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PMCOL 343 > 5-cardio > Flashcards

5-cardio Flashcards

1
Q

what is cardiac output= (what is multiplied)

A

stroke volume x heart rate

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2
Q

what is venous return

A

rate of return of blood to heart

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3
Q

what is afterload

A

resistance heart has to pump against determined by arteriolar pressure and peripheral resistance

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4
Q

what is preload

A

stress on ventricular wall before systole

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5
Q

what does left ventricular end diastolic pressure =

A

preload

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6
Q

what does preload=

A

what does left ventricular end diastolic pressure

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7
Q

what does cardiac work =

A

stroke volume x arterial pressure

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8
Q

what does increased cardiac work do to oxygen consumption

A

increases

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9
Q

what happens to stroke volume when left ventricular end diastolic pressure increases

A

increases

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10
Q

what happens to cardiac work when left ventricular end diastolic pressure increases

A

increases

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11
Q

what happens with a venodilator to preload

A

it decreases

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12
Q

what happens with a venodilator to stroke volume

A

decreases

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13
Q

what happens with a venodilator to cardiac work

A

decreases

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14
Q

what does arteriolar vasodilators do to afterload

A

decreases

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15
Q

what does arteriolar vasodilators do to arterial pressure

A

decrease

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16
Q

what does arteriolar vasodilators do to cardiac work

A

decrease

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17
Q

how do the coronary vessels react with an increased O2 demand

A

they dilate

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18
Q

what can cause an increase in O2 demand

A

stress or exercise

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19
Q

what causes angina

A

when oxygen demand is greater than supply

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20
Q

what 5 things can increase local coronary flow

A
  • low o2 tension
  • high co2 tension
  • release of lactate
  • release of adenosine
  • presence of prostacyclin (PGI2)
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21
Q

what direction does coronary flow occur (where does it start and end)

A

from aorta to ventricles

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22
Q

what is systole (pressure difference with ventricles and aorta)

A

pressure in ventricles greater than pressure in aorta

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23
Q

what is diastole (pressure difference with ventricles and aorta)

A

pressure in aorta greater than in ventricles

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24
Q

what can mechanical pressure do to systole

A

prevent it

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25
does coronary flow happen during diastole or systole
diastole
26
what happens to mechanical pressure in diastole
reduce
27
what does coronary perfusion pressure =
coronary artery diastolic pressure - left ventricular end diastolic pressure
28
what happens with alpha receptor activation
constriction
29
what happens with beta2 receptor activation
dilation
30
what happens to coronary vessels when there is angina/ischemia
maximally dilated (they want to get as much blood as possible)
31
what happens when you use coronary dilators with angina
more flow to normal area and less to ischaemic areas - coronary steal
32
what is coronary steal
when drugs dilate the coronary vessels, there is a reduced flow to ischemic tissues and more to normal tissues
33
what is the diastolic coronary artery pressure going to be distal to plaque COMPARED to before plaque
it will be smaller than before plaque
34
what happens to LVEDP when the ischemic heart starts to fail
it increases
35
what 2 things happen when the plaque occludes the vessel
hypoxia and anginal pain
36
what are 3 different ways that anti-anginal drugs can work
- lower LVEDP (reduce preload) - prolong diastolic time (reduce HR) - reduce work load (reduce O2 demand)
37
what is 1 thing all anti-anginal drugs do
reduce cardiac work load
38
what do anti-anginal drugs do to LVEDP
decrease
39
what do anti-anginal drugs do to diastolic time
prolong
40
what do anti-anginal drugs do to HR
decrease
41
what do anti-anginal drugs do to work load
reduce
42
what do anti-anginal drugs do to oxygen demand
reduce
43
what is an example of a venodilator
nitroglycerine (glyceryl trinitrate)
44
what does nitroglycerine do to the LVEDP
lower
45
does nitroglycerine affect veins or arterioles more what effect
dilates veins more than arterioles
46
what does nitroglycerine do to venous capacitance
increase
47
what does nitroglycerine do to venous pooling
increase
48
what does nitroglycerine do to venous return
decrease
49
what does nitroglycerine do to LVEDP
decrease
50
what does nitroglycerine do to preload
decrease
51
what happens to stroke volume when you decrease LVEDP
decrease
52
what does nitroglycerine do to arterial pressure
decrease
53
what does nitroglycerine do to stroke volume
decrease
54
what does nitroglycerine do to workload
decrease (CW=SV x AP)
55
what does nitroglycerine do to oxygen consumption
decrease
56
what does nitroglycerine do to coronary vessels
causes vasodilation (but not steal/ not too much)
57
does nitroglycerine cause coronary steal?
no
58
what does nitroglycerine do to collateral vessels!!!!
open them (this allows flow to the ischaemic area)
59
how is nitroglycerine administered for acute attacks
sublingual
60
how is nitroglycerine administered prophylactically
transdermal
61
what are the untoward effects of nitroglycerine
headache and tolerance
62
what does propranolol do to diastolic time
prolong
63
what does propranolol do to heart rate during exercise
reduce
64
what does propranolol do to coronary perfusion time during exercise
increase
65
what does propranolol do to O2 demand during exercise
decrease
66
what does propranolol do to afterload
reduce
67
what does propranolol do to BP
lower
68
what does propranolol do to cardiac work
lower
69
how does propranolol reduce afterload
lowers BP therefore reduces cardiac work
70
when is propranolol especially useful
after the first myocardial infarction to prevent re-infarction
71
what do verapamil and nifedipine do (generally)
reduce cardiac work
72
how do verapamil and nifedipine work
block ca++ channels
73
what do verapamil and nifedipine do to afterload and contractility
reduce
74
verapamil and nifedipine what do they do to cardiac work
reduce
75
what are 3 ways to treat heart attack in emergency
aspirin, nitroglycerine, altepase (tissue plasminogen activator)
76
what are 2 ways to prevent heart attack (drugs)
low dose aspiring, antianginals (b blockers, ca channel blockers)
77
how do nitrates relax coronary smooth muscle
they act like NO from endothelial cells
78
what creates erection (3)
NO release from nerves in penis, relax smooth muscle, fills with blood
79
what is the mechanism of action of sildenafil
inhibits cyclic GMP phosphodiesterase so there are more effects of NO on penis

PMCOL 343 (31 decks)

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