End diastolic volume- how much blood in ventricles when filled End systolic volume- how much blood in ventricles after ejection

Systole- contraction Diastole- relaxation

Cardiovascular Flashcards by Dana Pocasangre

EDV

ESV

End diastolic volume- how much blood in ventricles when filled
End systolic volume- how much blood in ventricles after ejection

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Heart Failure characterized by back up of fluids into the pulmonary circulation that can give rise to pulmonary edema

Left sided HF

ineffective left ventricular contractile function

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Drug class that reduces fluid retention but can cause hypokalemia and arrhythmias

Diuretics

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Most commonly occurs in the lower extremity and is a serious disorder, complicated by pulmonary embolisms, recurrent episodes, and chronic venous insufficiency

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Fluid accumulation in the pericardial sac

Pericardial Effusion

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Increased hydrostatic pressure as fluid accumulates from fluid backup

Heart Failure

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Heart Failure characterized by fluid back up into the systemic and hepatic venous systems, peripheral edema or ascites, external jugular veins

Right Sided HF- “cor pulmonale”

ineffective right ventricular contractile function

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Can be caused by massive vasodilation from allergic response or absolute losses of fluids due to sweating, burns, vomiting, diarrhea, hemorrhage

Too little perfusion can lead to shock, decrease in blood flow to tissues and organs can lead to loss of function

Hypotension

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Systole

Diastole

Systole- contraction
Diastole- relaxation

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Decreased cardiac output because of reduced end diastolic volumes
Any condition impedes expansion of the ventricles (pericardial effusion)

Dystolic dysfunction

Reduced ability of the left ventricle to relax and fill during diastole

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Cholesterol Levels

LDL

HDL

Total

Triglycerides

LDL < 100mg/dl

HDL > 40-60 mg/dl

Total <200mg/dl

Triglycerides <10-150mg/dl

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Hypertrophy of muscle mass that can lead to obstruction of blood filling

Hypertrophic Cardiomyopathy

Usually caused by genetic mutations that may be inherited or acquired
Adaption of the heart due to increased workload of the heart over time

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Involves extremely rigid ventricular walls that restrict blood filling by spare contractile properties of the muscle

Restricve Cardiomyopathy

Primary cause is endocarditis
Secondary causes are amyloidosis, hemochromatosis, sarcoidosis

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Results from narrowing of coronary arteries due to atherosclerotic processes, reduced blood flow to the heart

Coronary Artery Disease (CAD)

Classic sign: angina
nitrates such as nitroglycerin are potent vasodilators, can help reperfuse blocked tissues

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Increased tension on blood vessel walls leads to an increase in blood pressure

Over time can lead to hypertrophy

Hypertension

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Formation of scar tissue between the pericardial layers

Restrictive/Constrictive Pericarditis

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Bad cholesterol

Can lead to atherosclerosis

LDL - Low-density lipoproteins

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List some complications of shock

Acute respiratory distress syndrome
acute renal failure
GI ulceration
DIC
multiple organ dysfunction syndrome

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Venous stasis ulcers is caused by _____

Advanced venous insufficiency/ hypertension

fluid is shifting that leads to edema that gives rise to skin breakdown and ulcers, at risk for necrosis and infection

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Accumulation of exudates such as blood in the pericardial sac leading to rapid increase in pressure

The rapid compression of heart impairs diastolic filling reducing cardiac output and compromising perfusion to the body

Cardiac Tamponade

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A sudden elevation in MAP
May occur with ischemia, chest pain, pulm edema, intercerebral hemorrhage, abnormal renal function
causes problems in all body systems
- renal- decreased perfusion, uremia, renal failure
- cardiac- CAD, angina, heart failure
- cerebral function- TIA’s aneurysm formation, intracranial hemorrhage
CAN BE FATAL

Hypertensive Crisis

usually due to increase in TPR causes by reduced arterial radius

Increases afterload, atherosclerosis and MI may increase as a result of HTN

Drugs aimed at reducing TPR:

Beta-adrenergic blockers, calcium channel blockers to promote vasodilation
ACE inhibitors that block vasoconstrictor angiotensin II

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Decreased contractility of the heart
Decreased ejection fraction, usually less than <40%

Systolic dysfunction

left ventricle can’t pump enough blood into the systemic circulation during systole

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_____ shock: Inadequate blood volume

Venous return reduced as fluid is lost from the intravascular space and results in decreased ventricular filling and drop in stroke volume

Hypovolemic Shock

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Change in dilation of blood vessel wall, can lead to rupture and bleeding

Typically formed in aorta, vessel off left side of heart, under pressure, can also form in arteries or veins

Aneurysm

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Increased aterial or venous pressure or arterial dilation Decreased plasma proteins or increased permeability to proteins Lymph failure Decreased osmotic pressure, Increased Hydrostatic Pressure, Obstruction

Increased Hydrostatic pressure Decreased osmotic pressure Obstruction

**Stroke Volume = \_\_\_\_\_**

**Stroke Volume = EDV- ESV** **Stroke Volume- how much blood gets out in a stroke (beat)** **End diastolic volume - End systolic volume**

Includes Trauma, Venous stasis, and Altered coagulability

Virchow's Triad contributes significantly to thrombus formation

Management of Hypercholesteremia

* Primary target is lowering LDL * Dietary and lifestyle changes * pharmacologic treatments * Statins- prevent liver from manufacturing cholesterol * Bile acid sequestrants * Cholesterol absorption inhibitors * Fibrates * NIctonic acid

* Low-resistance vessels that stretch and constrict like a coil * Vasoconstricts/vasodilates to effect distribution of blood * primarily responsible for blood pressure

Arteries

* Regulates blood pressure * CO X total peripheral resistance (TPR- radius of vessels)

Mean Arterial Pressure (MAP)

end-diastolic volume at the beginning of systole, directly related to the degree of stretch of the myocardial sarcomeres

Preload

Risk factors of atherosclerosis

* Hypertension * Smoking * High cholesterol * Obesity * Diabetes Results in: * CAD, TIA's, CVA's, renal stenosis, arterial occlusive disease

**Disease of the lower extremities characterized by venus hypertension, varicose veins, and venous ulcers** **S/S associated with impaired blood flow, tissue congestion, edema, impairment of tissue nutrition**

**Chronic Venous Insufficiency**

**Acute inflammatory response that results in exudate accumulation around the heart**

**Acute Pericarditis**

**Small, spherical dilation of vessel at a bifurcation point** **Seen in structures like Circle of Willis in brain where bifurcated vessels are common**

**Berry aneurysm**

HTN without evidence of other diseases accounts for 90% of htn causes: genetic factors, sodium intake, DM, smoking, alcohol \>140/90

Primary/essential Hypertension

Another disease condition increases CO or TPR and indirectly increases MAP Examples: Adrenal tumors (release catecholamine), aldosterone (increased fluid retention), stress

Secondary HTN

* Vasculitis that affects medium-size arteries * Plantar or digital vessels (foot/leg) * Men 25-40 years old, heavy smokers * primarily arterial but inflammation can involve adjacent veins and nerves * S/S- pain, impaired circulation, sensitivity to cold * Chronic ischemia -\> ulceration and gangrene

Thromboangiitis obliterans (Buerger's disease)

**Narrowing of valve opening leads to greater resistance to blood flow throught the valve**

**Stenosis**

Sudden, progressive loss of consciousness Can be from: * Vasovagal response- stimulation of vagus nerve * Postural syncope- Getting up too quickly * Carotid sinus syncope- pressure on carotid arteries

Syncope

Major function is to maintain blood volume but also important in defense and fat absorption

Lymphatics

Difference between hydrostatic and interstitial fluid pressure favors \_\_\_\_\_

Filtration

**Good cholesterol**

**HDL- High-density lipoproteins**

Cardiac Drugs * Digitalis inhibits \_\_\_\_\_ * Nitroglycerine & Calcium channel blockers are \_\_\_\_\_ * Beta-adrenergic antagonists reduce _____ & \_\_\_\_\_

* NA-K-ATPase * vasodilators * reduce contractility and heart rate

\_\_\_\_\_ shock: blood flow impeded by physical or mechanical obstruction Inadequate circulating blood volume results from obstruction in great vessels that interferes with filling/emptying of the heart- results in reduced cardiac output

Obstructive Shock

* A _regulated variable_ governed by feedback inhibition * changes in cardiac output may be compensated by changes in TPR and the reverse * Hemorrhage or other severe blood loss causes lowered cardiac output * reaction would be to increase vasoconstriction to increase TPR which would then maintain it * Controlled variables: Heart rate, vasoconstriction, vasodilation

Mean Arterial Pressure (MAP) CO X TPR

Involves dilation of heart chambers impairing the function of the heart as a pump

Dilated Cardiomyopathy * Generally there is impairment of the ventricles ability to pump during systole * Leads to hypertrophy of the heart * Causes include damage to the heart from toxic, metabolic, or infectious agents

* Atherosclerosis distal to aortic arch * typically seen in older men * Risk factors: smoking, diabetes * Gradual vessel occlusion * Ischemic pain at rest * Damage and ulceration of blood vessels * gangrene can develop

Peripheral artery disease (PAD)

**Extends over part of circumference of vessel, appears like a sac**

**Saccular aneurysm**

**Intravascular volume is inappropriately distributed** **Vasodilation causes hypovolemia** **Includes septic shock, neurogenic shock, and anaphylactic shock**

**Distributive Shock**

Ejection Fraction

* How well the ventricles are at getting the blood out * Assesses efficiency of the heart * Ideally want \>75% * SV/EDV

* Leaky thin-walled vessels with a large cross-sectional area allowing slow passage of blood that facilitates transport and exchange * Site of fluid balance regulation * "Starling forces" govern filtration on arterial side and reabsorption on venus side * If not enough volume is returned, can lead to accumulation in tissues (edema)

Capillaries

Group includes : * acute myocardial infarction (MI) * STEMI * NSTEMI * unstable angina Caused by _____ and \_\_\_\_\_ Risk factors \_\_\_\_\_

Acute Coronary Syndrome (ACS) * caused by atherosclerosis and embolism * risk factors include: diabetes, hypertension, obesity, smoking, high fat-to-carb ratio, family history of heart disease

Infection of the endocardium, heart valves, or cardiac prosthesis resulting from bacterial or fungal invasion

Endocarditis * Caused by IV drug use, prosthetic heart valves, or have had rheumatic heart disease * Bacteremia leads to ulceration and necrosis of heart valves * Treatment includes antibiotics and supportive therapy

**Cardiac Output = \_\_\_\_\_**

**Cardiac Output = HR X SV** **Cardiac Output- volume pumped by each ventricle per minute** **Heart Rate X Stroke Volume**

Atrial Depolarization Ventricular depolarization Ventricular Repolarization

P wave QRS complex T wave

the force that the heart must work against to eject blood from the ventricle, ventricular pressure at the end of systole

Afterload

**False aneurysm resulting from a tear in tunica intima, allows blood to enter vessel wall and creates pockets filled with blood**

**Dissecting aneurysm**

**Failure of valve to close completely results in backflow (regurgitation) of blood to previous compartment**

**Insufficiency**

Difference between osmotic pressures in plasma and interstitial fluid favor \_\_\_\_\_

Absorption

\_\_\_\_\_ shock: The heart fails as a pump and can't maintain cardiac output

Cadiogenic Shock

* Intense vasospasm of arteries/arterioles in fingers/toes * Young women, restriction of blood flow * secondary type associated w/ other diseases or vasospasm like frostbite, occupational trauma, collagen diseases, neurologic disorders, occlusive disorders * Scleroderma

Raynauds Phenomenon

**Involves the entire circumference of vessel, characterized by gradual, progressive dilation**

**Fusiform aneurysm**

* Low-resistance vessels that help maintain blood pressure * ensure proper venous return (preload, EDV) * Sympathetic stimulation contracts smooth muscle to raise pressure

Veins

Cardiovascular Flashcards

(64 cards)