how the CV system fails

Question 1

what is a haemorrhagic stroke?

Answer 1

cerebral blood vessel rupture

Question 2

what is an ischaemic stroke?

Answer 2

cerebral blood vessel blockage

Question 3

what causes a blood vessel to burst?

Answer 3

• stresses

- damage

Question 4

in a cylinder what is the vessel wall tension?

Answer 4

proportional to P x radius

Question 5

what are the activities of the endothelium?

Answer 5

• blood vessel tone
• fluid filtration
• haemostasis
• white cell recruitment
• angiogenesis
• hormone trafficking

Question 6

what is an acute myocardial infarction?

Answer 6

a region of heart tissue that is dying or dead

Question 7

what causes an acute myocardial infarction?

Answer 7

usually due to a blocked coronary artery

Question 8

what is atherosclerosis?

Answer 8

a disease process that results in the furring of the arteries

Question 9

what causes atherosclerosis?

Answer 9

hyperlipaemia, immune action of unknown aetiology

Question 10

what is coronary artery disease?

Answer 10

a disease process resulting in obstruction of the arteries supplying the heart tissue

Question 11

what are the symptoms of coronary artery disease?

Answer 11

angina or asymptomatic

Question 12

what is the cause of coronary artery disease?

Answer 12

atherosclerosis

Question 13

what is plaque rupture?

Answer 13

a fibrous cap of plaque that burst open

Question 14

what does the sympathetic nervous system do during an acute MI?

Answer 14

releases adrenaline and noradrenaline in response to pain and haemodynamic abnormalities

Question 15

what does the sympathetic nervous system do during heart failure?

Answer 15

increases heart rate and increases contractility, increases peripheral resistance and increases risk of arrhythmia

Question 16

what is pulmonary oedema?

Answer 16

fluid accumulation in lungs

Question 17

what does pulmonary oedema lead to?

Answer 17

impaired gas exchange

Question 18

what causes pulmonary oedema?

Answer 18

left heart failure

Question 19

what are the symptoms of pulmonary oedema?

Answer 19

dyspnoea/orthopnoea which leads to hypoxia

Question 20

what is ascites?

Answer 20

accumulation of fluid in the peritoneal cavity

Question 21

what is peripheral oedema?

Answer 21

swelling of tissues especially in ankles

Question 22

what is compensation?

Answer 22

maintaining homeostasis of physiological function despite stressors or malfunctions which happens via endogenous physiological feedback

Question 23

what is decompensated heart failure?

Answer 23

the failure of the heart to maintain adequate blood circulation, after long-standing vascular disease causing respiratory distress

Question 24

what causes cardiac remodelling?

Answer 24

injury: MI, hypertension, valve disease, response to increase afterload or preload

Question 25

what is the result of cardiac remodelling?

Answer 25

hypertrophy or dilation

Question 26

what are the treatments for cardiac remodelling?

Answer 26

ACE inhibitors or spironolactone

Question 27

what is eccentric ventricular hypertrophy?

Answer 27

dilation due to volume overload

Question 28

what is concentric ventricular hypertrophy?

Answer 28

thickening due to pressure overload

Question 29

what is another name for ADH?

Answer 29

vasopressin

Question 30

what is aldosterone?

Answer 30

a steroid that causes kidneys to reabsorb more NaCl and therefore more water

Question 31

where is aldosterone secreted from?

Answer 31

the adrenal cortex

Question 32

what does angiotensin II do?

Answer 32

- causes vasoconstriction - increased fluid retention - increases ADH secretion - contributes to ventricular hypertrophy and remodelling

Question 33

what does thiazine do?

Answer 33

blocks reabsorption in the distal convoluted tubule

Question 34

what does K+ sparing diuretics do?

Answer 34

inhibits aldosterone receptors in cortical collecting duct

Question 35

what causes left sided heart failure?

Answer 35

the right heart pumps into lungs but the left atrium its too full

Question 36

what symptoms do you get from left sided heart failure?

Answer 36

respiratory symptoms

Question 37

what is congestive heart failure?

Answer 37

pulmonary vasculature is congested and in extreme fluid leaks out of blood vessels into lungs

Question 38

what symptoms do you get with right sided heart failure?

Answer 38

systemic symptoms

Question 39

what happens with right sided heart failure?

Answer 39

increase in central venous pressure leading to peripheral oedema or ascites

Question 40

what are symptoms of heart failure?

Answer 40

- fatigue - peripheral oedema - dyspnoea

Question 41

what is a key difference between and MI and heart failure?

Answer 41

MI is anatomical and heart failure is physiological

Question 42

what unites all forms of heart failure?

Answer 42

fluid retention

Question 43

what is cardiogenic shock?

Answer 43

critically low perfusion due to low cardiac output leading to insufficient perfusion of tissues especially the heart

Question 44

how does cardiogenic shock progress?

Answer 44

positive feedback

Question 45

how do you treat cardiogenic shock?

Answer 45

aggressive intravenous fluid and oxygen and airway maintained

Question 46

what are treatments of chronic heart failure?

Answer 46

- ACE inhibitors - diuretics - beta blockers

Question 47

what are the 2 methods for low cardiac output?

Answer 47

- increase sympathetic activity | - kidney accumulates fluid

Question 48

what happens when you increase sympathetic activity?

Answer 48

- the fast response - increases heart rate, increases heart contractility - vasoconstriction

Question 49

what happens when the kidney accumulates fluid?

Answer 49

- the slower response - decreases glomerular filtrate rate - increased central venous pressure - increased venous return and increased preload

Question 50

what happens with heart failure or infarct?

Answer 50

- normal pressure - ends with shock - rare before age of 50

Question 51

what happens with haemorrhage?

Answer 51

- loss of fluid leads to loss of pressure - ends with shock - any age

Question 52

what are the 4 main ways the body tries to decompensate heart failure?

Answer 52

- the kidney increases plasma volume - the heart is unable to pump extra fluid - the capillaries leak fluid into tissues - the lungs cannot exchange oxygen and carbon dioxide

Question 53

why does the kidney increase plasma volume?

Answer 53

- to compensate for poor perfusion of renal tissue - the kidney responds to it as if it a haemorrhage - this leads to fluid overload

Question 54

why is the heart unable to pump extra fluid?

Answer 54

- fluid damming leads to increased venous hydrostatic pressures - increased back pressure further damages heart - positive feedback loop leads to rapid deterioration

Question 55

what are the treatments for low output heart failure?

Answer 55

- prevent acute decompensated heart failure - counteract cardiac remodelling - minimise symptoms