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Flashcards in 5 Cardiac part 3 Deck (26)
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1
Q

Hypertension definition

A

Two or more BPs at two consecutive visits Diastolic over 90 or systolic 140-160

2
Q

Primary HTN

A

Idiopathic or essential
95% of all cases
Etiology based on modifiable and non modifiable risk factors
Clinical manifestations base on specific organs damaged

3
Q

Non-modifiable risk factors

A

Inheritance
Age
Race - African Americans. Due to sodium retention, SNS hyperactivity, RAAS hyperactivity, vasodilator deficits or socioeconomic factors

4
Q

Modifiable Risk Factors

A
Sedentary lifestyle (decreased vasc compliance and fat)
Diet (LDLs, K+, Fiber)
Salt intake (Affects RAAS + volume retention)
Abdominal Obesity - insulin resistance, SNS and RAAS stimulation
5
Q

More modifiable HTN risk factors

A

Insulin resistance - more SNS to compensate
Smoking - endothelial damage
-ETOH SNS activation and increased cardiac function and PVR (moderation reduces VD)
Cocaine - sodium channel blockade and increase in SNS

6
Q

Clinical manifestations

A

Strong correlation with atherosclerosis and what goes with it (MI, Stroke)
Hypertensive retinopathy
Chronic renal disease, nephropathy, albuminuria
ED

7
Q

Secondary HTN

A
From underlying disease process like
Renal disorders
Adrenocortical disorders
Pheochromo
Coartcation of Aorta
Oral contraceptives
8
Q

Renal disorders HTN

A

Decrease renal perfusion (usually from atherosclerosis) results in more renin, increases PVR and fluid retention

9
Q

Adrenocortical disorders HTN

A

More aldosterone or glucocorticoid release from adrenals

Ultimate result Na+ retention

10
Q

Pheochromocytoma HTN

A

Tumor of adrenal medulle leads to proliferation and release of catechols which increase PVE and cardiac function

11
Q

Coarctation of the Aorta HTN

A

Narrowing of aorta (usually distal to subclav arteries)

Increase upper body pressure but decreased lower where kidneys are so increased RAAS

12
Q

Oral contraceptives HTN

A

Increased E and progesterone leads to water retention from sodium

13
Q

Hypertensive Crisis (malignant hypertension)

A

Acute elevation of pre-existing HTN
Diastolic over 120
Acute effects are seen cerebral, renal and within eye

14
Q

Cerebral effects from hypertensive crisis

A

Vasospasm of cerebral arteries and cerebral edema leads to ichemia related neuro manifestations

15
Q

Renal effects from hypertensive crisis

A

Decreased renal activity leads to retention of waste, lyte issues, pH disorders

16
Q

Eye effects from hypertensive crisis

A

Increase optic nerve pressure leads to visual deficits

17
Q

PIH Pregnancy induced hypertension

A

5-10% of pregnancy

Major cause of maternal and neonatal mortality worldwide

18
Q

PIH 3 stages

A
Preeclampsia
Eclampsia
HELLP
Hemolysis
Elevated liver enzymes
Low platelet
19
Q

Etiology PIH

A

Unknown but possible from maternal response to placenta (when placenta delivers PIH disappears)

20
Q

Pathology PIH

A

Vasoconstriction of blood vessels which increases BP and decreases perfusion to kidneys (proteinuria and edema, CNS (sensory disturbances and seizures), liver (HELLP)

21
Q

Definition of postural hypotension

A

Decrease in systolic 20 or diastolic 10 within 3 minutes of standing due to a pooling of blood in lower ext

22
Q

Age related etiologies of orthostatic hypotension

A
Decreases:
ANS response
ADH and RAAS
Skeletal muscle
Blood volume
23
Q

Blood volume related etiologies of orthostatic hypotension

A

Dehydration

Diuretic use

24
Q

Impaired mobility etiology orthostatic hypotension

A

Decreased mobility reduces blood volume, muscle activity, venous tone and PVR

25
Q

ANS disorders causing orthostatic hypotension

A

CVA involving cardiovasc center
Diabetes related PVD
Spinal cord injury

26
Q

Clinical manifestations orthostatic hypotension

A
Usually related to neuro hypoperfusion
Lightheaded/dizzy
Nausea
Weakness
Syncope