Cardiovascular System and Aging Flashcards Preview

Semester 3 FS Exam 4 > Cardiovascular System and Aging > Flashcards

Flashcards in Cardiovascular System and Aging Deck (43):
1

What doesn't change with age

Resting heart rate
Plasma volume and hematocrit
Peak developed tension
Resting length-tension relationship

2

Changes - properties of the myocardium - excitation contraction coupling

Prolonged activation - inc time to peak tension
Prolonged AP
Prolonged relaxion - longer refractory period

3

Changes - Passive myocardial properties

Changes in mm tissue materials
Type, amount and distribution of non-contractile protein, collagen and elastin

4

Changes - Age change - collagen

Inc in collagen
Cross linkage of collagen
Inc in conc of lipfuscin I

5

Effects of changes with age

Inc stiffness
Dec ventricular compliance
Impaired diastolic filling
LV EDP
* Inc exertional dyspnea

6

Cardiac structure - observations

Left ventricular hypertrophy
Inc LV wall thickness
Inc heart mass
Inc ratio of heart mass/body weight

7

Cardiac structure - LV cavity dimension

No change

8

Cardiac structure - net effect of changes

Changes correlate with pressure overload

9

Cardiac structure - causes of hypertrophy

Inc myocyte size
Inc Collagen and collagen alterations
Inc lipsofusion and other inclusions

10

Cardiac structure - overall results

Stiffer and more rigid myocardium

11

Cardiac function - observations

Dec ventricular compliance
Prolonged isovolumetric relaxation
Dec rate of elderly diastolic filling
Inc end diastolic pressure
No change in LVEDV

12

Cardiac function - Cardiac output - Rest

Relatively no change in CO

13

Cardiac function - Cardiac output - Exercise

Variable changes in SV
Dec max HR

14

Cardiac Output =

HR x SV

15

Cardiac function = With exercise young

Inc HR, Dec EDV = SV plateaus

16

Cardiac function = with exercise aged

Dec max HR, Inc late LVDV = SV

17

Autonomoic modulation of CV function - Observations

Inc resting + exercise NE
Dec receptor responsiveness
Dec response to catecholamines

18

Autonomic modulation of CV function - Beta adrenergic effects on blood vessels and HR

Dilation of blood vessels is not as quick
Dec HR?

19

Autonomic modulation of CV function - Pacemaker cells in the heart - at 75 yo

10% of the pacemaker cells of a 20 yo
Inc cardiac arrhythmia

20

Atrial fibrillation

Irregular beating of atria
Inc incidence

21

Artial fibrilation prevalence

more than 10% after 80 yo

22

Atrial fibrillation Symptoms

Palpitations, shortness of breath, angina

23

Atrial fibrillation - diagnosis

Physical exam
ECG

24

Atrial fibrillation - Complications

Heart failure
Stroke

25

Atrial fibrillation - prognosis

Good with treatment

26

Sick sinus syndrome - prevalence

Inc progressively with age

27

Sick sinus syndrome - etiology

Degeneration of sinus node pacemaker cells

28

Sick sinus syndrome - Symptoms

Dizziness, syncope, fatigue, effort, intolerance, heart failure, angina

29

Sick sinus syndrome - Diagnosis

ECG Bradycardia
Tachydysrhythmias

30

Sick sinus syndrome - Treatment

permanent pacemaker

31

Sick sinus syndrome - complications

inc risk of stroke

32

Vascular aging - altered vascular properties

Material composition of vasculature
Vascular tree
Ability of peripheral arterioles to dilate dec

33

Vascular aging - observe with aging

Inc intimal thickening
Fragmentation of elastin
Calcification
Inc collagen

34

Vascular aging - what inc

Stiffness (dec distensibility)
Arterial pressure (inc systolic)
LV wall thickness

35

Vascular aging - inc stiffness - from

Inc pulse wave velocity
Dec volume distensibility

36

Vascular aging - inc aterial pressure because of

Vasculature (aorta) fails to sustain forward flow
Inc LV work with systole
Inc cardiac afterload

37

Vascular aging - inc LV wall thickness because of

Catecholamine response
Dec VD with exercise (dec exercise tolerance

38

Cardiovascular reflexes - observe

Dec myocardial response
Dec baroreceptor sensitivity

39

Cardiovascular performances - dec in functional capacity limits

ability to exercise/work

40

Cardiovascular performances - Cardiac output changes

Little to no change at rest
Dec with ex

41

Cardiovascular performances - VO2 max

Dec VO2 max

42

Cardiovascular performance - Blood pressure changes

Systolic inc throughout life for both M and F
Diastolic inc until middle age and then returns normotensive (50-59)

43

Clinical implications of age related changes in BP regulation

Orthostatic hypertension
Postprandial hypotension
Situational syncope
Hypotensive response to dec blood volume, preload lowering medications, tachydysrhythmias