cardiovascular disorders Flashcards
(263 cards)
1
Q
What is Varicose Veins?
A
A condition where blood pools in a vein, typically the saphenous veins of the leg, causing it to become distended, tortuous, and palpable. Often caused by trauma to venous valves and worsened by gravity.
2
Q
What are risk factors for varicose veins?
A
Age, female gender, family history, obesity, pregnancy, previous leg injury, prolonged standing, constrictive clothing, and leg crossing.
3
Q
What is Chronic Venous Insufficiency (CVI)?
A
A condition where veins can’t efficiently return blood to the heart, leading to pooling, lower extremity edema, and skin changes like hyperpigmentation.
4
Q
What are symptoms of CVI?
A
Leg swelling, hyperpigmentation of ankles/feet (may extend to knees), skin ulcers, sluggish circulation, infection due to poor immune delivery.
5
Q
What are noninvasive treatments for varicose veins?
A
Leg elevation, compression stockings, and exercise.
6
Q
What are invasive treatments for varicose veins?
A
Endovenous ablation, sclerotherapy, surgical ligation, conservative vein resection, and vein stripping.
7
Q
What is a thrombus?
A
A blood clot that remains attached to a vessel wall.
8
Q
What is an embolus?
A
A traveling particle (usually a thrombus) that detaches and moves through circulation, possibly lodging elsewhere.
9
Q
What are the 3 components of Virchow’s Triad?
A
1) Venous stasis, 2) Endothelial damage, 3) Hypercoagulability.
10
Q
What is phlebitis?
A
Acute inflammation of a vein, causing pain, tenderness, swelling, and redness. May be superficial or deep.
11
Q
What is superficial phlebitis?
A
Inflammation of veins near the surface, usually from IV lines or varicose veins. Not dangerous but uncomfortable.
12
Q
What is deep vein phlebitis?
A
Inflammation of deeper veins, commonly in the legs. Dangerous—may lead to pulmonary embolism if clots dislodge.
13
Q
What is thrombophlebitis?
A
Inflammation of a vein due to a blood clot. May be superficial or deep (e.g., DVT).
14
Q
What are symptoms of thrombophlebitis?
A
Red, tender, cord-like vein, warmth and swelling. If DVT, deep aching, leg swelling, possible SOB (PE).
15
Q
How is DVT typically prevented?
A
Early ambulation, pneumatic devices, prophylactic anticoagulants, D-dimer testing, Doppler ultrasound.
16
Q
How can you distinguish a thrombus from an embolus?
A
A thrombus is stationary; an embolus is mobile and can travel to cause distant blockages (e.g., pulmonary embolism).
17
Q
What defines hypertension?
A
Persistent elevation of systemic arterial blood pressure due to increased resistance, blood volume, or both.
18
Q
Why is high sodium intake a risk for HTN?
A
It causes fluid retention, increasing blood volume and pressure. Shifts the pressure–natriuresis curve.
19
Q
Why is low potassium intake risky for HTN?
A
Potassium helps excrete sodium and relax blood vessels. Without it, sodium is retained and vessels remain constricted.
20
Q
How does obesity contribute to HTN?
A
It activates SNS and RAAS, promotes inflammation and insulin resistance, causing vasoconstriction and salt retention.
21
Q
How does physical inactivity contribute to HTN?
A
Leads to reduced vascular health, obesity, and insulin resistance. Also reduces nitric oxide production.
22
Q
Why does alcohol raise blood pressure?
A
It increases sympathetic tone, damages vessels, and raises cortisol and catecholamine levels.
23
Q
How does smoking affect blood pressure?
A
Nicotine causes vasoconstriction and endothelial damage, promoting atherosclerosis and vessel stiffness.
24
Q
How does stress contribute to HTN?
A
Chronic stress elevates cortisol and sympathetic activity, increasing vascular tone and heart rate.
25
What defines a hypertensive crisis?
A sudden BP spike (often diastolic > 140 mmHg) with or without organ damage (urgency vs. emergency).
26
What are neurological signs of hypertensive crisis?
Headache, dizziness, confusion, seizures, altered LOC—due to cerebral edema and pressure.
27
What are cardiac signs of hypertensive crisis?
Chest pain, palpitations, SOB, sudden heart failure—due to myocardial ischemia or infarction.
28
What are ocular signs of hypertensive crisis?
Papilledema, blurred vision, temporary blindness—due to retinal vessel damage.
29
What are renal signs of hypertensive crisis?
Hematuria, proteinuria, reduced urine output—due to glomerular damage.
30
Why do multiple signs matter in hypertensive crisis?
Suggests systemic involvement and target organ damage—confirms it’s an emergency, not just high BP.
31
What is Left Ventricular Hypertrophy (LVH) in hypertension?
The LV thickens due to pumping against increased resistance. Thick walls impair filling and reduce cardiac output.
32
What is ischemic chest pain?
Non-reproducible pain from oxygen-starved heart tissue. Not relieved by movement or palpation.
33
What is the difference between musculoskeletal and cardiac chest pain?
MSK pain is reproducible with movement or palpation; cardiac pain is not.
34
How does hypertension damage coronary arteries?
High BP causes endothelial damage, promotes plaque buildup, and narrows vessels—leading to CAD.
35
What medications are used in prehospital cardiac ischemia management?
ASA, nitroglycerin (if SBP > 100), IV access, and serial 12-leads.
36
How does hypertension affect the brain?
Chronic high BP leads to vessel damage, reduced blood flow, and increased risk of stroke (ischemic or hemorrhagic).
37
What does FAST stand for in stroke assessment?
Face drooping, Arm weakness, Speech difficulty, Time to call 911.
38
How does hypertension affect the eyes?
It causes retinal vessel sclerosis, increased pressure, and potential vision loss.
39
What is a dissecting aortic aneurysm?
A tear in the aortic wall allows blood to separate layers, forming a false lumen that can rupture.
40
What are signs of an abdominal aortic aneurysm (AAA)?
Tearing pain, hypotension, pulsatile abdominal mass, and systolic BP difference between arms.
41
What precautions are taken if AAA is suspected?
Avoid deep palpation, handle gently, rapid transport to surgical center.
42
How does hypertension affect lower extremity arteries?
Reduces perfusion, leads to ischemia, necrosis, and gangrene—especially in diabetics or immobile patients.
43
What are signs of poor perfusion in the feet?
Coldness, delayed cap refill, foul discharge, discoloration, and numbness.
44
What lifestyle changes help treat hypertension?
Exercise, healthy diet, reduced salt/alcohol intake, smoking cessation, weight loss.
45
What do beta blockers do?
Decrease heart rate and output, lowering blood pressure.
46
How do ACE inhibitors lower BP?
Block angiotensin II formation → vasodilation, less salt/water retention.
47
What do calcium channel blockers do?
Relax vascular smooth muscle → vasodilation and reduced workload on the heart.
48
What do diuretics do in hypertension?
Promote fluid loss through urine → reduces blood volume and pressure.
49
What is orthostatic hypotension?
A drop in BP (≥20 systolic or ≥10 diastolic) upon standing, causing dizziness or fainting.
50
What causes orthostatic hypotension?
Dehydration, medications, bed rest, neuropathy, Parkinson’s disease.
51
What is an aneurysm?
Localized dilation or outpouching of a blood vessel or cardiac chamber.
52
What is the difference between true and false aneurysms?
True involves all 3 vessel layers; false (pseudoaneurysm) is a blood leak outside the vessel.
53
What is Raynaud’s phenomenon?
Episodic vasospasm of arteries (usually fingers/toes) due to cold or stress.
54
What are the three color phases of Raynaud’s?
White (pallor), blue (cyanosis), red (hyperemia).
55
What is arteriosclerosis?
Hardening and thickening of artery walls, reducing elasticity and blood flow.
56
What is atherosclerosis?
Type of arteriosclerosis caused by lipid-laden macrophages (foam cells) forming plaques.
57
What causes atherosclerosis?
Endothelial injury, inflammation, fatty streaks, plaque buildup, and rupture.
58
Why is high LDL cholesterol dangerous?
It forms plaques in vessels, leading to ischemia, MI, stroke, or PAD.
59
How does aspirin help in cardiovascular disease?
It inhibits platelets, reducing clot risk and improving blood flow.
60
What is Peripheral Artery Disease (PAD)?
Atherosclerotic narrowing of peripheral arteries, especially in the legs.
61
What are PAD risk factors?
Diabetes, smoking, HTN, high cholesterol, obesity, sedentary lifestyle, age > 60.
62
What is the CAD–Ischemia–MI continuum?
A progressive cycle starting with risk factors → CAD → ischemia → MI → heart failure → death.
63
What is myocardial ischemia?
Temporary reduction in blood flow to the myocardium, causing chest pain and risk of infarction.
64
What causes myocardial ischemia?
Coronary artery narrowing due to atherosclerosis, often worsened by exertion.
65
What is Acute Coronary Syndrome (ACS)?
A group of emergencies caused by sudden reduced blood flow to the heart, usually from plaque rupture.
66
What is unstable angina?
Reversible ischemia presenting with chest pain at rest or worsening frequency/intensity.
67
How do you differentiate unstable angina from NSTEMI?
Unstable angina = no troponin elevation; NSTEMI = elevated troponin but no ST elevation.
68
What is a myocardial infarction (MI)?
Irreversible heart muscle damage due to prolonged ischemia from complete vessel occlusion.
69
What are MI symptoms?
Crushing chest pain, SOB, diaphoresis, nausea, radiating pain, feeling of impending doom.
70
What is the difference between STEMI and NSTEMI?
STEMI = full-thickness infarct with ST elevation. NSTEMI = partial thickness, no ST elevation.
71
What are ECG leads for a lateral MI?
Leads I, aVL, V5, V6 → Left Circumflex artery.
72
What are ECG leads for an inferior MI?
Leads II, III, aVF → Right Coronary Artery or LCx.
73
What are ECG leads for an anterior MI?
Leads V1–V4 → Left Anterior Descending artery.
74
What happens functionally to the heart during an MI?
↓ contractility, ↓ stroke volume, ↓ EF, ↑ end-diastolic pressure, SA node malfunction.
75
What is cardiac output (CO)?
The volume of blood the heart pumps per minute (CO = HR × SV).
76
What is acute pericarditis?
Inflammation of the pericardium, often from viral infection. Causes positional chest pain.
77
What are signs of pericarditis?
Pleuritic chest pain worse lying down, better leaning forward. ST elevation in many leads.
78
What is pericardial effusion?
Accumulation of fluid in the pericardial sac, may cause tamponade.
79
What is Beck’s triad for tamponade?
Hypotension, JVD, muffled heart sounds.
80
What are cardiomyopathies?
Diseases of the myocardium that impair its ability to pump—can be dilated, hypertrophic, or restrictive.
81
What is dilated cardiomyopathy (DCM)?
Ventricles enlarge and weaken → ↓ contractility, ↓ EF, heart failure.
82
What causes DCM?
Alcohol, ischemia, diabetes, renal failure, infections, chemotherapy.
83
What is hypertrophic cardiomyopathy (HCM)?
Thickened heart muscle, often septum, causing obstruction and ↓ filling (diastolic dysfunction).
84
What is hypertrophic obstructive cardiomyopathy (HOCM)?
Inherited form of HCM that obstructs LV outflow—major cause of sudden cardiac death in young athletes.
85
What is restrictive cardiomyopathy?
Ventricular walls are stiff and noncompliant → impaired diastolic filling with preserved systolic function.
86
What are signs of restrictive cardiomyopathy?
JVD, peripheral edema, fatigue, exercise intolerance.
87
What is valvular stenosis?
Narrowing of a heart valve opening, increasing pressure in the preceding chamber.
88
What causes aortic stenosis?
Bicuspid valve, calcification, or rheumatic heart disease.
89
What are signs of aortic stenosis?
LV hypertrophy, angina, syncope, systolic murmur radiating to carotids.
90
What is mitral stenosis?
Narrowing of the mitral valve, usually from rheumatic fever → LA enlargement, AFib, pulmonary symptoms.
91
What is valvular regurgitation?
Incomplete valve closure → blood leaks backward during contraction.
92
What are signs of aortic regurgitation?
Bounding pulses, widened pulse pressure, LV dilation, diastolic murmur.
93
What is mitral regurgitation?
Blood leaks into LA during systole → pulmonary edema, AFib, holosystolic murmur to axilla.
94
What is tricuspid regurgitation?
Blood leaks into RA during RV contraction → JVD, hepatomegaly, edema.
95
What is mitral valve prolapse (MVP)?
One or both valve cusps billow into LA during systole. Often asymptomatic but may cause palpitations, chest pain.
96
What is infective endocarditis?
Infection of endocardial surface, often due to staph/strep, causing vegetations on valves.
97
What are signs of infective endocarditis?
Fever, murmur, Osler nodes, Janeway lesions, petechiae, emboli.
98
How is infective endocarditis treated?
Prolonged IV antibiotics, possible surgery for valve repair.
99
What is the role of D-dimer in DVT?
It detects fibrin degradation → high levels suggest thrombus formation.
100
What is the difference between thrombus and embolus?
Thrombus is stationary, embolus moves through circulation and can block distant vessels.
101
What’s the risk of embolization in DVT?
Part of the clot may break off and travel to the lungs → pulmonary embolism.
102
What is pulmonary embolism (PE)?
A blockage in a pulmonary artery due to a blood clot, usually from a DVT.
103
What are symptoms of PE?
Sudden SOB, chest pain, tachypnea, hypoxia, hemoptysis, anxiety.
104
What is post-thrombotic syndrome?
Chronic pain, swelling, and skin changes in limb after DVT due to persistent venous obstruction.
105
Why is DVT often asymptomatic?
Because it can develop slowly and deep veins don’t always trigger pain or swelling early.
106
What are superficial thrombophlebitis causes?
IV lines, varicose veins, trauma, infection, immobility.
107
What are symptoms of superficial thrombophlebitis?
Red, tender vein that feels like a cord, localized pain and swelling.
108
What is Virchow’s Triad used for?
To explain the 3 factors contributing to thrombosis: stasis, vessel injury, hypercoagulability.
109
What diagnostic tools are used for DVT?
Doppler ultrasound, D-dimer testing.
110
What’s the first-line treatment for hypertensive emergency?
IV antihypertensives and rapid BP reduction under hospital care.
111
What’s the function of the aorta?
It carries oxygenated blood from the heart to the body; composed of 3 layers.
112
What are signs of retinal involvement in HTN crisis?
Blurry vision, papilledema, floaters, temporary blindness.
113
What organs are most vulnerable to HTN?
Brain, heart, kidneys, eyes—due to thin-walled or high-perfusion systems.
114
What can cause orthostatic hypotension acutely?
Dehydration, blood loss, antihypertensive medications.
115
What can cause chronic orthostatic hypotension?
Parkinson’s, diabetic neuropathy, immobility.
116
What is the baroreceptor reflex?
A reflex that detects BP drops and causes vasoconstriction and increased HR.
117
What type of aneurysm involves all vessel wall layers?
True aneurysm.
118
What is a false aneurysm (pseudoaneurysm)?
Blood collects outside the vessel wall but is contained by surrounding tissue.
119
What are causes of aneurysms?
HTN, atherosclerosis, smoking, infections, Marfan syndrome.
120
What’s a major sign of a ruptured aneurysm?
Sudden severe pain (e.g., tearing), hypotension, shock, syncope.
121
What is preload?
The volume of blood in ventricles at the end of diastole.
122
What is afterload?
The resistance the LV must overcome to eject blood.
123
What is ejection fraction (EF)?
The percentage of blood ejected from the LV each beat. Normal = 55–70%.
124
What is pulsus paradoxus?
A drop in SBP >10 mmHg on inspiration, seen in tamponade.
125
What is Dressler’s Syndrome?
Post-MI pericarditis due to autoimmune reaction.
126
What is amyloidosis?
A disease where abnormal protein deposits stiffen tissues, including the heart.
127
What is Frank-Starling Law?
Greater stretch (preload) leads to stronger contraction—up to a point.
128
What is myocardial remodeling?
Structural heart changes (e.g., dilation, hypertrophy) due to chronic strain or injury.
129
What is congestive heart failure (CHF)?
Heart’s inability to pump effectively, causing fluid buildup in lungs/body.
130
What is the difference between right- and left-sided heart failure?
Right = peripheral edema, JVD; Left = pulmonary congestion, SOB.
131
What are signs of left-sided HF?
Orthopnea, paroxysmal nocturnal dyspnea, pulmonary crackles, fatigue.
132
What are signs of right-sided HF?
JVD, hepatomegaly, ascites, peripheral edema.
133
What is the cardiac output equation?
CO = HR × Stroke Volume.
134
What are the most common bacteria in infective endocarditis?
Streptococci, Staphylococci, Enterococci.
135
What are Osler nodes?
Painful red nodules on fingers/toes in endocarditis.
136
What are Janeway lesions?
Painless macules on palms/soles in endocarditis.
137
What is hypoxia?
Decreased oxygen supply to tissues.
138
What is ischemia?
Reduced blood flow leading to insufficient oxygen delivery.
139
What is necrosis?
Irreversible cell death due to prolonged ischemia.
140
What does troponin elevation indicate?
Myocardial injury or infarction.
141
What is a holosystolic murmur?
Murmur heard throughout systole, often from regurgitant valves.
142
What is heart block?
Impaired electrical conduction between atria and ventricles.
143
What is the function of the SA node?
Acts as the heart’s natural pacemaker, initiating each heartbeat.
144
What are the coronary arteries?
Vessels supplying blood to the heart muscle (LAD, RCA, LCx).
145
What is a 12-lead ECG?
An electrical recording of heart activity from 12 angles to detect ischemia, infarction.
146
What is a STEMI?
ST-Elevation MI: full-thickness infarction with clear ECG changes.
147
What is an NSTEMI?
Non-ST-Elevation MI: partial thickness infarct with elevated troponins but no ST changes.
148
What is a stent?
A mesh tube inserted to keep an artery open after angioplasty.
149
What is CABG?
Coronary Artery Bypass Grafting—a surgical rerouting of blood around blocked arteries.
150
What is the role of magnesium in vision disturbances?
Deficiency can cause instability in vision, possibly triggering ocular migraines.
151
What is amaurosis fugax?
Temporary monocular blindness caused by retinal ischemia, often in HTN or embolic events.
152
What is a capillary refill test?
A quick test to assess peripheral perfusion; delayed refill suggests poor circulation.
153
What is gangrene?
Tissue death due to loss of blood supply, often in the extremities.
154
What are the 3 major ECG ischemia findings?
ST elevation, ST depression, and T-wave inversion.
155
What is preload dependent circulation?
A situation (e.g., RV infarct) where cardiac output depends on high venous return.
156
Why is nitroglycerin dangerous in RV infarct?
It reduces preload, which may dangerously lower cardiac output in these patients.
157
What is a 15-lead ECG used for?
To detect posterior wall MI not seen on a 12-lead.
158
What are signs of acute coronary syndrome (ACS)?
Chest pain, nausea, diaphoresis, SOB, radiating discomfort.
159
What is a pericardial knock?
Early diastolic sound heard in constrictive pericarditis.
160
What is a murmur?
An abnormal heart sound caused by turbulent blood flow, often due to valve issues.
161
What is cardiac tamponade?
Compression of the heart from fluid in the pericardial sac → ↓ cardiac output.
162
What is left atrial enlargement?
LA dilation due to volume/pressure overload, commonly from mitral valve disease.
163
What is syncope?
Temporary loss of consciousness due to inadequate cerebral perfusion.
164
What is hyperlipidemia?
Elevated lipid levels in the blood, including cholesterol and triglycerides.
165
What is LDL?
Low-density lipoprotein, “bad” cholesterol that contributes to atherosclerosis.
166
What is HDL?
High-density lipoprotein, “good” cholesterol that helps remove LDL from the bloodstream.
167
What is a bruit?
A vascular sound indicating turbulent flow, often from narrowed arteries.
168
What is aortic root dilation?
Enlargement of the aorta near the valve, increasing risk for regurgitation and aneurysm.
169
What is heart rate variability (HRV)?
The variation in time between heartbeats; low HRV may indicate poor autonomic regulation.
170
What is systemic vascular resistance (SVR)?
The resistance in the blood vessels that the heart must overcome to eject blood.
171
What are catecholamines?
Hormones (e.g., epinephrine) that increase HR, BP, and glucose during stress.
172
What is an antiplatelet medication?
A drug (e.g., ASA) that prevents platelets from clumping and forming clots.
173
What is vasodilation?
The widening of blood vessels, reducing resistance and BP.
174
What is vasoconstriction?
The narrowing of blood vessels, increasing resistance and BP.
175
What is pulse pressure?
Difference between systolic and diastolic BP; widened in aortic regurgitation.
176
What is the RAAS system?
Renin-Angiotensin-Aldosterone System—regulates BP through fluid balance and vasoconstriction.
177
What is nitric oxide’s role in BP?
It’s a vasodilator that helps keep vessels relaxed and BP low.
178
What is a hypertensive urgency?
Severely elevated BP without organ damage.
179
What is a hypertensive emergency?
Severely elevated BP with signs of organ damage (e.g., stroke, MI, renal failure).
180
What is transient ischemic attack (TIA)?
A “mini-stroke” with temporary neurological symptoms and no permanent damage.
181
What is baroreceptor sensitivity?
The ability of pressure sensors in arteries to adjust BP; declines with age.
182
What is pulse deficit?
A difference between heartbeats heard and pulses felt, often from arrhythmias.
183
What is the role of aspirin in MI?
It inhibits platelet aggregation, improving blood flow past occlusions.
184
What is left ventricular failure?
Inability of the LV to pump blood effectively → backs up into lungs.
185
What is right ventricular failure?
RV can’t pump to lungs → systemic congestion and edema.
186
What is peripheral edema?
Swelling in limbs due to fluid buildup, often from right-sided HF.
187
What is orthopnea?
Difficulty breathing when lying flat, common in left-sided HF.
188
What is paroxysmal nocturnal dyspnea (PND)?
Sudden nighttime SOB due to fluid shifting into lungs during sleep.
189
What is an S3 heart sound?
A low-pitched sound after S2, associated with HF and volume overload.
190
What is an S4 heart sound?
A sound before S1, associated with stiff ventricles (e.g., HTN, HCM).
191
What is a wide pulse pressure?
A large gap between systolic and diastolic pressures, seen in aortic regurgitation.
192
What is pedal edema?
Swelling of the feet and ankles, often from heart or venous failure.
193
What is BNP?
Brain Natriuretic Peptide—released from heart during volume overload; elevated in HF.
194
What is a PVC?
Premature Ventricular Contraction—an early heartbeat from the ventricles.
195
What is fibrillation?
Chaotic electrical activity causing ineffective heart pumping (e.g., AFib, VFib).
196
What is cardiogenic shock?
A state of poor perfusion due to the heart’s failure to pump adequately.
197
What is atherosclerotic plaque?
A buildup of lipids and inflammatory cells inside artery walls.
198
What is a stroke volume?
The amount of blood ejected by the LV with each beat.
199
What is pericardial friction rub?
A scratching sound heard with pericarditis, best at end expiration while leaning forward.
200
What is ventricular remodeling?
Long-term changes in heart shape and size after injury (e.g., post-MI or in HF).
201
What are varicose veins?
Swollen, twisted veins visible under the skin caused by pooled blood from damaged valves, most commonly in the legs.
202
What is phlebitis and how is it different from varicose veins?
Phlebitis is inflammation of a vein, often causing pain, redness, and swelling. It may occur with or without a visible varicose vein.
203
What defines hypertension and what are its diagnostic values?
Hypertension is defined as a consistent elevation in systemic arterial blood pressure. Diagnostic values: SBP ≥ 140 mmHg or DBP ≥ 90 mmHg.
204
What are the signs and symptoms of a hypertensive crisis?
Severe headache, blurred vision, confusion, chest pain, dyspnea, decreased urine output, nausea, seizures, altered LOC.
205
How does hypertension contribute to atherosclerosis?
HTN damages arterial walls, leading to inflammation and plaque buildup, accelerating atherosclerosis.
206
How can hypertension be a diagnostic clue for an abdominal aortic aneurysm (AAA)?
HTN causes vessel wall stress that may result in tearing of the aortic wall. A sudden increase in BP in a patient with tearing back/abdominal pain is suggestive of AAA.
207
What is orthostatic hypotension and how is it diagnosed?
A drop in SBP ≥ 20 mmHg or DBP ≥ 10 mmHg within 3 minutes of standing. Confirmed by measuring BP lying and then standing.
208
What are 9 signs and symptoms of orthostatic hypotension?
Dizziness, lightheadedness, blurry vision, weakness, fainting, nausea, fatigue, confusion, headache.
209
How would you and your partner identify orthostatic hypotension in a patient?
Ask about positional symptoms, take BP lying then standing, observe for dizziness, pallor, instability.
210
What is an aneurysm?
A localized dilation or outpouching of a blood vessel wall due to weakening of its layers.
211
What causes thrombus formation?
Virchow’s triad: endothelial injury, stasis of blood flow, and hypercoagulability.
212
What is the difference between a thrombus and an embolus?
A thrombus is a stationary clot; an embolus is a clot or material that travels through the bloodstream.
213
What is an embolism?
A blockage in a blood vessel caused by an embolus such as a blood clot, air bubble, or fat droplet.
214
How do emboli relate to strokes?
An embolus can lodge in cerebral arteries, cutting off oxygen and causing an embolic stroke.
215
What is the difference between ischemic and hemorrhagic stroke?
Ischemic: caused by vessel blockage (clot). Hemorrhagic: caused by vessel rupture and bleeding.
216
What is the difference between a CVA and a TIA?
CVA (stroke) causes permanent damage; TIA is temporary with full recovery, often a warning sign.
217
What is Raynaud's phenomenon and who is at risk?
It is episodic vasospasm of extremities (fingers/toes) triggered by cold/stress. Young women are most at risk.
218
What are the signs and symptoms of Raynaud's phenomenon?
Triphasic color changes (white, blue, red), numbness, tingling, and pain in affected areas.
219
What is the mechanism of PAD and its risk factors?
PAD results from atherosclerosis narrowing peripheral arteries. Risk factors: smoking, diabetes, HTN, high cholesterol.
220
What are the signs and symptoms of PAD?
Claudication, leg pain on exertion, cold feet, non-healing wounds, weak pulses.
221
What are the risk factors and symptoms of CAD?
Risk factors: HTN, diabetes, smoking, obesity, sedentary lifestyle. Symptoms: angina, SOB, fatigue.
222
How does the CAD-Ischemia-MI-CHF continuum progress?
Risk factors → atherosclerosis → CAD → ischemia → infarction → LV dysfunction → heart failure → death.
223
What is the difference between stable and unstable angina?
Stable: predictable, with exertion, relieved by rest. Unstable: occurs at rest, more severe, may precede MI.
224
What are the key steps in evaluating ischemic chest pain or MI?
12-lead ECG, OPQRST assessment, risk factor history, vital signs, oxygen sats, rule out MSK pain.
225
What can paramedics do for ischemic chest pain prehospital?
Give ASA, acquire 12-lead ECG, establish IV, administer nitro (if BP >100), rapid transport.
226
What is acute pericarditis?
Inflammation of the pericardium, often viral. Pain worsens lying down, improves sitting forward.
227
What is a pleural effusion?
Excess fluid in the pleural space around the lungs, causing SOB, chest discomfort, decreased breath sounds.
228
What is cardiomyopathy?
A disease of the heart muscle that reduces its ability to pump—types include dilated, hypertrophic, and restrictive.
229
What is valvular stenosis?
Narrowing of a heart valve that impedes blood flow and increases pressure in the preceding chamber.
230
What causes aortic regurgitation and what are its effects?
Caused by valve disease or aortic dilation. Blood leaks back into LV, causing dilation, hypertrophy.
231
What are signs of aortic regurgitation?
Wide pulse pressure, diastolic murmur, bounding pulses, LV enlargement.
232
What are signs of mitral regurgitation?
Holosystolic murmur, radiates to axilla, pulmonary edema, possible AFib.
233
What are signs of tricuspid regurgitation?
JVD, peripheral edema, holosystolic murmur increasing with inspiration.
234
What is Frank Starling’s Law?
Increased stretch leads to stronger contraction—up to a physiological limit.
235
How does LVH disrupt Frank Starling’s Law?
Thickened walls reduce chamber compliance, decreasing preload and limiting stroke volume.
236
How does atherosclerosis affect Frank Starling’s Law?
Stiff vessels reduce blood delivery to myocardium, impairing preload and contractility.
237
What is the difference between a CVA and a TIA?
A CVA (stroke) causes permanent neurological damage due to a blockage or bleed in the brain. A TIA (transient ischemic attack) is temporary, lasts less than 24 hours, and fully resolves without lasting damage—but is a warning sign of stroke risk.
238
What is anaphylaxis and how is it treated?
Anaphylaxis is a life-threatening allergic reaction involving widespread vasodilation, bronchoconstriction, and shock. It is treated with epinephrine IM, airway support, oxygen, and antihistamines.
239
What is a hypertensive crisis?
A severe elevation in blood pressure (SBP >180 or DBP >120) that can lead to organ damage (hypertensive emergency) or occur without organ damage (hypertensive urgency). Symptoms may include headache, chest pain, confusion, visual disturbances, and seizures.
240
What is the difference between a thrombus and an embolus?
A thrombus is a clot that forms and stays in one location. An embolus is a piece of material (often a thrombus) that travels through the bloodstream and may cause a blockage elsewhere (e.g., stroke, PE).
241
What does the Coronary Artery Disease continuum describe?
It outlines the progression from risk factors → atherosclerosis → CAD → ischemia → MI → heart failure → death. It emphasizes that each stage feeds into the next if untreated.
242
What is Frank Starling’s Law and how is it affected in heart disease?
Frank Starling’s Law states that the more the heart muscle is stretched during filling (preload), the stronger the next contraction will be. In LVH or stiffened ventricles (e.g., HCM, CAD), this relationship is impaired, limiting output.
243
What are key signs of opioid overdose and treatment steps?
Pinpoint pupils, respiratory depression, altered LOC, bradycardia. Treat with naloxone (Narcan), airway support, and oxygenation.
244
Why are toxidromes important in toxicology?
Toxidromes are symptom clusters that help identify the type of toxin or overdose (e.g., cholinergic, anticholinergic, opioid). They guide treatment decisions when history is unclear.
245
What’s the difference between a STEMI and an NSTEMI?
STEMI = full-thickness infarction with ST elevation on ECG. NSTEMI = partial-thickness infarction with elevated troponins but no ST elevation on ECG.
246
What is the difference between stable and unstable angina?
Stable angina is predictable, triggered by activity, and relieved by rest. Unstable angina is new, worsening, or occurs at rest—a sign of high MI risk.
247
What are the differences between right- and left-sided heart failure?
Right-sided HF: causes systemic congestion (JVD, ascites, leg edema)
## Footnote
Left-sided HF: causes pulmonary congestion (SOB, orthopnea, crackles, pink frothy sputum)
248
What is CVA?
Permanent neurological damage from stroke
249
What is TIA?
Temporary stroke symptoms resolving within 24 hrs
250
What is Anaphylaxis?
Severe allergic reaction with airway and circulatory collapse
251
What is HTN Crisis?
Critically high BP with or without organ damage
252
What is a Thrombus?
Stationary clot
253
What is an Embolus?
Traveling clot/material that can cause blockage
254
What is STEMI?
Full-thickness MI with ST elevation
255
What is NSTEMI?
Partial-thickness MI with elevated troponins, no ST elevation
256
What is Stable Angina?
Predictable chest pain on exertion
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What is Unstable Angina?
Unexpected chest pain at rest or with less effort
258
What are the causes of Right-sided HF?
Causes peripheral edema, JVD, hepatomegaly
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What are the causes of Left-sided HF?
Causes pulmonary edema, SOB, orthopnea
260
What is Frank Starling’s Law?
Greater preload = stronger contraction (to a limit)
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What is Toxidrome?
Symptom cluster to identify poisoning/overdose type
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What is the CAD Continuum?
Progression: risk factors → ischemia → MI → HF → death
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What is Opioid Overdose?
Triad: pinpoint pupils, respiratory depression, ↓LOC; treated with naloxone
