests = no MI

treat - stay in hospital until MRI can rule out, then beta-blockers, ACE inhibitors and/or diuretics

94
Q

how to diagnose and treat hypertension?

A

diagnose - elevated bp readings (systolic over 140 and diastolic over 90) and track for a while, careful, complete med history, physical exam, lab eval

treat - diuretics, ACE inhibitors, ARBs, vasodilators, CCBs, limit sodium, dietary managements, wt reduction, exercise, reduction of stressful situations and cessation of smoking

95
Q

What is malignant hypertension, s/s, etiology, and how to diagnose and treat

A
  • life-threatening, severe form of hypertension
  • s/s r severe headache, blurred vision, dyspnea
  • etiolgoy is unknown
  • diagnose w/ notable bp elevation (if v. severe 200+/120+)
    = treat w/ IV vasodilators, monitor bp
96
Q

What is pericarditis, etiology, and what can it result in (worst case scenario)?

A
  • acute or chronic inflammation of pericardium, the sac enclosing and protecting the heart (blood or inflammtory exudate is relassed into pericardial sac)
  • is idiopathic or consequence of inflammation or infection elsewhere in the body (other causative agents r viruses, bacteria, trauma, rheumatic fevere, mlignatn neoplastic disease, MI)
  • acutre inflammation can cause adhesions btwn pericardium and heart, loss of elasticity, fibrous calcifications of visceral membrane, interfering with heart’s abiltiy to contrract normally
97
Q

s/s of pericarditis?

A
  • s/s r fever, malaise, chest pain that fluctuates with inspiration or heartbeat, dyspnea, chills, anxious, feeling “pounding heart”, detecable friction rub or grating sound, tachycardia
98
Q

diagnose and treat pericarditis?

A

diagnose - blood studies t oidentify causative organism, elevated WBC, ESR, cardiac enzyme levels, ECG (pericardial fluid and thickened pericardium)

treat - antibiotic treatment and surgical drainage or aspiration, complete bed rest, administration of analgesics, antipyretics and NSAIDS, corticosteroids

99
Q

What is rheumatic heart disease, s/s?

A
  • cardiac manifestations that occur after rheumatic fever
  • s.s r acutre endocarditiis, which leads to chornic cardiac involvement, stenosis of valves, particularly mitral and aoritic valves, dynspnea, tachycardia, edema, nonproductive couhg and cardiac murmurs
  • after rheumatic fever vegetations may become enlarged or valves may become scarried, causing stenosis
100
Q

diagnose and treat rheumatic heart disease?

A

diagnose - history of rheumatic fever, cardiac murmurs, ECG show vegetations or resulting damage to valves

treat - aimed at reducing srtenosis of valves, relieve stenosis, replace valve, good dental hygein, prophylactic antiobiotics

101
Q

What is valvular heart disease + diagnose and treat?

A
  • acquired or congenital disorder that can involve any ofthe 4 valves of heart
  • can occur in ofrm of either insufficiency or stenosis
  • insufficinecy (failure of valves to close completely, allowing blood to forced back int previous chamber and increases heart workload (stenosis, hardneing of cusps of valves that prevents complete opening of valves impedes blood flow to next chamber
  • mostly valve
  • diagnose w/ ECG, chest radiographic studies, echo, cardiac catherization
  • treat w/ digiitalis or quindine for arrhythmias and antibiotic prophylaxis
102
Q

What is mitral stenosis + s/s?

A
  • hardening of cusps of mitral valve that prevents complete and normal opening of valve for passage of blood from L atrium into L ventricle
  • s/s r exertional dyspnea and fatigue, cough and palpitations, hemoptysis, cyanotic
103
Q

how to diagnose and treat mitral stenosis?

A

diagnose - can be insidious or acutre, cardiac murmur (diastolic murmur), Echocardiography

treat - limit sodium, diuretucs, anticoagulants, atrial fibrillation = digoxin, surgical intervention w/ comissurotomy to free up valve and allow adequate blood flow (can be done nonsurgically with balloon valvuloplasty

104
Q

What is mitral insufficiency, s/s and etiology?

A
  • mitral valve fails to close completely and allows blood from L ventricle to flow back into L atrium
  • s/s r dyspnea and fatigue, heart murmur as blood leaks back into L atrium
  • may be caused by scar tissue from inflammation and vegetations (from endocarditis), rheumatic fever, mitral valve prolaspe (MVP), CAD, or MI, or cardiac dilation
105
Q

how to diagnose and treat mitral insuffiency?

A

diagnose - thorough pt history (hisotry of sore thraot or rheumatic fever), physical exam = murmur, echo = insufficiency, ECG, chest radiography, cardiac catherization

treat - bed rezst, oxygen therapy, antibiotics, surgical repair or replacement

106
Q

what is mitral valve prolapse, s/s, and etiology

A

benign condition
one or more cusps of mitral valve protrude back into left atrium during ventricular contraction
- most pt r asympomatic, some experience chest pain, dyspnea, dizziness, fatigue, syncope, severe anxity
- caused by abnormally long or short tendinease, malfunctioning papillary muscles, regurgitation of blood during Left ventricular systole = rushing, gurgling cardiac murmur

107
Q

how to diagnose and treat mitral valve prolapse

A

diagnose - typical click-murmur syndrome on ausculation, Echo, premature ventricular cnotract (PVC) r detected

treat - for asymptomatic pt dont need treatment, those who experience discomfort and anxirty r treated with beta-blockers, advised to av void caffeine, smoking and large, heavy maeals

108
Q

What are blood vessel composed of (3 layers)

A
  • tunica intima, tunica media, tunica externa
  • lining of vessel lumen, tunica intima: is composed of smooth, thin endothelium allowing minimal friction with flowing blood
  • tunica media: composed of smooth muscle and elastic tissue that r under control of sympathetic nervous system (allows constriction or dilation of vessel walls and changes in bp) (more in arteries to compensate for strong bp under which arteries must function)
    tunica externa: is made of connective tissue and support and protect vesslels
109
Q

WWhat hat is Monckeberg arteriosclerosis?

A
  • aka medial calcific sclerosis
  • involves arterial tunica media
  • destruction of muscle and elastic fibers along with calcium deposits
110
Q

What is an aneurysm + etiology?

A
  • weakening and resulting local dilation of wall of an artery
  • common cause is buildup of atherosclerotic plaque, can be trauma, infection or inflammation, and congential tendencies
111
Q

s/s of aneurysm?

A
  • either insidious or sudden and acute
  • based on location, size and extent of dilation
  • discovered during physical exam when abd is palpated, abdominal radiographic study
  • abd or back pain
  • pulsating mass is observed in abd
  • leakage from wall of artery or sudden rupture of weak area
112
Q

What is phlebitis, s/s, etiology, diagnose and treat?

A
  • inflammation of a vein, most often in lower legs
  • s/s r pain and tenderness in affected area, swelling, redness, warmth, tender, cordlike mass under skin, affects tunica intima, resulting in formation of clots (thrombophlebitis)
  • cause is unknown (venous stasis, obesity, blood disorders, injury and surgery)
  • clinical picture and history
  • treat w/ analgesics, dont massage affected tender area bc can form clots or emboli
113
Q

What is thromboplebitis, s/s, etiology?

A

-result of inflammation of a vein with formation fo a thrombus on vessel wall
- interferes w/ blood flow, resulting in edema, as with phlebitis, pain, swelling, heaviness, warmth, chills and fever
- caused by venous stasis, blood disroders that cause a hypercoagulable state and injury tto venous wall

114
Q

diagnose and treat thromboplebitis?

A

diagnose - gross edema in 1 leg, tender to palpation, radiographic venography and ultrasonography

treat - immobilize to prevent thrombus from spreading and dislodgint to become an embolus, heparin to prevent clot from enlarging and antibiotics (usually resolves itself, if not surgical intervention to ligate affected vessel)

Pathophysiology - Diseases (22 decks)

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