15. when CVS goes wrong

Question 1

2 types of hypertension

vascular disease

Answer 1

primary- more common, linked to lifestyle
secondary hypertension- known medical cause
1 kidney diease leads to an increase in angiotensin II leading to vasoconstriction / expansion of extracellular fluid
2. endocrine disorders eg diabetes3. adrenal medulla disease-excessive adrenaline secretion

Question 2

treatment of hypertension

Answer 2

voltage gated Ca2+ antagonists inhibit membrane depolarisation and bring about vasodilation
angiotensin ii receptor antagonists blocs angiotensin ii so cant vasoconstrict
ACE inhibtors so no aldosterone production or vasoconstriction

Question 3

hypertension is a major risk factor for

Answer 3

atherosclerosis 
storke/cardiovascular accident 
heart failure 
renal failure 
aneurysms (weakness in artery wall cant maintain high bp so risk of rupturing)

Question 4

what is arteriosclerosis

Answer 4

hardening and thickening of artey walls
loss of tissue elasticity
can be caused by atherosclerosis

Question 5

atherosclerosis

Answer 5

caused by damage to the endothelium of blood vessels
atheromas (fatty plaque) builds up in wall of blood vessel, narrows lumen and restricts blood flow. also lipid, macrophage accumulation
plaques can detach in fragments and become lodged in small vessels causing thrombosis (clot)

Question 6

coronary artery disease/ ischaemic heart disease

Answer 6

occlusion to flow of blood in a coronary artery, muscle dies
myocardial infarction
treat with stents pain is due to K+ ions binding to pain receptorsw when tissue is damaged

Question 7

what are the two types of valvlar defects

Answer 7

1. regurgitation- valve doesn’t close fully so backflow and turbulence, plus decrease in cardiac output
2. stenosis: valve doesn’t open fully, obstructs the flow
   can cause hypertrophy in order to maintain CO

Question 8

arrhythmias

Answer 8

deviation of the hearts normal SAN rhythem

Question 9

bradycardia

Answer 9

slow rhythm

treatment iis artificial pacemaker

Question 10

tachycardia is a fast rhythm two types

Answer 10

sinus- can involve caffeine

non sinus results from the addition of abnormal impulses to the normal cycle. detected by ecg

Question 11

what three things can cause non sinus tachycardia

Answer 11

automaticity
triggered beats
re-entry activity/circus activity

Question 12

symptoms of tachycardias

Answer 12

uncontrolled twitching// quivering of muscle fibres
during centricular fibrillation blood is not removed from the heart
results in sudden cardiac death

Question 13

triggered beats

Answer 13

defects in ion channels that are involved in ventricular action potentials
causes multiple depolarisations leading to ventricular arrythmias
produces a sustained abnormal rhythm

Question 14

LQT syndrome

Answer 14

triggered beats

increase in qt interval action potentials don’t repolarise

Question 15

re-entry / circus movement

Answer 15

transmission of electrical impulses is abnormal
causes atrial flutter
blocked conduction pathway results in electrical activity dissipating into different directions, disharmony between atria and ventricles heart damage

Question 16

chronic heart failure

Answer 16

inadequate CO
decline in contractility due to stiff and thick chambers
caused by damage to cardiac muscle(they become so thick due to hypertension or a valve defect as the venticles have had to work harder)
heart cant fill in diastolic
ventricles cant pump in systolic the ventricular muscles become stretched

Question 17

symptoms of chronic heart failutw

Answer 17

breathless ness fatigue
left ventricular failure= fluid build up in lungs
right ventricular failure= systemic capillary pressure increases, fluid builds up in body