C12 Cardiovascular Flashcards
Layers of heart?
-myocardium (cardiac cells)
- endocardium (inner lining)
- epicardium (single layer of epithelium)
- pericardium (protects)
Chambers of the heart?
Two atria and two ventricles
Heart valves?
tricuspid, pulmonary, mitral and aortic
Systole?
contraction
Diastole
relaxation in between contractions
How blood pumps through the body?
- Deoxygenated blood enters the heart:
Deoxygenated blood, low in oxygen and high in carbon dioxide, returns from the body through the superior and inferior vena cava into the right atrium. - Right atrium to right ventricle:
The right atrium contracts, pushing the blood through the tricuspid valve into the right ventricle. - Right ventricle to pulmonary artery:
The right ventricle contracts, pumping the blood through the pulmonary valve into the pulmonary artery, which carries it to the lungs. - Lungs and oxygenation:
In the lungs, the blood picks up oxygen and releases carbon dioxide, becoming oxygenated. - Pulmonary veins to left atrium:
The oxygenated blood returns to the heart through the pulmonary veins, entering the left atrium. - Left atrium to left ventricle:
The left atrium contracts, pushing the blood through the mitral (bicuspid) valve into the left ventricle. - Left ventricle to aorta:
The left ventricle contracts, pumping the oxygenated blood through the aortic valve into the aorta, the main artery that carries blood to the rest of the body.
Cardiac valves?
Ensure one-way system of blood flow. Have cusps held in place by tendons (chordae tendineae) attached to the heart’s inner walls by small papillary muscle
Cardiac valve- malfunctions?
- The valve doesn’t close completely
-Valve opening is too narrow (Stenosis)- common- plaque build-up
-Leaking blood back (regurgitation)- common- plaque build-up or genetics
Blood Vessel Types?
Arteries, arterioles, veins, venules, and capillaries
Arteries?
blood from the heart
Veins?
blood to the heart
Blood is made up of?
plasma, blood cells, and water
Plasma
hormones, nutrients, and wastes
Atrial Fibrillation- Description
2 atria in the heart beat irregularly and out of rhythm with lower ventricles
* Hypertension, congenital/hereditary defects, hyperthyroidism, MI, valve problems, viral
infections.
Atrial Fibrillation-Symptoms
- Tachycardia
- Confusion
- Chest pain
- Weakness and SOB
Atrial Fibrillation-Dx
- ECG
- Holter monitor (1 or 2 days)
Atrial Fibrillation- Treatment
- Beta/Ca channel blockers
Cardioversion (cardiac treatments) - Cryoablation (surgery) (freeze what’s sending incorrect signals)
Atrial Fibrillation- Prognosis
Increases the likelihood of a CVA or MI (myocardial infarction) fivefold
Coronary Artery Disease (CAD)- Description
Narrowing of the coronary arteries to such extension that there is
inadequate blood supply to portions of the myocardium.
- Atherosclerosis- fat buildup
- Angina (blood flow reduced) and heart attack (blockage
CAD is the ____ because ____?
- single leading cause of death in the US
- Higher risk: Age, hereditary factors, obesity, cholesterol, diabetes, hypertension,
smoking, stress, menopause.
CAD-Symptoms
- *Angina: burning, squeezing, thightness
in the chest. Radiation to the neck,
shoulder, bladder and left arm. - Nausea, vomiting
- Sweating
- SOB
CAD-Dx
- Risk factors for CAD
- ECG
- Stress test (+ echo)
- MRA (magnetic angiogram)
- Cardiac catheterization
CAD- Treatment
- Lifestyle changes
- Medication and/or surgery
Angina Pectoris-Description
Uncomfortable squeezing, pressure, or pain in the chest resulting
from ischemia to a part of the myocardium.
Loss of blood flow
-Three forms
-Atherosclerosis/susceptible individual
Angina Pectoris- Symptoms
- Burning, squeezing and chest tightness (conscious)
- Radiation to the neck, shoulder, bladder
and left arm. - Women, abdominal and back pain
- Nausea, vomiting
- Average 3 min (<15 min) (any more considered MI)
Angina Pectoris- Dx
- ECG
- Stress test
- MRA (magnetic angiogram)
- Cardiac catheterization
Angina Pectoris-Treatment
- Lifestyle changes
- Medication
- Percutaneous coronary
intervention (PCI) - Minimal invasive surgery
- Laser angioplasty
- Atherectomy
- Coronary artery bypass
graft surgery
Myocardial Infarction (MI)- Description
Occlusion of one or more coronary arteries and the subsequent
necrosis of a section of the heart tissue saved by those arteries.
Loss of blood flow.
- Hereditary, obesity, elevated triglyceride, smoking, diabetes, sedentary lifestyle and
chronic stress.
MI- Symptoms
-Same as angina pectoris but does not resolve (conscious)
* Chest pain that may radiate to the left
arm, neck and jaw.
* Occasional confusion and indigestion
* Women use to feel fatigue, nausea,
vomiting and SOB
MI- Dx
- CAD history
- Episode of chest pain
- ECG
- Elevated CPK and CPK-MB over a 72h- in blood damage to heart cells
- Echocardiography
MI- Treatments
Time is critical (<1h)
* 911 and transport
* NTG treatment
* Bed rest, sedation and
analgesia
* Therapeutic hypothermia
Cardiac Arrest- Description
abrupt loss of heartbeating. (unconscious)
- CAD, MI, circulatory collapse, shock, ventricular fibrillation,
hemorrhage, drug overdose, electrocution, drowning or
physical trauma.
Cardiac Arrest- Symptoms
- Prolonged angina
- Dyspnea
- Sudden tachycardia or bradycardia
Cardiac Arrest- Dx
- Absence of respiratory and pulse
- ECG (ventricular fibrillation or asystole).
Cardiac Arrest- Treatment
- CPR
- Defibrillator (ALS unit)
Prognosis-Time is critical (<10 min)
Congestive Heart Failure (CHF)- Description
affects left or/and right ventricule limiting the pumping power of
the heart muscle causing congestion (circulatory, pulmonary and kidneys).
- Hypertension, CAD, MI. Cardiomyopathies, heart valve disease and congenital defects
CHF- Symptoms
- LV failure: dyspnea and fatigue
- RV failure: JVD, hepatomegaly and
systemic symptoms. - Advanced CHF:
Tachypnea
Palpitations
Edema
Diaphoresis (excessive sweating) and Cyanosis
CHF- Treatment
- Diuretics
- Bed rest
- ACE inhibitors (blocks blood vessel narrowing) and ARBs (relaxes BV and raises BP)
- Weight loss
- No smoking
- Salt restriction
CHF-Dx
- ECG
- Chest x-ray
- CBC, electrolytes, BUN and creatinine
- Echocardiography with EF
- Cardiac CT and MRI
- Cardiac catheterization
Hypertension- Description
Persistently elevated BP that develops without apparent cause
and normally progresses over a number of years.
- Idiopathic (higher risk black adults)
- Risk factors: stress, obese, high salt and saturated fats diets, diabetes,
sedentary lifestyle, smokers, oral contraceptives.
AHA
Hypertension- Symptoms
Asymptomatic (“Silent killer”)
* Light symptoms:
o tinnitus
o nocturia
o fatigue
o palpitations
Hypertension- Dx
- BP (130/80)
- Bruits- abnormal, whooshing or swishing sound heard over an artery with stethoscope, indicates turbulent blood flow
Hypertension- Treatment
- Lifestyle change
- Anti hypertensive drugs
- Diuretics or vasodilators
Atherosclerosis- Description
Thickening of the walls of small arteries and arterioles with a
resulting loss of elasticity.
* Most common in coronary and cerebral arteries.
* Unclear etiology (life style)
Atherosclerosis- Symptoms
- Asymptomatic.
- If symptomatic:
o Claudication- cramping in legs
o Bruits
o Headache
o Dizziness
o Muscle cramping
o Ischemia- reduced blood flow to specific area to body
Atherosclerosis- Dx
- Blood test for high lipid panel
- Doppler ultrasound for blockage
- Ankle-brachial index
- ECG
- Angiogram
- CT scan
Atherosclerosis- Treatment
- Exercise
- Diet low in
saturated fats and
cholesterol - Medications
- Aspirin, heparin or
warfarin - Thrombolytic
therapy - Bypass surgery
Iron-deficiency Anemia- Description
Inadequate reserves of iron in the body.
- The most common blood condition in the US.
- Premenopausal women and adolescents.
- Excessive blood loss, menorrhagia, pregnacy, chronic intestinal disease, low iron intake,
overuse of NSAIDs.
Iron-deficiency Anemia- Symptoms
- Extreme fatigue
- Pallor
- Headache
- Cold hands and feet
- Irritability
- Severe:
o Dyspnea
o Tachycardia
o Increased infections
o Brittle nails
Iron-deficiency Anemia- Dx
- Blood test (Hb, Hct, Fe, Ferritin).
- RBC count (high microcytic)
- GI bleeding, colonoscopy.
- Ultrasound (other reasons for excessive
menstrual flow).
Iron-deficiency Anemia- Treatment
- Iron supplements
- Dietary intake of iron
- Vit C and Ca supplements
Folic Acid Deficiency Anemia- Description
Inadequate folic acid within the body leading to megaloblasts.
- Insufficient folic acid from increased utilization (ie. pregnancy, infancy or blood
disorders) or impaired absorption or poor diet/alcoholism. - More common in pregnant women, infants, children and adolescents
Folic Acid Deficiency Anemia- Symptoms
- Weakness and fatigue
- Anorexia
- Pallor
- Forgetfulness
- Irritability
- Diarrhea
Folic Acid Deficiency Anemia- Dx
- Physical exam
- Blood test (CBC,folate and Vit B12).
- Extreme cases: bone marrow aspirations
Folic Acid Deficiency Anemia- Treatment
- Folic Acid supplements
- Dietary intake of folic acid
Leukemia- Description
progressive, malignant disease of the blood-forming organs and are
marked by the unrestrained growth of abnormal leukocytes and their precursor in the
blood and bone marrow.
- Classified as Acute (fatal in less than 6 mo if not treated) or Chronic (slow progression)
Leukemia has 2 types of cells?
myeloblasts or lymphoblasts
Leukemia- Etiology and risk factors
- Idiopathic (most cases)
Risk factors: - Exposure to chemicals
- Chemotherapy
- Exposure to radiation
- Certain Genetic diseases
- Human T-cell leukemia virus 1
- Myelodysplatic syndrome
Leukemia- Symptoms
- Fever
- Night Sweats
- Frequent infections
- Fatigue and tiredness
- Headache
- Bleeding (gums) and easy bruising
- Petechiae (tiny red spots on the skin)
- Swelling or discomfort in the abdomen.
- Enlarged spleen
- Swollen lymph nodes (neck or armpit)
- Weight loss and Anorexia
- Prolonged menses
- Vomiting
- Confusion
- Loss of muscle control
- Seizures
- Tachycardia
- Palpitations
Leukemia- Dx
- Blood test (thrombocytopenia,leukocytosis,
anemia and neutropenia). - Biopsy of bone marrow
- Karyotype
Leukemia- Treatment
- Chemotherapy or radiotherapy
- Biological therapy .
- Bone marrow transplant
- Stem cell transplantation
