Issues with Cardiovascular System

Question 1

Hypertension

Answer 1

blood pressure readings on two separate days are both showing a systolic measurement of 140mmHg and/or a diastolic measurement of 90mmHg

Changes in cardiovascular structure and function
Damage to kidney vasculature
Reduction in blood flow to the brain
Damage to peripheral and ocular vasculature

Question 2

Hypotension

Answer 2

lower than normal reading for the individual patient combined with relevant signs and symptoms.

Hypovolaemia (reduced circulating blood volume, due to fluid loss or inadequate fluid intake
Impairment of peripheral vasoconstriction
Cardiac filling is obstructed and so output is reduced
Cardiac output is reduced due to dysfunction of the pumping mechanism of the heart

Question 3

Heart Failure

Answer 3

Compensatory mechanisms initiated as heart function is increasingly challenged and impaired.
Hypertrophy, vasoconstriction and increased calcium load (calcium responsible for constriction/dilation) are all deployed – vasoconstriction increases blood pressure and potential vessel and organ damage and increased calcium may cause arrhythmia

Question 4

Atherosclerosis

Answer 4

patchy focal disease of the arterial wall.
fatty streaks develop
foam cells filled with lipids develop
foam cell death causes lipid pools to appear
smooth muscle cells proliferate in the plaque
growth of plaque occludes the vessel

Question 5

Ischaemic Heart Disease

Answer 5

Myocardial ischaemia causes myocardial cells to switch from aerobic to anaerobic metabolism in order to compensate for reduced blood flow and oxygenation of coronary tissue. This causes impairment of connected functions in the heart, including the mechanical and electrical.

Question 6

Pre-eclampsia

Answer 6

Abnormal placental development, immunologic aberrations and endothelial dysfunction, potentially related to genetic predisposition
Foetal growth restriction occurs frequently in pregnancies complicated by preeclampsia.
Several mechanisms of uterine and placental dysfunction contribute to intrauterine growth restriction
Usually begins after 20 weeks of pregnancy in women whose blood pressure had previously been in the standard range

Question 7

Peripheral Vascular Disease

Answer 7

arteriosclerosis obliterans
a reduction in blood flow to arms or legs
if causing pain in the legs it is named claudication

Question 8

Arrhythmia

Question 9

Ectopic tachycardia

Answer 9

rapid heart action in response to impulses arising outside of the main pacemaker of the heart – that is, the sinoatrial node.

Question 10

Sinus tachycardia

Answer 10

Rapid (100-160 beats per minute) beat that originates in the sinoatrial node.
Normal occurrence during exercise or with short term stress - pathological if occurring at rest.

Question 11

POTS – Postural Orthostatic Tachycardia Syndrome

Answer 11

An abnormally large increase in heart rate on standing

Question 12

Supraventricular Tachycardia

Answer 12

An irregularly fast or erratic heartbeat affecting the atria of the heart – heartbeat typically between 150 and 220 beats per minute

Question 13

Ventricular Tachycardia

Answer 13

Defined as any rhythm faster than 100 beats per minute, including three or more consecutive irregular beats, arising distal to the location of the bundle of His in the electrical conduction pathways of the heart.

Question 14

Atrial Fibrillation

Answer 14

Remodelling of heart fibres occurs during the progress of AF
AF requires an initiating event and atrial tissue being vulnerable to this event
As with ectopic tachycardia, foci of increased automaticity, frequently in pulmonary veins, may be key initiators

Question 15

Heart Block

Answer 15

Atrioventricular
Bundle branch
Tachybrady (fast-slow pattern)

Question 16

Bradycardia

Answer 16

A heart beat of less than 60 beats per minute

Question 17

Cardiac Arrest

Answer 17

Cardiac arrest involves ‘sudden cessation of heart activity, consciousness and breathing’

Question 18

Hypertrophic Cardiomyopathy and Left Ventricular Outflow Obstruction

Answer 18

Hypertrophic cardiomyopathy - genetic cardiovascular disease, marked by hypertrophy of the septum and ventricles of the heart

Question 19

Anaemia

Answer 19

Nutritional deficiency (iron, B12)
Inherited cell defect (intrinsic haemolytic anaemia)
Extrinsic haemolytic anaemia (autoimmune, malignancy, infection)
Bone marrow failure (pancytopaenia)

Question 20

Intermittent Claudication

Answer 20

Essentially a ‘cramp’, this is a muscle pain caused by ischaemia (lack of blood supply and therefore oxygen) of the muscles

Question 21

Raynaud’s Disease

Answer 21

A severe vasospasm leading to blanching (pallor and cyanosis) of affected digits (fingers and/or toes, less often nose or ears) and pain on reperfusion triggered by cold or sometimes stress.

Question 22

Venous insufficiency

Answer 22

An escape and reversal of blood flow against it’s normal pathway of travel, often due to valvular incompetence and invariably in the lower limbs.

Question 23

Varicose Veins

Answer 23

Enlargement and twisting of veins usually subsequent to venous insufficiency, commonly in the lower limbs