Cardio part 2.1 Flashcards
(28 cards)
what is a hTN emergency
anything over 180 systolic and 120 or above
pt may have severe HQ , retinal hemorrhage and papilledema
changes in sensorwmun and decreased levels or consciousness and seizure can occur
* go to emergency with any of these findings
what is primary hypertension-
- silent killer
- (0-95%)
- HTN with no underlying causes
what causes secondary HTN
d.t chronic renal failure and or stenosis of renal arteries
what happens to the kD during HTN
increases renin and angiotensin
reasons for 2 HTN
There are multiple etiologies for secondary hypertension including but not limited to: Medications such as NSAIDs Sleep apnea Pheochromocytoma Hyperaldosteronism (Conn's syndrome) Cushing's syndrome Hyperparathyroidism Acromegaly Hyperthyroidism/ Hypothyroidism
Reno vascular HTN
high blood pressure caused by narrowing of the arteries supplying the kidneys. It is a form of secondary hypertension - a form of hypertension whose cause is identifiable. RAS induces renin secretion that causes the angiotensin conversion, causing aldosterone release and then water retention and potassium depletion.
potential mechanisms for 1 HTN
Na+
- abn NA+ transport d.t defect in or inhibition of the Na-K pump
- Inc, cellular perm. to Na+
- net result is an increased intracellular sodium which may make the cell more sen
- SM contracts stronger
Potential cause of 1 HTN ca+
genetic condition inherited as a dominant trait that results in abnormal connective tissue, due to production of abnormal fibrillin-1 protein.
This syndrome is noted in 5–9% of all individuals who develop aortic dissection.
Individuals with Marfan’s syndrome tend to have aneurysms that are localized to the aorta relative to other vessels and are more prone to proximal dissections of the aorta
Potential cause of HTN
renin-angiotension
genetic condition inherited as a dominant trait that results in abnormal connective tissue, due to production of abnormal fibrillin-1 protein.
This syndrome is noted in 5–9% of all individuals who develop aortic dissection.
Individuals with Marfan’s syndrome tend to have aneurysms that are localized to the aorta relative to other vessels and are more prone to proximal dissections of the aorta
What is the most common cause of renal disease
the second most common cause
HTN
DM
how does renal dz contribute to HTN
increased production of renin which results in salt retention and systemic vasoconstriction
HTN is the leading cause of what
ischemic heart dz, PVD, cerebrovascular dz, ventricular hypertrophy and CHF
What are the 3 types of hypertension
labile, benign, accelerated
Labile HTN
BP elevations which are inconsistent. Individuals that have increased Catecholamines form seeing doc “white coat HTN”
-can occur with pheochromocytoma ( usu dramatic event)
how do pt with pheochromocytoma present
- paroxysmal HA, sweats, palpitations, HTN and orthostatic hypotension
what is pheochromocytoma?
tumor on the adrenal gland
Benign HTN
- potential sequelae of long standing HTN include MI, stroke, renal disease and renal failure, peripheral vascular disease and blindness,
What is an Aneurysm
ballooning out” of an a vessel wall due to underlying weakness of the wall and/ or the force of increased blood pressure.
Where to Aneurysms occur
- in any vessel but arteries more common.
- aorta and the circle of Willis are vessels in which aneurysm development has the greatest potential for increased morbidity and mortality
what is a berry aneurysm
occurs where there is a greater degree force compared to the surrounding ares. I.e circle of willis, where there are a lot od branches
describe an aortic dissection
extremely severe and potentially life threatening comp. HTN
Dissection usu. through the medial tissue layer of the aorta and can affect the ascending aorta, the aortic arch, descending aorta and abdominal aorta.
how does a pt with aortic dissection ptc
excruciating pain the may be resistant to tx w/ very large morphine
-immediate blood pressure control must be achieved
MArfans- diseases
- genetic condition dominant- production of abnormal fibrillin-1 protein.
- This syndrome is noted in 5–9% of all individuals who develop aortic dissection.
- tend to have aneurysms that are localized to the aorta relative to other vessels and are more prone to proximal dissections of the aorta
Marfans characteristics
Marfan’s patients are often very tall individuals with long extremities and especially long digits.
Collagen abnormalities in the vessel wall result in the vessel becoming extremely vulnerable to damage and particularly susceptible to aortic dissection.
