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Flashcards in Cardiovascular 2 Deck (53)
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what is the most important risk factor in atherosclerosis



what are the 2 processes in atherosclerosis that result in disease

chronic inflammation and healing


describe chronic inflammation in atherosclerosis

high cholesterol damages the endothelial cells on blood vessels. these then increase their permeability to allow lipid and monocytes to move into the tunica intima. macrophages then engulf the lipid but cannot do anything with it. instead it forms foam cells


describe healing in atherosclerosis

cytokines then move to the site of inflammation, cause proliferation of smooth muscle, this then forms a fibrous cap over the foam cells. this is now known as an atheroma


how can chronic periodontitis be related to hypertension

the inflammatory markers produced in perio disease migrate to the liver and can increase systemic inflammation which increases atherosclerosis production


give an example of a chronic coronary condition

ventricular hypertrophy - caused by hypertension, pump has to pump harder against more resistance, heart muscle increases in size as myocytes proliferate, size of chamber decreases in size and blood flow to heart remains the same, becomes ischaemic


what kinds of valvular disease

insufficiency - failure to close
stenosis - failure to open


why might a blood vessel tumour appear in the elderly

haemangioma - hamartoma is congenital, bengin but as the mucosa thins with age it becomes apparent


what causes kaposi sarcoma and who is more vulnerable

human herpes virus 8, immunocompromised people especially HIV positive patients


what defines hypertension

raised blood pressure, higher than 140/90, take 3 measurements with 15 mins of rest between


what are some risk factors for hypertension

age - less elasticity, gender, genetics, obesity and diabetes


what is the result of hypertension

increased atherosclerosis, increases risk of heart problems, stroke and dvt. also can result in renal failure


what are the types of hypertension

essential - unsure of cause
renal - caused by renal stenosis, low blood flow to kidney, increases renin secretion to increase fluid retention
endocrine - tumour on adrenal gland, pressing on kidney and increasing cortisol secretion - increasing fluid resorption


what are the signs and symptoms of hypertension

usually none, may have a headache or TIA


what investigations can be done

urine sample - check electrolytes for reabsorption in kidney, check blood for creatinine, urea and cholesterol


how is hypertension treated

elderly - diuretics and calcium channel blockers
young - beta blockers and ACE inhibitors


what is heart failure defined as

heart unable to meet demands of body


what is the difference between high output and low output heart failure

high - when heart cant meet demands as demands are increasing, low - when heart cant meet basic demands


how can heart failure and hypertension be linked

heart failure - body thinks body has lost blood due to reduced output, increases blood pressure to counteract, this then makes heart failure worse


what might cause heart failure

damage to heart muscle - angina or MI
pressure overload - aortic stenosis, hypertension
arrythmias - atrial fibrillation, drugs - beta blockers, corticosteroids and anti-cancer drugs


what are the symptoms and signs for heart failure

depends on what side is effected
left - tachycardia, low HR, breathless, low bp
right - liver and gastrointestinal problems, oedema and ascites - increased venous pressure


how can heart failure be treated

reduce hypertension, treat valve disease or arythmias, positive ionotropes - digoxin


what is valve stenosis

blockage of heart valve, unable to open fully, backs up left ventricle which can affect pulmonary system


what is valve insufficiency

failure to close valves, get back flow into ventricle


what is the effect of valve disease

reduced cardiac output


what causes valve disease

heart muscle damage, mi or ischaemia, aortic aneurysm, cant cover full width, rheumatic disease, congenital


what is rheumatic disease

host produces antibodies against streptocci infection. these antibodies can attack the heart valves, lead to calcification of valves. infections can be caused by dental treatment or infections


how can valve disease be investigated

ultrasound, see the blood flow in real time, can see direction of travel of blood


what kind of heart valves can be used for replacement

porcine - pig valves, similar to human, but only last 10 years, dont need to be on anticoagulants, better for elderly or young children
mechanical - everyone else, needs to be on anticoagulants for life but can last a long time


what is tachycardia

increase of heart rate, atrial fibrillation