Lecture 9 Heart and Blood Vessels Flashcards Preview

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Flashcards in Lecture 9 Heart and Blood Vessels Deck (132):
1

Define congenital cardiovascular disease

Heart disease present from birth

2

Define congenital cardiovascular disease

Heart disease present from birth

3

Define cardiac failure

4

How does heart compensate and what results?

Cardiac hypertrophy and/or dilation. Eventually inability to maintain normal.

5

Signs/symptoms of CV disease?

All-over excessive fluid filled veins -> systemic venous congestion and oedema. SOB, Fatigue, pulmonary oedema (fluid in lungs).

6

Define stenosis (valvular heart disease).

Failure to completely open.

7

What are the three ways for valvular heart disease?

Stenosis, incompetence/regurgitation and vegetations

8

What does incompetence/regurgitation mean for valvular heart disease?

Failure to close, allowing reversible flow

9

What does vegitation mean for valvular heart disease?

Abnormal tissue growth on valve (fibrin, platelets and bacteria)

10

What is the most common valvular disease?

Stenosis of aortic and mitral valves. (2/3rd of

11

What is valvular stenosis mainly due to?

Primary valve cusp abnormality

12

Why do vegetations form?

From infective endocarditis & rheumatic fever

13

What is the clinical presentation of vegetations?

Sepsis, heart failure, new murmur.

14

As well as general reasons like hypertension and age degeneration, what are underlying causes of valvular disease?

Calcific aortic valve disease? Carcinoid syndrome, prosthetic heart valves and IV drug use

15

What is the pathological cause for mitral stenosis?

Rheumatic fever

16

What is the pathological cause for mitral incompetence?

Rheumatic fever, Dilation of mitral valve, papillary muscle fibrosis/dysfunction, degeneration of valve cusps

17

What is the pathological cause for aortic stenosis?

Rheumatic fever, calcific degerneration

18

What is the pathological cause for aortic incompetence?

Rheumatic fever, dilation of aortic root, rheumatological disorders.

19

Ehst is the pathological cause for endocarditis?

Rheumatic disease, bacteria, IV drug use, calcific valve disease, prosthetic heart valves

20

What are the clinical features of mitral stenosis?

Murmur. L atrial and R ventricle hypertrophy. Pulmonary hypertension.

21

What are the clinical features of mitral incompetence?

Murmur. Variable haemodynamic effect

22

What are the clinical features of aortic stenosis?

Murmur. L ventricle hypertrophy. Angina, syncope, L vent failure/ sudden death.

23

What are the clinical features of aortic incompetence?

Murmur. Collapsing pulse. Angina. L vent failure/ sudden death

24

What are the clinical features of endocarditis?

Murmurs. malaise, clubbing, arthralgia, pyrexia, skin lesions, spenomegaly, glomerulonephritis, haematuria,

25

Define endocardium?

inner lining of the heart and its valves

26

Where does infection occur in the endocardium?

Edge of heart valves

27

What does endocarditis on the R side mean?

IV drug use

28

What affects abnormal valves usually after dental extraction/ cleaning/ bronchoscopy or tonsillectomys?

Streptococci (a haemolytic). Cocci (cucu) because I never saw this after tonsillectomys

29

What affects previously normal valves?

IV drug abusers

30

When considering prophylaxis and endocarditis?

MUST give antibiotics to those at risk of developing endocarditis prior to any procedure that may produce a bacteraemia.

31

Define preicardium

Heart sac

32

What causes pericarditis and mycarditis?

TB, uraemia, carcinoma, MI, post surgery, Drugs, connective tissue disease, radiation, viral, bacterial, parasitic,

33

Name some unusual cardiac diseases?

Cardiomyopathy, Sarcoidosis, amyloidosis, thyrotoxicosis, myxoedema, alcoholism, pregnancy, drug induced.

34

Name dilated cardiac diseases

Idiopathic, alcohol, peripartum, genetic, myocarditis and sarcoid

35

Name hypertrophic cardiac diseases

Idiopathic, genetic, storage disease

36

Name restrictive cardiac diseases?

Idiopathic, amyloidosis, radiation induced, chemo related

37

What can hypertrophic cardiomyopathy led to?

end stage dilation

38

a 1/3rd of hypertrophic cardiomyopathy have?

intermittent left ventricular outflow obstruction

39

Clinical features of HCM?

Black outs, SOB, chest pain, palpitations, atrial fib,

40

What causes HCM?

50% familial, autosomal dominant. Genetic defect 1 of 4 genes that encode cardiac contractile elements

41

What I didn't know that could cause aneurysms?

Autoimmune diseases, bacteria, fungus, syphilis

42

Aneurysm treatments?

Stents, surgery, reducing arterial pressure

43

Where are atherosclerotic aneuryms found?

Lower abdominal aorta and iliac arteries

44

Where are aortic dissections found?

Aorta and major branches

45

Where are berry aneurysms found?

circle of willis

46

Where are micro aneurysms found?

intracerebral vapillaries

47

Where are syphilitic aneurysms found?

ascending & arch of aorta

48

Where are mycotic (infective) aneurysms found?

Root or aorta and and vessel

49

What are the clinical effects of atherosclerotic aneurysms

Lower limb ischaemia, pulsatile abdominal mass, rupture, massive haemorrhage

50

What are the clinical effects of aortic dissection?

Loss of peripheral pulses, haemopericardium, rupture, double barrelled aorta

51

What are the clinical effects of micro-aneurysms?

Intracerebral haemorrhage (hypertension)

52

What are the clinical effects of syphilitie aneurysms?

Aortic incompetence

53

What is the circle of willis?

Circle of vessels around the base of the brain

54

What is the circle of willis?

Circle of vessels around the base of the brain

55

Define cardiac failure

heart unable to pump blood at rate required for normal functioning

56

How does heart compensate and what results?

Cardiac hypertrophy and/or dilation. Eventually inability to maintain normal.

57

Signs/symptoms of CV disease?

All-over excessive fluid filled veins -> systemic venous congestion and oedema. SOB, Fatigue, pulmonary oedema (fluid in lungs).

58

Define stenosis (valvular heart disease).

Failure to completely open.

59

What are the three ways for valvular heart disease?

Stenosis, incompetence/regurgitation and vegetations

60

What does incompetence/regurgitation mean for valvular heart disease?

Failure to close, allowing reversible flow

61

What does vegitation mean for valvular heart disease?

Abnormal tissue growth on valve (fibrin, platelets and bacteria)

62

What is the most common valvular disease?

Stenosis of aortic and mitral valves. (2/3rd of

63

What is valvular stenosis mainly due to?

Primary valve cusp abnormality

64

Why do vegetations form?

From infective endocarditis & rheumatic fever

65

What is the clinical presentation of vegetations?

Sepsis, heart failure, new murmur.

66

As well as general reasons like hypertension and age degeneration, what are underlying causes of valvular disease?

Calcific aortic valve disease? Carcinoid syndrome, prosthetic heart valves and IV drug use

67

What is the pathological cause for mitral stenosis?

Rheumatic fever

68

What is the pathological cause for mitral incompetence?

Rheumatic fever, Dilation of mitral valve, papillary muscle fibrosis/dysfunction, degeneration of valve cusps

69

What is the pathological cause for aortic stenosis?

Rheumatic fever, calcific degerneration

70

What is the pathological cause for aortic incompetence?

Rheumatic fever, dilation of aortic root, rheumatological disorders.

71

Ehst is the pathological cause for endocarditis?

Rheumatic disease, bacteria, IV drug use, calcific valve disease, prosthetic heart valves

72

What are the clinical features of mitral stenosis?

Murmur. L atrial and R ventricle hypertrophy. Pulmonary hypertension.

73

What are the clinical features of mitral incompetence?

Murmur. Variable haemodynamic effect

74

What are the clinical features of aortic stenosis?

Murmur. L ventricle hypertrophy. Angina, syncope, L vent failure/ sudden death.

75

What are the clinical features of aortic incompetence?

Murmur. Collapsing pulse. Angina. L vent failure/ sudden death

76

What are the clinical features of endocarditis?

Murmurs. malaise, clubbing, arthralgia, pyrexia, skin lesions, spenomegaly, glomerulonephritis, haematuria,

77

Define endocardium?

inner lining of the heart and its valves

78

Where does infection occur in the endocardium?

Edge of heart valves

79

What does endocarditis on the R side mean?

IV drug use

80

What affects abnormal valves usually after dental extraction/ cleaning/ bronchoscopy or tonsillectomys?

Streptococci (a haemolytic). Cocci (cucu) because I never saw this after tonsillectomys

81

What affects previously normal valves?

IV drug abusers

82

When considering prophylaxis and endocarditis?

MUST give antibiotics to those at risk of developing endocarditis prior to any procedure that may produce a bacteraemia.

83

Define preicardium

Heart sac

84

What causes pericarditis and mycarditis?

TB, uraemia, carcinoma, MI, post surgery, Drugs, connective tissue disease, radiation, viral, bacterial, parasitic,

85

Name some unusual cardiac diseases?

Cardiomyopathy, Sarcoidosis, amyloidosis, thyrotoxicosis, myxoedema, alcoholism, pregnancy, drug induced.

86

Name dilated cardiac diseases

Idiopathic, alcohol, peripartum, genetic, myocarditis and sarcoid

87

Name hypertrophic cardiac diseases

Idiopathic, genetic, storage disease

88

Name restrictive cardiac diseases?

Idiopathic, amyloidosis, radiation induced, chemo related

89

What can hypertrophic cardiomyopathy led to?

end stage dilation

90

a 1/3rd of hypertrophic cardiomyopathy have?

intermittent left ventricular outflow obstruction

91

Clinical features of HCM?

Black outs, SOB, chest pain, palpitations, atrial fib,

92

What causes HCM?

50% familial, autosomal dominant. Genetic defect 1 of 4 genes that encode cardiac contractile elements

93

What I didn't know that could cause aneurysms?

Autoimmune diseases, bacteria, fungus, syphilis

94

Aneurysm treatments?

Stents, surgery, reducing arterial pressure

95

Where are atherosclerotic aneuryms found?

Lower abdominal aorta and iliac arteries

96

Where are aortic dissections found?

Aorta and major branches

97

Where are berry aneurysms found?

circle of willis

98

Where are micro aneurysms found?

intracerebral vapillaries

99

Where are syphilitic aneurysms found?

ascending & arch of aorta

100

Where are mycotic (infective) aneurysms found?

Root or aorta and and vessel

101

What are the clinical effects of atherosclerotic aneurysms

Lower limb ischaemia, pulsatile abdominal mass, rupture, massive haemorrhage

102

What are the clinical effects of aortic dissection?

Loss of peripheral pulses, haemopericardium, rupture, double barrelled aorta

103

What are the clinical effects of micro-aneurysms?

Intracerebral haemorrhage (hypertension)

104

What are the clinical effects of syphilitie aneurysms?

Aortic incompetence

105

What are the clinical effects of mycotic (infective) aneurysms?

Thrombosis or rupture. Cerebral infarction of haemorrage.

106

What is the circle of willis?

Circle of vessels around the base of the brain

107

When is someone offered 24hr ambulatory monitoring?

When they have BP 140/90

108

What is mild diastolic bp between?

95-104mmHg

109

What is moderate diastolic bp between?

105-114mmHg

110

What is severe diastolic bp?

>115mmHg

111

Primary hypertension is also known as?

Essential hypertension (95%)

112

Risk factors for essential hypertension?

(non-modifiable) Genes, family history. (Modifiable) diet, lifestyle weight, alcohol, smoking.

113

Causes of secondary hypertension?

Renal (polycystic kidney disease), Endocrine (thyrotoxicosis), vascular (raise IV volume), neurogenic (acute stress)

114

What is benign hypertension?

Remains stable, normal life until complications arise

115

What is malignant hypertension?

Accelerated hypertensive disease, 5% of cases. Rapid ^ BP 90% die in first year.

116

Hypertension can lead to what for blood vessels?

atherosclerosis, arteriosclerosis and ^risk of MI, rupture and dissection

117

Define sclerosis

Thickening/hardening of body tissue

118

Hypertension can lead to what for the heart?

Heart disease, left ventricular hypertrophy, cardiac failure and MI

119

Hypertension can lead to what for the kidney?

Benign nephrosclerosis and renal failure

120

Hypertension can lead to what for the eyes?

Hypertensive retinopathy,

121

What are retinopathy grades?

Grade I: thicking of arterioles. II: arteriolar spasms. III haemorrages. IV Papilloedema (seen in malignant hypertension)

122

Define adverse prognosis?

preventing success in outcomes

123

Factors indicating adverse prognosis in hypertension?

Male, young, black ethnicity, smoker, persistent diastolic BP > 115, diabetes, hypercholesterolemia, obesity, organ damage.

124

What can diabetic vascular disease cause?

Damage to vessels/ kidneys/ nerves/ retinas

125

Complications of diabetic vascular disease?

Gangrene, renal failure and blindness

126

Define gangrene

Localised death of tissue

127

How can diabetic vascular disease be improved?

effective diabetes control

128

What is deep vein thrombosis?

When normal venous return is impeded -> thrombosis.

129

What causes DVT?

immobility, malignancy, pregnancy, child birth, oestrogens, haematological disorders, IV cannulas.

130

What is varicosities?

Common problem. Torte and distended veins. Ulceration on ankles and lower legs.

131

What causes varicosities?

incompetent valves in legs, imparied venous return, stasis, oedema, fibrin deposits around veins.

132

Common congenital CV diseases?

Septal defects, patent ductus arteriosus, corarctation of aorta (narrowed), transposition of vessels, fallot's tetralogy