CP8-2 cardiovascular pathology 2 Flashcards
(27 cards)
What is the cardiac output equation?
heart rate x stroke volume = cardiac output
What are two types of heart failure?
Systolic
Diastolic
When is systolic heart failure diagnosed?
When ejection fraction is below 40% (between 40 and 60% is borderline)
When does a patient have diastolic heart failure?
when they have a normal ejection fraction but reduced preload due to blood being in the ventricle before contraction
What is left ventricular heart failure? What is its pathogenesis?
Insufficient left ventricular output due to increased pressure in left ventricle reducing cardiac output, lowering BP. Sympathetic overdrive then stimulates the renin-angiotensin-aldosterone system increasing HR, afterload and preload causing the heart to work harder, ventricular hypertrophy and
How do patients with left ventricular heart failure present?
Dyspnoea
Fatigue
Palpitation
Peripheral oedema and ascites
What are complications of left ventricular heart failure?
Arrhythmia
Sudden cardiac death
What is right ventricular heart failure and what’s its pathogenesis?
Insufficient right ventricular output due to lung disease which causes pulmonary hypertension. This increases the workload of the right side of the heart leading to right ventricular hypertrophy, dilation and failure
How do patients with right ventricular heart failure present?
Worsening breathlessness
Peripheral oedema
Existing lung pathology
What is aortic stenosis?
Most common valvular heart disease usually due to senile calcification causing narrowing of the aortic valve.
What 2 diseases are risk factors for aortic stenosis?
Congenital bicuspid aortic valve
Chronic rheumatic disease
How might a patient with aortic stenosis present?
Chest pain
Dyspnoea
Syncope
What causes a systolic ejection murmur to be heard in aortic stenosis?
as narrowing and calcification of the aortic valve results in left ventricular outflow obstruction which sounds like a murmur
What is aortic regurgitation?
When an incompetent aortic valve causes back flow of blood back into the heart
What can causes aortic regurgitation?
Anything that dilates the root of the aorta e.g.
Marfan’s syndrome
Ankylosing spondylitis
Congenital abnormalities
How do patients with a aortic regurgitation present?
Dyspnoea
…
What is the pathogenesis of mitral valve stenosis?
Reduced blood flow from left atrium to left ventricle increase pressure in left atrium increasing its size. This leads to pulmonary oedema and dyspnoea and increases risk of AF which can lead to clot formation and
What is mitral stenosis?
Fusion of cusps of mitral valve
When does mitral regurgitation occur?
When there is mitral valve prolapse or IHD
Can also happen in mitral valve prolapse when one leaflet prolapses into the left atrium during systole
What is mitral regurgitation?
When blood leaks back through the mitral valve into the left atrium
What are some common congenital heart diseases?
Atrial septal defects
Ventricular septal defects
Coarctation of the aorta
Tetralogy of fallout
How does the ventricular septum develop?
From the apex of the heart/ventricles and grows caudally
How does blood flow change with atrial and ventricular septum defects?
Causes a left to right shunting of blood due to increased pressure in left side of the heart
What is the most common atrial septum defect?
Ostium secundum
