Heart Disease Flashcards
(222 cards)
1
Q
William Harvey 1578-1657
A
Figured out how the heart worked and is known as the “father of the circulatory system”
2
Q
Egypitans
A
Believed that the heart was the center of emotions and intellect
3
Q
Romans
A
thought that the heart manufactured blood
4
Q
William harvey discovered that…
A
the heart’s main action is in systole –> pump out blood to the rest of the body
- blood goes out of the heart in the arteries and comes back via the veins
5
Q
How does the heart work?
A
used blood comes back from the vena cava and goes through the right atrium
blood goes down through the tricuspid valve and into the right ventricle
it is pumped into the lungs and as it circulates through the lungs, it picks up oxygen and is delivered back to the left atrium
goes down to the left ventricle and through the aortic valve and delivers oxygen to every cell in the body
6
Q
Vena Cava
A
large vein where used blood comes back to the heart
7
Q
Blood that is deoxygenated =
A
blue colour
8
Q
Blue that is oxygenated =
A
red colour
9
Q
Used blood comes back from the Vena Cava …
A
and comes back through the Right atrium
10
Q
arteries …
A
go away from the heart
11
Q
Veins…
A
return to the heart
12
Q
All arteries carry oxygenated blood except…
A
pulmonary artery
13
Q
all veins carry deoxygenated blood except…
A
pulmonary vein
14
Q
the heart pumps…
A
5-6 L/min
15
Q
Capilalries
A
red blood cells go one by one through the capillaries
16
Q
capillaries merge to become…
A
veins
17
Q
veins merge together and become…
A
vena cava
18
Q
problems with the heart ?
A
- failure to pump enough blood
- impairment of electrical activity
- reduced flow of blood through coronary arteries
- improper functioning of heart valves
19
Q
Risk factors for heart disease
A
- family history
- ear lobe crease can be a marker for risk of heart disease
- Baldness: hormonal connections?
- Sex
- Smoking! Most common to heart disease
- obesity
- Diabetes
- Hypercholesterolemia
- Homocysteine
- Inflammation
- Bacteria?
- Hypertension
20
Q
Diabetes
A
- too much glucose
- detect CVD by measuring blood glucose
- often asymptomatic
- if you have fasting blood glucose >7mM, they will do an oral glucose tolerance test
- first signs of diabetes can be double vision, excessive thirst, or excessive urination
21
Q
Cholesterol
A
- blood levels of cholesterol are linked to heart disease
- 1/3 of all heart attacks and strokes can be avoided in people at high risk by using a statin drug to lower cholesterol
- not all cholesteroal is bad!
22
Q
Gender? Male vs. Female
A
- males have higher risk : 10x greater than permenopausal women
- women have atypical symptoms which are often missed –> higher mortality
- people thought the cause of this was due to estrogen decrease after menopause but estrogen was given and they still couldn’t reduce Cardiovascular disease risk
23
Q
Lipitor
A
- statin drug
- brings down bad cholesterol levels when taken regularly
- atorvastain
24
Q
LDL
A
bad cholesterol
25
HbA1C
- see how much glucose is bound to RBC surface - every 3 months ish
- Allow us to follow the progress
- want
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Diabetes - Fasting/premeal
| IDEAL
4-6
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Diabetes - Fasting/premeal
| OPTIMAL
4-7
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Diabetes - Fasting/premeal
| SUBOPTIMAL/DIABETIC
7.1-10
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Diabetes - Fasting/premeal
| INADEQUATE (SERIOUSLY ILL)
>10
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1-2hrs post-meal
| IDEAL
5-8
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1-2hrs post-meal
| OPTIMAL
5-10
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1-2hrs post-meal
| SUBOPTIMAL (DIABETIC)
10.1-14
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1-2hrs post-meal
| INADEQUATE (SERIOUSLY ILL)
>14
34
what percentage of pre-diabetics will develop diabetes in 5-10 years?
50%
35
Zocor (Hypercholesterolemia drug)
simvastatin
| - intervenes with the formation of cholesterol
36
Side effects of lipitor and zocor
muscle aches and can impact liver
37
Homocysteine
- High levels = more likely to come down with heart disease
38
Homocysteine Level is controlled by...
Vitamin B
39
Homocysteine is formed by ...
nutrients from the thionine
- metabolizes the homocysteine
- when B vitamins are present homocysteine breaks down and is eliminated
- without adequate B vitamins homocysteine reach toxic levels
40
Is homocysteine a marker or a cause of heart disease?
marker
| - whatever causes heart disease also causes high levels of homocysteine
41
Inflammation
- C-Reactive protein
- body's reaction to an injury
- associated with redness
42
Redness
blood cells rush to the site of the problem and they dilate the blood vessels on the way there
43
Risk factor for heart disease
swelling in the arteries
44
Measured by which protein?
c-reactive protein CRP
45
high levels =???
CPR > 100 mg/L
46
CRP levels are of some use in...
differentiating between bacterial and viral infections
47
high CRP levels =
bacterial infections
48
Intermediate CRP levels (10-50 mg/L)
= both bacterial and viral conditions
49
Hypertension
- high blood pressure
50
Systolic
- blood pressure when heart is pumping out blood
51
diastolic
blood pressure is resting between beats
52
normal
120/80 mmg
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blood pressure
systolic/diastolic
d= denominator = diastolic
54
Caused by...
increased stress, diet
55
How to reduce high blood pressure?
Exercise
56
How to reduce high blood pressure?
Dietary approach to stop hypertension
- a diet high in whole grains, fruits, vegetables, and low fat-dairy and restricted in fat
- vegetarians have lower risk of hypertension
57
How to reduce high blood pressure?
Bacteria!
58
Does C section or vaginal delivery affect later health status?
C-section babies are more likely to be autistic or have gastric intestinal diseases
59
Why do C-section babies are more likely to be autistic or have gastric intestinal diseases?
when you are in the womb, you are in a sterile environment
- the first encounter with the world is delivery
- you encounter your mom's bacteria, which strengthens your immune system
- if there is no birth canal the bacteria that the baby is exposed to is the skin bacteria of the mom which is very different to the bacteria in the birth canal
60
Bacteria part 2
many kids get antibiotics at a young age which knocks out all kinds of bacteria --> bacteria imbalance
61
How to reduce high blood pressure?
potassium lowers blood pressure
62
what increases blood pressure?
sodium
| - processed food
63
How to reduce high blood pressure?
Medications
64
High blood pressure medications
diuretics
65
High blood pressure medications
ace inhibitors
66
High blood pressure medications
beta blockers
67
High blood pressure medications
calcium channel blockers
68
High blood pressure medications
angiotension receptor antagonists
69
DASH
Dietary Approach to Stop Hypertension
70
DASH
diet rich in whole grains, fruits, veggies, and low-fat dairy and restricted in fat
- control of salt intake
71
Diuretics
- make you pee more
- lowers volume of blood --> lows blood pressure
- generally safe drugs
- Cheap
- Generically available
- first drug
72
How do diuretics work?
- make it difficult for the kidneys to retain water and salt, which are then filtered out into the urine
- increase the amount of urine = reduces the amount of fluid in the blood stream and reduces PRESSURE ON ARTERY walls
- sometimes: potassium supplements + diuretics
73
Angiotension Converting Enzyme Inhibitors
- Vasotec
- not recommended during pregnancy
- take if diuretics don't work
74
Angiotension Converting Enzyme Inhibitors blocks the formation of...
angiotension II which increases the blood pressure
75
Angiotension Converting Enzyme Inhibitors: fight or flight
you need to circulate the blood more --> you need higher pressure
76
how does Angiotension Converting Enzyme Inhibitors work?
ace inhibitors block the production of angiotension II (which raises blood pressure)
- angiotension's normal role is to maintai equilibrium when blood pressure drops
- it acts directly on the arteries, and tightens them to raise the pressure
77
ace inhibitors can bring blood pressure down quickly but alos in rare cases...
can cause kidney damage or a reduction in the number of white blood cells - leading to an increased susceptibility to infection
78
Beta blockers
- block adrenaline (stress hormone)
79
Beta blockers reduce high blood pressure by...
throttling back the force and speed of the heart
- decrease heart workload and vasoconstriction
80
BB can also reduce blood pressure by...
a direct effect on the body's master controls - the central nervous system
81
Calcium Channel Blockers
- act by dilating the arteries and reducing resistance to the flow of blood
- block Ca2+ entry into cells --> smooth muscle relaxation --> blood vessel dilation
82
CCB have proved to be beneficial not only for high blood pressure but also for...
angina and other problems of a weakened heart
83
Newest Drugs
Angiotensin II receptor antagonist
84
Newest Drugs
Valsertan
85
Newest Drugs
used when everything else has failed
86
Angiotension II receptor antagonists
a new class of drogs that lower blood pressure by blocking the angiotension from binding to "receptor sites" in the smooth muscles of the blood vessels
- this blocking action stops the angiotension from tightening the arteries and raising the blood pressure
87
Angina
squeezing of the chest
88
angina is when the blood doesn't flow through which artery properly?
coronary arteries
89
the heart muscle needs..
oxygen
90
coronary arteries surround the ______ like a crown and feed the _______
HEART
91
Angina is usually due to the lack of ...
blood flow and the lack of O2 supply
92
Coronary artery occlusion due to ...
atherosclerotic plaque buildup
93
Coronary arteries ...
left anterior descending
94
Coronary arteries ...
right coronary artery
95
Coronary arteries ...
left circumflex
96
Stable angion - angina pectoris
angina induced by exertion - relieved by the removal of exertion
97
Unstable angina
angina at rest - requires treatment
| - vasopastic
98
ballooning out of the artery
body recognizes this as an injury and tries to stop the flow of liquid by forming a blood clot
- blood clot blocks the floow of blood too much!
99
Angina tests
stress tests: look at the heart's activity at rest and response to stress --> determine if b.v. have been occluded
100
Angina tests
monitoring the heart
101
Angina tests
injecting radioactive thalium
102
Angina treatment
nitroglycerin - explosive!
| - can be used as a pill
103
Nitroglycerin dilates...
the blood vessel so the blood can flow through
104
Nitroglycerin comes as a ...
- tablet
| - ointment - nitro-bid
105
Side effects of ointment
- someone used the ointment
| - had a heart attack, abumlance came and when they started his heart a little spark was created
106
Nitroglycerin comes as a ...
patch : nitro-dur 0.2
107
Nitroglycerin comes as a ...
nitro-bid capsules
108
Side effects of nitroglycerin
headaches
109
Special case
some man put a Nitroglycerin patch on his private part and then did it with his wife and then she got a really bad headache ...
110
Angina treatment
BETA BLOCKERS
111
beta blockers block
adrenalin = stress hormone
112
Adrenalin causes
quick increase in blood pressure and increase in glucose
113
where is the extra glucose in body stored?
liver
114
release of glucose is a response to
adrenalin
115
Angina treatment
CALCIUM ANTAGONISTS
116
CALCIUM ANTAGONISTS
reduce the work of the heart
117
Angina: heart has to work harder or less to get blood flowing?
harder
118
Angina treatment
DIETARY SUPPLEMENTS
119
DIETARY SUPPLEMENTS
L-Arginine
120
L-Arginine
- amino acid
- releases nitroxyl = causes angina
- viagra releases nitroxyl and dilates the blood vessel
121
Arginine
- combines with hydrogen peroxide in body to form nitric oxide
122
Arginine stops ___ from forming and widens blood vessels
plaque
123
Arginine prevents ___ from forming clots
platelets
124
Angina tests
cath lab : inject dyes to get coronary angiogram
125
Arginine
taken as a dietary supplement - unregulated and effectiveness is unknown
126
CHF
Congestive Heart Failure
127
CHF
heart is unable to properly fill or empty or a combination of both
128
CHF the heart is not pumping efficiently due to ...
weakened muscle - usually in the left ventricle
129
CHF causes
constant fatigue
130
CHF causes
short of breath
131
CHF causes
congestion of fluid --> edema
132
CHF can be caused by
coronary artery disease
133
CHF can be caused by
high blood pressure
134
CHF can be caused by
heart valve problems
135
CHF can be caused by
abnormal heart rythms
136
CHF can be caused by
thyroid problems
137
CHF treatment
pumping deficiency has to be increased or workload of heart has to be decreased
138
CHF treatment
left ventricle - most important - squeezes the blood out of the aorta and into the rest of the body
139
CHF used to be known as ...
DROPSY in the 1800s
140
CHF can be caused by
Digitals
141
CHF treatment
Ace inhibitors
142
Ace inhibitors
relax constricted blood vessles
143
CHF treatment
beta blockers
144
beta blockers
improve pumping function
145
CHF treatment
diuretics
146
diuretics
reduce fluid build up
147
William withering
first treatment for congestive heart failure
148
William withering
foxglove plant
149
william withering
digitalis
150
Digitalis
extract of the plant
151
active chemical of digitalis
digoxin
152
digoxin is used in
lanoxin tablets
153
CHF treatment
CoQ10
154
Coenzyme Q10
levels are reduce in hearts of congestive heart failure patients
155
Coenzyme Q10 are necessary for
energy production
156
Coenzyme Q10 effectiveness is...
not certain yet
157
Coenzyme Q10
natural substance in muscles and is involved in formation of ATP
158
Cardiac Arrythmias
irregular heart rhythms due to problems with the electrical circuit of heart
159
Cardiac Arrythmias can originate from
pacemakers or myocardium
160
Cardiac Arrythmias treatment
amiodarone - most common
161
Cardiac Arrythmias treatment
pacemaker - implanted in the chest cavity and produces a signal to produce a regular heart beat
162
Heart Attack
- myocardial infraction
- chest pain
- blood clot in corneal artery
- heart becomes deprived of oxygen
163
Blood clots
platelets caused the blood clots
| - produce proteins that form a mesh with embedded red blood cells
164
how many people suffer from heart attacks/year in North America?
1.5 million
165
how many die immediately?
25%
166
how many are unaware they are having a heart attack?
25%
167
can degenerate into
ventricular fibrillation
168
ventricular fibrillation
deprivation of oxygen in heart
| - heart vibrates irregularly
169
ventricular fibrillation treatment
automatic defbrillator
170
Treatment for Heart attack
MONA
171
MONA
Morphine
Oxygen
Nitro
Aspirin
172
Morphine treats
pain
173
Oxygen
increase oxygen levels in blood
174
Nitro
dilate blood vessles
175
Aspirin
prevent future blood clots
176
Treatment for Heart attack
adrenaline / atropine
177
adrenaline
if heart has stop inject to start it again
178
Treatment for Heart attack
Electrocardiogram
179
Electrocardiogram
determines if there is a heart attack
180
Treatment for Heart attack
tropoin/creatine kinase
181
tropoin - creatine kinase
both released by cells when they die - test for these levels
182
Treatment for Heart attack
aspirin (ASA)
183
aspirin
stops from forming meshes - bloot clots
184
Treatment for Heart attack
Plavix
185
Treatment for Heart attack
Heparin Lock Flush
186
Heparin Lock flush
naturally occuring in the body
187
Heparin Lock flush risk
increases chances of bleeding --> hemorrhage
188
Treatment for Heart attack
thrombolytics
189
thrombolytics
dissolve a blood clot
190
thrombolytics
aspirin is very weak- thrombolytics is better at preventing future blood clots
191
(thrombolytics) Activase
tissue plasminogen activator
192
(thrombolytics) plasminogen
naturally occurring protein has to be activated to release a chemical plasmin to dissolve the blood clot
193
Treatment for Heart attack
Ace inhibitors
194
Ace inhibitors
regulate the blood pressure
195
Treatment for Heart attack
Cath Lab
196
Cath lab
insert a tube and snake it up to the heart while looking through an x-ray machine
197
Cath lab will show where the
blockage is
198
(cath lab) angioplasty
widening of the blood vessel with a balloon
- cahteter
- inflate it and open the blood vessel
199
Placing stents in arteries during angioplasty is very effective at
keeping heart blood vessels open
200
what percentage of people do the arteries narrow again in even after the stents are implanted?
15-25%
201
the renarrowing is called??/
in-stent restenosis
202
what forms in response to the injury created when the stent was implanted, which then leads to restenosis
scar tissue
203
risk of in-stent restenosis, so instead you can use
drug-elucidating stents
204
Drug eluting stent
- sirolimus - reduces inflammation
| - body sees stent as a foreign substance and will want to try and get rid of it - drug reduces this
205
Treatment for Heart attack
bypass surgery
206
bypass surgery
- invasive procedure
- resolves the probelm!
- nypassing the blocked artery
- open the chest and get at the heart
207
in bypass surgery you build a path where..
the blood can flow around the blockage
208
Bypass surgery aka
artery or vein graft
209
bypass surgery is often used for severe or diffuse
occlusion
210
bypass surgery can give
anticoagulants for prophylaxis
211
Treatment for Heart attack
heart-lunch machine
212
heart-lunch machine
oxygenate the blood
213
heart-lunch machine mimics the
pumping pulses of the heart for a short period of time
214
heart-lunch machine connect it so it pumps the blood
back into the heart
215
heart-lunch machine stimulates with
electricity to get the heart stating again
216
heart-lunch machine - persantine - dipyridamole - medication
reduces the chance of blood clots
217
heart-lunch machine side effects
mental illness- depression
| - mental functions don't go back to normal
218
Artificial valves
if valves aren't opening and closing properly
219
Heart attack treatment
Artificial hearts
220
Artifical hearts problem...
how do you power it?
- you need a source of energy to pump5-6L of blood
- it needs to be plugged into some sort of external energy supply
- short term
221
Dr. chris barnard in 1967 survived for...
only 3 weeks because body rejected the heart
| - heart-lunch machine
222
Herat trasplants problem
lack of hearts
