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PMCOL 343 > 5-cardio > Flashcards

5-cardio Flashcards

1
Q

what is cardiac output= (what is multiplied)

A

stroke volume x heart rate

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2
Q

what is venous return

A

rate of return of blood to heart

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3
Q

what is afterload

A

resistance heart has to pump against determined by arteriolar pressure and peripheral resistance

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4
Q

what is preload

A

stress on ventricular wall before systole

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5
Q

what does left ventricular end diastolic pressure =

A

preload

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6
Q

what does preload=

A

what does left ventricular end diastolic pressure

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7
Q

what does cardiac work =

A

stroke volume x arterial pressure

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8
Q

what does increased cardiac work do to oxygen consumption

A

increases

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9
Q

what happens to stroke volume when left ventricular end diastolic pressure increases

A

increases

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10
Q

what happens to cardiac work when left ventricular end diastolic pressure increases

A

increases

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11
Q

what happens with a venodilator to preload

A

it decreases

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12
Q

what happens with a venodilator to stroke volume

A

decreases

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13
Q

what happens with a venodilator to cardiac work

A

decreases

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14
Q

what does arteriolar vasodilators do to afterload

A

decreases

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15
Q

what does arteriolar vasodilators do to arterial pressure

A

decrease

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16
Q

what does arteriolar vasodilators do to cardiac work

A

decrease

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17
Q

how do the coronary vessels react with an increased O2 demand

A

they dilate

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18
Q

what can cause an increase in O2 demand

A

stress or exercise

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19
Q

what causes angina

A

when oxygen demand is greater than supply

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20
Q

what 5 things can increase local coronary flow

A
  • low o2 tension
  • high co2 tension
  • release of lactate
  • release of adenosine
  • presence of prostacyclin (PGI2)
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21
Q

what direction does coronary flow occur (where does it start and end)

A

from aorta to ventricles

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22
Q

what is systole (pressure difference with ventricles and aorta)

A

pressure in ventricles greater than pressure in aorta

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23
Q

what is diastole (pressure difference with ventricles and aorta)

A

pressure in aorta greater than in ventricles

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24
Q

what can mechanical pressure do to systole

A

prevent it

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25
Q

does coronary flow happen during diastole or systole

A

diastole

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26
Q

what happens to mechanical pressure in diastole

A

reduce

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27
Q

what does coronary perfusion pressure =

A

coronary artery diastolic pressure - left ventricular end diastolic pressure

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28
Q

what happens with alpha receptor activation

A

constriction

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29
Q

what happens with beta2 receptor activation

A

dilation

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30
Q

what happens to coronary vessels when there is angina/ischemia

A

maximally dilated (they want to get as much blood as possible)

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31
Q

what happens when you use coronary dilators with angina

A

more flow to normal area and less to ischaemic areas - coronary steal

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32
Q

what is coronary steal

A

when drugs dilate the coronary vessels, there is a reduced flow to ischemic tissues and more to normal tissues

33
Q

what is the diastolic coronary artery pressure going to be distal to plaque COMPARED to before plaque

A

it will be smaller than before plaque

34
Q

what happens to LVEDP when the ischemic heart starts to fail

A

it increases

35
Q

what 2 things happen when the plaque occludes the vessel

A

hypoxia and anginal pain

36
Q

what are 3 different ways that anti-anginal drugs can work

A
  • lower LVEDP (reduce preload)
  • prolong diastolic time (reduce HR)
  • reduce work load (reduce O2 demand)
37
Q

what is 1 thing all anti-anginal drugs do

A

reduce cardiac work load

38
Q

what do anti-anginal drugs do to LVEDP

A

decrease

39
Q

what do anti-anginal drugs do to diastolic time

A

prolong

40
Q

what do anti-anginal drugs do to HR

A

decrease

41
Q

what do anti-anginal drugs do to work load

A

reduce

42
Q

what do anti-anginal drugs do to oxygen demand

A

reduce

43
Q

what is an example of a venodilator

A

nitroglycerine (glyceryl trinitrate)

44
Q

what does nitroglycerine do to the LVEDP

A

lower

45
Q

does nitroglycerine affect veins or arterioles more

what effect

A

dilates veins more than arterioles

46
Q

what does nitroglycerine do to venous capacitance

A

increase

47
Q

what does nitroglycerine do to venous pooling

A

increase

48
Q

what does nitroglycerine do to venous return

A

decrease

49
Q

what does nitroglycerine do to LVEDP

A

decrease

50
Q

what does nitroglycerine do to preload

A

decrease

51
Q

what happens to stroke volume when you decrease LVEDP

A

decrease

52
Q

what does nitroglycerine do to arterial pressure

A

decrease

53
Q

what does nitroglycerine do to stroke volume

A

decrease

54
Q

what does nitroglycerine do to workload

A

decrease (CW=SV x AP)

55
Q

what does nitroglycerine do to oxygen consumption

A

decrease

56
Q

what does nitroglycerine do to coronary vessels

A

causes vasodilation (but not steal/ not too much)

57
Q

does nitroglycerine cause coronary steal?

A

no

58
Q

what does nitroglycerine do to collateral vessels!!!!

A

open them (this allows flow to the ischaemic area)

59
Q

how is nitroglycerine administered for acute attacks

A

sublingual

60
Q

how is nitroglycerine administered prophylactically

A

transdermal

61
Q

what are the untoward effects of nitroglycerine

A

headache and tolerance

62
Q

what does propranolol do to diastolic time

A

prolong

63
Q

what does propranolol do to heart rate during exercise

A

reduce

64
Q

what does propranolol do to coronary perfusion time during exercise

A

increase

65
Q

what does propranolol do to O2 demand during exercise

A

decrease

66
Q

what does propranolol do to afterload

A

reduce

67
Q

what does propranolol do to BP

A

lower

68
Q

what does propranolol do to cardiac work

A

lower

69
Q

how does propranolol reduce afterload

A

lowers BP therefore reduces cardiac work

70
Q

when is propranolol especially useful

A

after the first myocardial infarction to prevent re-infarction

71
Q

what do verapamil and nifedipine do (generally)

A

reduce cardiac work

72
Q

how do verapamil and nifedipine work

A

block ca++ channels

73
Q

what do verapamil and nifedipine do to afterload and contractility

A

reduce

74
Q

verapamil and nifedipine what do they do to cardiac work

A

reduce

75
Q

what are 3 ways to treat heart attack in emergency

A

aspirin, nitroglycerine, altepase (tissue plasminogen activator)

76
Q

what are 2 ways to prevent heart attack (drugs)

A

low dose aspiring, antianginals (b blockers, ca channel blockers)

77
Q

how do nitrates relax coronary smooth muscle

A

they act like NO from endothelial cells

78
Q

what creates erection (3)

A

NO release from nerves in penis, relax smooth muscle, fills with blood

79
Q

what is the mechanism of action of sildenafil

A

inhibits cyclic GMP phosphodiesterase so there are more effects of NO on penis

PMCOL 343 (31 decks)

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