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Flashcards in Cardio Disorders Deck (132):
1

cardiovascular/heart disease

disease of the heart and/or blood vessels

2

heart disease is considered a consequence of

atherosclerosis

3

what are the effects of atherosclerosis?

thickening and hardening in the artery wall

4

what causes the effects of atherosclerosis?

thickening and hardening is caused by an accumulation of lipid-laden macrophages in the arterial wall.
increased inflammation signals

5

atherosclerosis is a consequence and cause of

increased blood pressure

6

atherosclerosis increases risk of

cardiovascular infarction
cerebrovascular infarction

7

atherosclerosis is thought to stem from

cholesterol

8

what does high blood pressure cause?

tearing of endothelium and therefore inflammation.
turbulent flow in a blood vessel

9

where is turbulent flow most apparent?

in areas of branching or constriction of the blood vessel

10

turbulent flow damages:

endothelium

11

A type LDL cholesterol is

large and less dense

12

B type LDL cholesterol is

Small and more dense

13

what are the risk factors for pattern B LDL cholesterol

Genetic
oral contraceptives
diet

14

what can increase your levels of patten B LDL cholesterol?

a very low fat high carb diet

15

dietary cholesterol has ____ impact on blood cholesterol

little

16

increased consumption leads to ____ absorption

reduced

17

where does most circulating cholesterol come from?

it is synthesized de novo

18

where is cholesterol synthesized?

80% in the liver
10% in intestine
5% in skin

19

what is the most potent activator of de novo cholesterol synthesis?

insulin

20

what is related to increased cholesterol synthesis?

increased fasting insulin.

21

what increases cholesterol synthesis from the liver?

insulin-stimulating meals

22

what are the most widely prescribed drug in the world?

statins

23

HMG-CoA reductase inhibitors

statins

24

what do HMG-CoA reductase do?

they play a role in synthesizing cholesterol in the liver.

25

which group of people do statins help the most?

people with previous history of cardiovascular event. They don't really help other people

26

what are some of the side effects of statins?

increased risk of diabetes (T2)
kidney failure
liver failure
muscle pain (muscle break down)

27

what is normal blood pressure

systolic: 90-119
diastolic: 60-79

28

what is prehypertension BP?

systolic: 120-139
Diastolic: 80-89

29

What is stage one (primary) hypertension BP?

systolic: 140-159
Diastolic: 90-99

30

what is stage 2 (secondary) hypertension BP?

Systolic: eq > 160
diastolic: eq > 100

31

primary hypertension

"essential" hypertension
affects 90-95% of individuals with hypertension
results from weight gain
associated with insulin resistance
there are genetic and environmental factors

32

Secondary hypertension results from

a structural, renal or endocrine problem

33

what reduces BP in hypertensives?

carb restriction

34

who does salt sensitivity affect the most?

people who are insulin resistant

35

in RAAS dysfunction, _____ is increased in obesity

Plasma Sodium content

36

what induces prolonged sodium retention in RAAs dysfunction?

CHO ingestion

37

insulin increases_____ in RAAS dysfunction

kidney sodium reabsorption

38

urinary sodium excretion ___ with insulin injection

decreases

39

insulin increases ____ secretion

aldosterone

40

in RAAS dysfunction, what is capable of eliciting an antidiuretic effect?

a very slight increase in plasma insulin

41

what reduces BP in hypertensives?

carb restriction

42

who does salt sensitivity affect the most?

people who are insulin resistant

43

in RAAS dysfunction, _____ is increased in obesity

Plasma Sodium content

44

what induces prolonged sodium retention in RAAs dysfunction?

CHO ingestion

45

Which neuro transmitter of the sympathetic nervous system is affected by primary hypertension due to insulin resistance and how?

insulin causes a dose-related increase in norepinephrine release. which then increases pulse and blood pressure.

46

urinary sodium excretion ___ with insulin injection

decreases

47

insulin increases ____ secretion

aldosterone

48

in RAAS dysfunction, what is capable of eliciting an antidiuretic effect?

a very slight increase in plasma insulin

49

primary hypertension due to insulin resistance enhances _____ activtiy

growth factor

50

there are receptors for ____ and ___ in capillary endothelial cells which causes vascular cells to be responsive to insulin

IGF-1 and insulin

51

enhanced growth factor activity causes ___ of the vascular wall

hypertrophy
-narrowing of vascular wall due to thickening of the wall. Narrower opening.

52

Primary hypertension due to insulin resistance affects the ____ nervouse system

sympathetic

53

Which neuro transmitter of the sympathetic nervous system is affected by primary hypertension due to insulin resistance and how?

insulin causes a dose-related increase in norepinephrine release. which then increases pulse and blood pressure.

54

how does insulin resistance induced primary hypertension affect nitric oxide.

Normally, insulin increases the production of endothelium derived NO which is a potent vasodilator.
But, insulin resistant endothelial cells can't release NO so then NO can't be produce to cause vasodilation

55

what is NO made from?

L-arginine

56

what improves blood pressure more than restricting salt and fat?

restricting carbs and weight loss

57

sodium has ___ effect on hypertension onset

no effect

58

preeclampsia

pregnancy induces hypertension

59

what is the leading cause of maternal death?

preeclampsia

60

what is going on in preeclampsia?

reduced kidney function leads to chronic excessive increased blood pressure.

61

what is eeclampsia?

toxin accumulation
seizures
death

62

what are some drug treatments for hypertension?

alpha blockers
beta blockers
diuretics
ACE inhibitors
metformin

63

what do alpha blockers do?

they reduce SNS activity which slows heart rate and stroke vol

64

what do beta blockers do?

reduce heart contractility

65

what is an aneurysm?

a local dilation or outpouching of a vessel wall or cardiac chamber

66

true aneurysm

involve all three layers of the arterial wall

67

false aneurysm

do not have distension of all three layers of the arterial wall.

68

thrombus

blood clot that remains attached to the vessel wall

69

thromboembolus

a clot (thrombus) that breaks free

70

thrombophlebitis

swelling of the veins cause by a thrombus

71

why are arterial thrombi so rare?

bc of the pressure in the arteries. Thrombi that are formed here are usually pushed out into the veins and become venous thrombi

72

embolism

bolus of matter in circulation in the blood stream
this can include:
dislodges thrombus
air bubble
aggregate of fat
bacteria
cancer cells
or a foreign substance

73

what is a common feature of peripheral artery disease?

intermittent claudication

74

what is intermittent claudication?

obstruction of arterial blood flow in the iliofemoral vessels resulting in pain with movement

75

what are thromboangitis obliterans?

buerger disease
lesions to the endothelial lining caused by inflammation.
obliterates the small and medium sized artering in perfusion. So you can't get blood out as well.

76

what are the effects of thromboangiitis obliterans?

pain
tenderness
hair loss in the affected area
gangrenous lesion
loss of oxygen to the tissues

77

what are some symptoms of thromboangiitis obliteran?

slow and sluggish blood flow

78

raynaud phenomenon /disease

episodic vasospasm in arteries and arterioles of the fingers, less commonly the toes
(where the fingers are whit or like green)
usually triggered by cold or stress

79

which diseases is raynaud phenomenon secondary to?

collagen vascular disease (scleroderma)
smoking
pulmonary hypertension

80

Deep vein thrombosis (DVT)

obstruction of venous flow leading to increased venous pressure

81

what are factors that increase your risk of DVT?

venous stasis
venous endothelial damage
hypercoagulable states

82

Myocardial ischemia

heart is not getting blood

83

temporary myocardial ischemia

deprivation of the coronary blood supply
result in angina pectoris

84

angina pectoris

chest pain from coronary ischemia

85

stable angina

recurrent pain from chronic coronary artery obstruction during effort

86

unstable angina

result of reversible ischemia
sign of possible future attacks

87

sustained ischemia

prolonged blockage of coronary artery
leads to myocardial infarction

88

myocardial infarction

myocardial inflammation and necrosis

89

myocardial infarction

sustained and complete obstruction of the myocardial blood supply

90

subendocardial infarction

affects only the inner 1/3 to 1/2 of the heart wall.

91

Why is the inner wall more affected in subendocardial infarction?

because blood supply goes first to outer wall.

92

transmural infarction

affects more than 1/2 of the heart wall
more serious

93

stent

a treatment for myocardial infarction that pushes plaque out of the way so that blood can pass. doesn't clear plaque

94

___ can induce ischemia in predisposed individuals

stress

95

insulin resistance increases risk of which cardiomyopathies?

dilated
hypertrophic

96

dilated cardiomyopathy

congestive cardiomyopathy
rounder than it should be

97

hypertrophic cardiomyopathy

when heart muscle gets thicker and it doesn't allow the chambers to fill up
hypertension is the leading cause

98

restrictive cardiomyopathy

deposition of material in myocardium
it has normal dimensions but doesn't move as it should.

99

systolic heart failure

inability of the heart to generate adequate cardiac output to perfuse tissues
the heart is just not able to generate enough force and its not able to it blood around the body

100

diastolic heart failure

pulmonary congestion

101

what is the cause of pulmonary congestion due to diastolic heart failure?

LV stiffening

102

why does diastolic heart failure cause pulmonary congestion?

is the left side isn't working well, it's having a hard time getting blood out so its having a hard time getting blood in from the lungs which then causes the lungs to get congested.

103

right heart failure

harder time getting blood to the lungs
causes by hypoxic pulmonary disease

104

what can result from an increase in left ventricular filling pressure that is reflected back into the pulmonary circulation

right heart failure

105

high output failure

inability of the heart to supply the body with blood borne nutrients despite adequate blood volume and normal or elevated myocardial contractiloty

106

valvular stenosis

narrowing of valves

107

what are types of valvular stenosis?

aortic stenosis
mitral stenosis

108

valvular regurgitation

leakage of valves

109

what are types of valvular reguritation?

aortic regurgitation
mitral regurgitation

110

mitral valve prolapse syndrome

when the valve is ballooning up into the atrium

111

aortic valve stenosis

stiffening and narrowing of the aortic valve
blood has difficulty exiting the heart
prolonged ejection sound

112

what are clinical manifestations of aortic valve stenosis?

crescendo-decrescendo systolic hear sound during systole
decrease in stroke volume
increased LV pressure (not getting all the blood out)
decreased systolic BP
decreased HR
hypertrophy of left ventricle resulting in ischemia, left heart failure

113

what does aortic valve stenosis cause a decrease HR?

the heart is trying to maintain function so it will reduce heart rate to not get too full

114

aortic regurgitation

failure of the aortic valve to properly close
blood leaks back into the ventricle after ventricular contraction

115

what are clinical manifestations of aortic regurgitation?

diastolic murmur (blowing sound) of high pitch over the left ventricle
dysrhythmia
hypertrophy of left ventricle
left heart failure
doppler echocardigram reveals blood flow back through aortic valve

116

mitral stenosis

narrowing or stiffening of the mitral valve
has a hard time opening
blood flow into the ventricle during diastole

117

what are clinical manifestations of mitral stenosis?

subtle crescendo diastolic murmur (rumbling)
decreased blood flow from left atrium to left ventricle
increased left atrial pressure
hypertrophy and dilation of left atrium
atrial dysrhythmias
increases pulmonary blood pressure
pulmonary edema
right heart failure

118

mitral regurgitation

failure of the mitral valve (left AV valve) to properly close
blood passing into atrium from ventricle during contraction

119

what are clinical manifestations of mitral regurgitation?

systolic murmur
dilated hypertrophied left ventricle
dilated left atrium
left heart failure
pulmonary hypertension and edema
right heart failure
doppler cardiography reveals blood flow back through mitral valve

120

Which side of the heart is dominant in utero?

the right ride because they don't need their lungs since mom is providing all the oxygen

121

what are the changes in dynamic that take place with a baby's first breath?

decreased pulmonary pressure and increased systemic vascular resistance

122

which structures go away with the baby's first breath?

ductus arteriosus
foramen ovale

123

what are some prenatal, environmental, and genetic risk factors for infant congenital heart defects?

maternal rubella
insulin-dependent diabetes
alcoholism
hypercalcemia
come prescription drugs
chromosome aberrations

124

what are some complications that may occur with congestive heart failure?

congestive heart failure
hypoxemia (which leads to cyanosis)

125

Patent ductus arteriosus

increases pulmonary blood flow
failure of the ductus arteriosus to close
blood moves from the aorta to the PA
blood that just got to the heart from the lungs is going back into the lungs.

126

atrial septal defect

increases pulmonary blood flow
abnormal communication between the atria
there is a communications between the atris so blood will leak from the left side to the right side and will then go back to the lungs where it had just come from.

127

ventricular septal defect

increases pulmonary blood flow
abnormal communication between the ventricles
most common type of congenital heart defect
less consequences the closer the defect is to the apex

128

atrioventricular canal defect

increases pulmonary heart flow results from nonfusion of the endocardinal cushions
the atrium and the ventricles are connected

129

tetralogy of fallot

decreases pulmonary blood flow
a mix of four syndromes:
ventricular septal defect
overriding aorta (aorta literally moved to left)
pulmonary valve stenosis
right ventricle hypertrophy
sending less blood to the lungs and increasing the amount of unoxygenated blood to the body
hypoxia

130

tricuspid atresia

imperforate tricuspid valve (lack of communication between the right atrium and left ventricle

131

coaractation of the aorta

narrowing of the lumen of the aorta that impedes blood flow
obstructive defect

132

hypoplastic left heart syndrome

obstructive defect
abnormal development of the left sided cardiac structures
requires a patent ductus arteriosis or a septal defect to move blood into systemic circulation