Alterations of cardiovascular Function

Question 1

Overview of Cardiovascular Disease

Answer 1

• leading cause of death in the US and in the world

- genetic, neurohormonal, inflammatory, metabolic mechanisms [underlying tissue and cellular alterations]

Question 2

Diseases of the Veins-

Varicose veins

Answer 2

• vein in which has pooled

- distortion, leakage, increased intravascular hydrostatic pressure, and inflammation of veins

Question 3

Diseases of the veins-

what causes varicose veins

Answer 3

-incompetent valves, venous obstruction, muscle pump dysfunction, or combination of these

Question 4

Diseases of the veins-

chronic venous insufficiency

Answer 4

-persistent ambulatory lower extremity venous hypertension

Question 5

Diseases of the veins-

treatment

Answer 5

• weight loss
• decrease time standing and sitting
• leg elevation, compression stockings, and physical exercise
• endovenous ablation (radiofrequency and laser) or foam sclerotherapy

Question 6

Diseases of the Veins-

Deep vein thrombosis (DVT) What is thrombosis?

Answer 6

clot

Question 7

Diseases of the Veins-

Deep vein thrombosis (DVT) What can a detached thrombus lead to?

Answer 7

(thromboembolus); can lead to pulmonary emboli

Question 8

Diseases of the Veins- what causes deep vein thrombosis (DVT)?

Answer 8

obstruction of venous flow leading to increased venous pressure

Question 9

Diseases of the Veins- what are the factors that contribute to deep vein thrombosis (DVT)?

Answer 9

Virchow triad-

1. venous stasis
2. venous intimal damage (hypertension, toxins, hyperlipidemia, infection)
3. hypercoagulable states

Question 10

Disease of the veins- what is postthrombotic syndrome?

Answer 10

• refers to signs in symptoms and signs of chronic venous insufficiency that develop following deep vein thrombosis
• a combination of reflux due to valvular incompetence and venous hypertension due to thrombotic obstruction is thought to contribute to post-thrombotic syndrome
• can cause chronic pain, swelling and other symptoms in your legs

Question 11

Diseases of the veins- what is the difference between varicose veins and chronic venous insufficiency?

Answer 11

• varicose veins seen with superficial veins
• chronic venous insufficiency is a condition that blood pools in the superficial and deep leg veins. CVI can occur with or without the presence of varicose veins; this condition develops when the blood pressure in the veins is abnormally high

Question 12

Diseases of the veins- What are clinical symptoms of DVT

Answer 12

• SOB
• sudden sharp chest pain
• coughing (may be blood)
• heaviness and swelling of leg
• pain or tenderness
• skin discoloration and ulcers
• a warm sensation
• edema
• may not have symptoms

Question 13

Diseases of the veins- What are risk factors of DVT?

Answer 13

• > 60
• overweight
• sit or stand for long periods of time

Question 14

Diseases of veins- DVT prevention

Answer 14

• prevention is crucial
• mobilization soon after surgery, illness, injury
• prophylatic low- molecular-weight heparin or direct thrombin inhibitors

Question 15

Diseases of veins- DVT Tests

Answer 15

-D-Dimer and Doppler

Question 16

Diseases of veins- DVT treatment

Answer 16

• low-molecular-weight heparin
• direct thrombin inhibitors
• aspirin therapy
• catheter directed thrombolytic therapy
• pharamcomechanical treatment

Question 17

Diseases of the veins- what is Superior vena cava (SVC) syndrome?

Answer 17

-progressive occulsion of the SVC that leads to venous distention in the upper extremities and head

Question 18

Diseases of the veins- what is the leading cause of SVC syndrome?

Answer 18

nonsmall cell lung cancer, small cell lung cancer, lymphoma

Question 19

Diseases of veins- What are clinical symptoms of SVC syndrome?

Answer 19

• edema
• venous distention of face, neck, trunk, upper extremities
• cyanosis
• dyspnea, dysphagia, hoarseness, stridor, cough, and chest pain
• CNS changes
• respiratory distress

Question 20

Diseases of the vein- SVC syndrome treatment

Answer 20

• radiation

- chemotherapy

Question 21

Diseases of the arteries- Isolated systolic Hypertension

Answer 21

-elevated systolic blood pressure accompanied by normal diastolic blood pressure

Question 22

Diseases of the arteries- hypertension

Answer 22

• consistent elevation of systemic arterial blood pressure

- sustained elevation of 140 mmHg systolic or higher OR 90 mmHg diastolic or higher

Question 23

Hypertension - Primary (essential) hypertension

Answer 23

genetic and environmental factors

Question 24

Hypertension- Secondary hypertension

Answer 24

is caused by altered hemodynamics from an underlying primary disease of drugs

Question 25

Hypertension- affects the entire cardiovascular system

Answer 25

systolic hypertension: most significant factor in causing target organ damage

Question 26

Hypertension- what does hypertension increase the risk for?

Answer 26

myocardial infarction (MI), kidney disease, and stroke

Question 27

Hypertension- what are risk factors for hypertension?

Answer 27

- positive family history - advancing age - gender: female >70 yrs of age; male <55 of age - race: black - increased Na+ intake - glucose intolerance (diabetes mellitus)/insulin resistance - heavy alcohol use - obesity - cigarettes

Question 28

hypertension: What causes hypertension?

Answer 28

- caused by increases in cardiac output or total peripheral resistance, or both - cardiac output increased: any condition that increases the heart rate or stroke volume - peripheral resistance increased: any factor that increases blood viscosity or reduces vessel diameter (vasoconstriction)

Question 29

hypertension: What is primary hypertension?

Answer 29

- extremely complicated interactions of genetics and the environment mediated by neurohormonal changes [genetics interact with diet, smoking, age, and other risk factors to cause chronic changes in vasomotor tone and blood volume] - overactivity of the sympathetic nervous system and RAAS and alterations in natriuretic peptides - inflammation, endothelial dysfunction, obesity-related hormones- and insulin resistance

Question 30

What causes secondary hypertension

Answer 30

systemic disease that raises peripheral vascular resistance and/or cardiac output

Question 31

what is complicated hypertension?

Answer 31

-hypertrophy and hyperplasia with associated fibrosis of the tunica intima and media is called vascular remodeling

Question 32

what is malignant hypertension (hypertensive crisis)?

Answer 32

- rapidly progressive hypertension - diastolic pressure is usually > 140 mmHg - can lead to encephalopathy

Question 33

What are clinical manifestations of hypertension?

Answer 33

early stages of hypertension have no clinical manifestation other than elevated blood pressure -called the silent disease