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PMCOL 343 > cardio 4 > Flashcards

cardio 4 Flashcards

1
Q

what is afterload

A

the resistance that the heart has to pump against

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2
Q

what determines afterload

A

arteriolar pressure and peripheral resistance

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3
Q

what is preload

A

stress on ventricular wall before systole

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4
Q

what is equal to preload

A

left ventricle end-diastolic pressure

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5
Q

what is the formula for cardiac output

A

Stroke volume x heart rate

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6
Q

what should cardiac output ideally be equal to

A

venous return

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7
Q

which is larger, venous capacitance or arterial capacitance

A

venous

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8
Q

what is cardiac output proportional to

A

rate and force of contraction

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9
Q

what are the two regulations of cardiac performance

A

intrinsic and extrinsic

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10
Q

what relationship guides the intrinsic regulation of cardiac performance

A

frank starling

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11
Q

what is the frank starling relationship

A

force of contraction is proportional to initial fiber length

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12
Q

what is a good measure of initial fiber length

A

LVEDP

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13
Q

the strength of heart pumping is dependent on

A

the amount of blood

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14
Q

in heart failure, what is the issue

A

more blood in heart does not increase the force of contraction

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15
Q

what is involved in the extrinsic regulation of the heart

A

sympathetic parasympathetic baroceptor reflex

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16
Q

what occurs if BP increases

A

carotid sinus baroceptors, CNS, increased vagal flow, decrease HR

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17
Q

what occurs if BP decreases

A

less carotid sinus baroceptor to CNS, decrease in vagal outflow, increase in sympathetic outflow, increase heart rate and vasoconstriction

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18
Q

what are the 3 causes of heart failure

A

infarct, ischemia, increased pressure or volume load

19
Q

what are signs of heart failure

A

reflex tachycardia
enlarged heart
oedema
dyspnea
elevated venous pressure
swollen ankles
swollen neck veins

20
Q

how does failure to pump affect sympathetic outflow?
how does this effect glomerular filtration?

A

increased
decreased

21
Q

what does enhances sympathetic outflow lead to

A

circulatory congestion

22
Q

what causes enlarged neck veins

A

pooling of blood in venous side of circulation

23
Q

how does sympathetic outflow affect venous pressure

A

increased

24
Q

what does increased venous pressure result in

A

fluid expelled from blood = edema and dyspnea

25
Q

what is the term for an enlarged and inefficient heart

A

maladaptive hypertrophy

26
Q

what are the 3 key ways to treat heart failure

A

enhance contracitilty
reduce fluid intake and increase fluid loss
reduce cardiac workload

27
Q

what cardiac glycoside is useful in treating HF

A

digoxin

28
Q

what are the 3 benefits of using cardiac glycosides in chronic EF

A

positive inotropic
negative chronotropic
edema reduced

29
Q

is arterial BP preserved with the use of cardiac glycosides

A

yes

30
Q

where do cardiac glycosides have indirect effects

A

supraventricular tissue
baroceptors
vagal tone

31
Q

where do cardiac glycosides have direct effects

A

purkinje fibres
ventricular myocardium

32
Q

where do cardiac gylcosides have effects

A

SA AV purkinje and ventricles

33
Q

how do cardiac glycosides effect vagal outflow

A

increased

34
Q

how do cardiac glycosides affect purkinje fibres

A

automaticity anf excitabilty

35
Q

how do cardiac glycosides affecrt ventricles

A

(+ ) INOTROPIC

36
Q

how can cardiac glycosides cause problems in the AV node

A

AV block

37
Q

what are catecholamine positive inotropic agents?

A

dopamine and dobutamine

38
Q

what receptor for dopamine and dobutamine act on

A

beta 1

39
Q

what effect do phosphodiesterase inhibitors

A

positive inotropic

40
Q

how do phosphodiesterase inhb=itors increase contracility

A

inhibit breakdown of cAMP, increased Ca through L, increased contractility

41
Q

what are the two phosphodiesterase inhibitors

A

amrinone and milrinone

42
Q

what is one more class of drug that has positive inotropic effects

A

changes to angiotensin II

43
Q

what is the SGLT2 inhibitor of interest

A

empagliflozin

PMCOL 343 (27 decks)

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