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NR507 - Advanced Pathophysiology > Week 2 - Cardiovascular system > Flashcards

Week 2 - Cardiovascular system Flashcards

1
Q

Coronary Artery Disease

A

Starts with damage to the epithelium, damage results in inflammatory process. Cholesterol binds to the damaged area, macrophages attach to try to break down plaque that shouldn’t be there then they die, cap forms over the top to contain it. This narrows the coronary artery disrupting blood flow to the heart.

Increases risk for thrombus and MI.

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2
Q

Stable angina pectoris

A

Chest pain that is “stable” or predictable. Happens regularly with exercise but never at rest.

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3
Q

Unstable angina

A

Plaque deposits in the coronary artery rupture and exposes necrotic WBC and cholesterol to the blood. Platelets bind to the damaged area resulting in a thrombus. The thrombus can wave back and forth with blood flow looking flow through the vessel intermittently. Can have chest pain at rest.

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4
Q

Thrombus

A

Blood clot

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5
Q

Thrombosis

A

Clot that blocks a blood vessel

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6
Q

Embolization

A

Anything that obstructs an artery, typically a thrombus or air

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7
Q

Preload

A

The amount of stretch of the ventricles exhibit at the end of ventricular filling. More volume=more stretch.

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8
Q

Causes of decreased preload

A
  1. Hemorrhage
  2. Cardiac tamponade
  3. Dehydration
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9
Q

Cardiac Tamponade

A

Compression of the heart by an accumulation of fluid in the pericardial sac

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10
Q

Cardiac output

A

The amount of blood the heart pumps out in 1 minute.

CO= HRxSV

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11
Q

Cor pulmonale

A

Right ventricular failure secondary to pulmonary hypertension.

  1. Increased vascular pressure (after load)
  2. Increased ejection force of the R ventricle
  3. Decreased RV EF
  4. Increase in blood remaining in RV
  5. Inability of the RA to eject the same amount of blood into the RV
  6. Increase in blood remaining in the RA
  7. Increased atrial preload
  8. Blood backs up into SVC & systemic veins
  9. jugular distention and R side HF
  10. Increased blood to the liver and spleen causes hepatosplenomegaly
  11. Increased BP forces fluids out of circulation and into the tissues causing peripheral edema.
  12. Increase pressure to L side of the heart.
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12
Q

Stroke Volume

A

The volume of blood pumped out of the left ventricle during each systolic cardiac contraction

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13
Q

Afterload

A

The force (load) with which the heart muscle must contract agains in order to pump blood. For example systemic vascular resistance.

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14
Q

Causes of Cor Pulmonale

A
  1. Pulmonary disease resulting in pulmonary hypertension (most common)
  2. RV MI
  3. RV hypertrophy
  4. Tricuspid valve damage
  5. Secondary to L HF
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15
Q

High Output Heart Failure

A

Inability of the heart to pump enough blood to meet the circulatory needs of the body despite normal blood volume and cardiac contractility. Anemia impairs oxygen delivery to the tissues.

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16
Q

Causes of High Output Heart Failure

A
  1. Nutritional deficiencies (thiamine) causing decreased function and output.
  2. Hyperthyroidism, fever, sepsis
    • increase basal rate, increase oxygen demands, not enough 02 causes hypoxia
17
Q

Compensated Heart Failure

A

The heart dries to compensate and the SNS is activated which stimulates increased heart rate (faster) and increased stroke volume (harder). Preload is increased and the heart needs more oxygen which isn’t available. Heart cells start to die off. To compensate for dead cells the remaining cells bulk up to maintain CO, they also need more oxygen and start to die off. Heart chambers become smaller due to hypertrophy

18
Q

Decompensated Heart Failure

A
  1. Overuse of the SNS means receptors are lost and there is a lowered response.
  2. Increased preload causes cell death and lack of oxygen
  3. Hypertrophy causes cell death due to lack of oxygen.
19
Q

Four Stages of Heart Failure

A

Stage A - no limit on physical activity, no HF symptoms
Stage B - Slight limit on physical activity, activity results in symptoms
Stage C - Clinical development of Heart Failure
Stage D - No physical activity without symptoms, symptoms at rest.

20
Q

Sounds of Aortic Regurgitation

A
  1. Early diastolic murmur, high pitched at left sternal border
  2. Diastolic rumbling at apex
  3. Systolic crescendo-decrescendo at left upper sternal border
21
Q

Sound of Aortic stenosis

A

Mid systolic crescendo-decrescendo murmur with an S4 gallop

22
Q

Sound of Mitral regurgitation

A

Blowing, pan-systolic murmur

23
Q

Sound of mitral stenosis

A

Rumbling, decrescendo murmur at apex of the heart

24
Q

Aortic Stenosis

A

Tight aortic valve resulting in blood backing up into the left ventricle and poor perfusion of body tissues.

25
Q

Aortic stenosis is caused by

A
  1. Bicuspid aortic valve - genetic, two valves instead of three
  2. Age related calcification
  3. Rheumatic fever
26
Q

Aortic regurgitation

A

When the aortic valve becomes floppy allowing blood back from the aorta into the ventricle when filling

27
Q

Causes of Aortic Regurgitation

A
  1. Aneurysm of the aortic annuals (tissue and valve)
  2. Endocarditis - vegetation on the valve
  3. Rheumatic fever
28
Q

Mitral valve regurgitation

A

Floppy mitral valve allowing fluid to backup into the pulmonary system and lungs.

29
Q

Mitral valve

A

Valve between the left atria and ventricle

30
Q

Tricuspid valve

A

Valve between the right atrium and right ventricle

31
Q

Aortic valve

A

Valve between the left ventricle and aorta

32
Q

Pulmonary Valve

A

Valve between the right ventricle and pulmonary artery.

33
Q

Causes of mitral valve regurgitation

A
  1. Anything that leads to left ventricle dilation including:
    - remodeling post MI
    - dilated cardiomyopathy
    - papillary muscle dysfunction
    - chordae tendonae
34
Q

Mitral valve prolapse

A

Mitral valve bulges into the left atrium (like an aneurysm)

35
Q

Causes of mitral valve prolapse

A
  1. Idiopathic (unknown cause)
  2. Secondary to connective tissue disorder
36
Q

Mitral valve stenosis

A

Tightened mitral valve

37
Q

Causes of mitral valve stenosis

A
  1. Rheumatic fever
  2. Endocarditis (inflammation/infection of mitral valve)

NR507 - Advanced Pathophysiology (9 decks)

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