Cardio Disorders Flashcards
1
Q
cardiovascular/heart disease
A
disease of the heart and/or blood vessels
2
Q
heart disease is considered a consequence of
A
atherosclerosis
3
Q
what are the effects of atherosclerosis?
A
thickening and hardening in the artery wall
4
Q
what causes the effects of atherosclerosis?
A
thickening and hardening is caused by an accumulation of lipid-laden macrophages in the arterial wall.
increased inflammation signals
5
Q
atherosclerosis is a consequence and cause of
A
increased blood pressure
6
Q
atherosclerosis increases risk of
A
cardiovascular infarction
cerebrovascular infarction
7
Q
atherosclerosis is thought to stem from
A
cholesterol
8
Q
what does high blood pressure cause?
A
tearing of endothelium and therefore inflammation.
turbulent flow in a blood vessel
9
Q
where is turbulent flow most apparent?
A
in areas of branching or constriction of the blood vessel
10
Q
turbulent flow damages:
A
endothelium
11
Q
A type LDL cholesterol is
A
large and less dense
12
Q
B type LDL cholesterol is
A
Small and more dense
13
Q
what are the risk factors for pattern B LDL cholesterol
A
Genetic
oral contraceptives
diet
14
Q
what can increase your levels of patten B LDL cholesterol?
A
a very low fat high carb diet
15
Q
dietary cholesterol has ____ impact on blood cholesterol
A
little
16
Q
increased consumption leads to ____ absorption
A
reduced
17
Q
where does most circulating cholesterol come from?
A
it is synthesized de novo
18
Q
where is cholesterol synthesized?
A
80% in the liver
10% in intestine
5% in skin
19
Q
what is the most potent activator of de novo cholesterol synthesis?
A
insulin
20
Q
what is related to increased cholesterol synthesis?
A
increased fasting insulin.
21
Q
what increases cholesterol synthesis from the liver?
A
insulin-stimulating meals
22
Q
what are the most widely prescribed drug in the world?
A
statins
23
Q
HMG-CoA reductase inhibitors
A
statins
24
Q
what do HMG-CoA reductase do?
A
they play a role in synthesizing cholesterol in the liver.
25
which group of people do statins help the most?
people with previous history of cardiovascular event. They don't really help other people
26
what are some of the side effects of statins?
increased risk of diabetes (T2)
kidney failure
liver failure
muscle pain (muscle break down)
27
what is normal blood pressure
systolic: 90-119
diastolic: 60-79
28
what is prehypertension BP?
systolic: 120-139
Diastolic: 80-89
29
What is stage one (primary) hypertension BP?
systolic: 140-159
Diastolic: 90-99
30
what is stage 2 (secondary) hypertension BP?
Systolic: eq > 160
diastolic: eq > 100
31
primary hypertension
"essential" hypertension
affects 90-95% of individuals with hypertension
results from weight gain
associated with insulin resistance
there are genetic and environmental factors
32
Secondary hypertension results from
a structural, renal or endocrine problem
33
what reduces BP in hypertensives?
carb restriction
34
who does salt sensitivity affect the most?
people who are insulin resistant
35
in RAAS dysfunction, _____ is increased in obesity
Plasma Sodium content
36
what induces prolonged sodium retention in RAAs dysfunction?
CHO ingestion
37
insulin increases_____ in RAAS dysfunction
kidney sodium reabsorption
38
urinary sodium excretion ___ with insulin injection
decreases
39
insulin increases ____ secretion
aldosterone
40
in RAAS dysfunction, what is capable of eliciting an antidiuretic effect?
a very slight increase in plasma insulin
41
what reduces BP in hypertensives?
carb restriction
42
who does salt sensitivity affect the most?
people who are insulin resistant
43
in RAAS dysfunction, _____ is increased in obesity
Plasma Sodium content
44
what induces prolonged sodium retention in RAAs dysfunction?
CHO ingestion
45
Which neuro transmitter of the sympathetic nervous system is affected by primary hypertension due to insulin resistance and how?
insulin causes a dose-related increase in norepinephrine release. which then increases pulse and blood pressure.
46
urinary sodium excretion ___ with insulin injection
decreases
47
insulin increases ____ secretion
aldosterone
48
in RAAS dysfunction, what is capable of eliciting an antidiuretic effect?
a very slight increase in plasma insulin
49
primary hypertension due to insulin resistance enhances _____ activtiy
growth factor
50
there are receptors for ____ and ___ in capillary endothelial cells which causes vascular cells to be responsive to insulin
IGF-1 and insulin
51
enhanced growth factor activity causes ___ of the vascular wall
hypertrophy
| -narrowing of vascular wall due to thickening of the wall. Narrower opening.
52
Primary hypertension due to insulin resistance affects the ____ nervouse system
sympathetic
53
Which neuro transmitter of the sympathetic nervous system is affected by primary hypertension due to insulin resistance and how?
insulin causes a dose-related increase in norepinephrine release. which then increases pulse and blood pressure.
54
how does insulin resistance induced primary hypertension affect nitric oxide.
Normally, insulin increases the production of endothelium derived NO which is a potent vasodilator.
But, insulin resistant endothelial cells can't release NO so then NO can't be produce to cause vasodilation
55
what is NO made from?
L-arginine
56
what improves blood pressure more than restricting salt and fat?
restricting carbs and weight loss
57
sodium has ___ effect on hypertension onset
no effect
58
preeclampsia
pregnancy induces hypertension
59
what is the leading cause of maternal death?
preeclampsia
60
what is going on in preeclampsia?
reduced kidney function leads to chronic excessive increased blood pressure.
61
what is eeclampsia?
toxin accumulation
seizures
death
62
what are some drug treatments for hypertension?
```
alpha blockers
beta blockers
diuretics
ACE inhibitors
metformin
```
63
what do alpha blockers do?
they reduce SNS activity which slows heart rate and stroke vol
64
what do beta blockers do?
reduce heart contractility
65
what is an aneurysm?
a local dilation or outpouching of a vessel wall or cardiac chamber
66
true aneurysm
involve all three layers of the arterial wall
67
false aneurysm
do not have distension of all three layers of the arterial wall.
68
thrombus
blood clot that remains attached to the vessel wall
69
thromboembolus
a clot (thrombus) that breaks free
70
thrombophlebitis
swelling of the veins cause by a thrombus
71
why are arterial thrombi so rare?
bc of the pressure in the arteries. Thrombi that are formed here are usually pushed out into the veins and become venous thrombi
72
embolism
```
bolus of matter in circulation in the blood stream
this can include:
dislodges thrombus
air bubble
aggregate of fat
bacteria
cancer cells
or a foreign substance
```
73
what is a common feature of peripheral artery disease?
intermittent claudication
74
what is intermittent claudication?
obstruction of arterial blood flow in the iliofemoral vessels resulting in pain with movement
75
what are thromboangitis obliterans?
buerger disease
lesions to the endothelial lining caused by inflammation.
obliterates the small and medium sized artering in perfusion. So you can't get blood out as well.
76
what are the effects of thromboangiitis obliterans?
```
pain
tenderness
hair loss in the affected area
gangrenous lesion
loss of oxygen to the tissues
```
77
what are some symptoms of thromboangiitis obliteran?
slow and sluggish blood flow
78
raynaud phenomenon /disease
episodic vasospasm in arteries and arterioles of the fingers, less commonly the toes
(where the fingers are whit or like green)
usually triggered by cold or stress
79
which diseases is raynaud phenomenon secondary to?
collagen vascular disease (scleroderma)
smoking
pulmonary hypertension
80
Deep vein thrombosis (DVT)
obstruction of venous flow leading to increased venous pressure
81
what are factors that increase your risk of DVT?
venous stasis
venous endothelial damage
hypercoagulable states
82
Myocardial ischemia
heart is not getting blood
83
temporary myocardial ischemia
deprivation of the coronary blood supply
| result in angina pectoris
84
angina pectoris
chest pain from coronary ischemia
85
stable angina
recurrent pain from chronic coronary artery obstruction during effort
86
unstable angina
result of reversible ischemia
| sign of possible future attacks
87
sustained ischemia
prolonged blockage of coronary artery
| leads to myocardial infarction
88
myocardial infarction
myocardial inflammation and necrosis
89
myocardial infarction
sustained and complete obstruction of the myocardial blood supply
90
subendocardial infarction
affects only the inner 1/3 to 1/2 of the heart wall.
91
Why is the inner wall more affected in subendocardial infarction?
because blood supply goes first to outer wall.
92
transmural infarction
affects more than 1/2 of the heart wall
| more serious
93
stent
a treatment for myocardial infarction that pushes plaque out of the way so that blood can pass. doesn't clear plaque
94
___ can induce ischemia in predisposed individuals
stress
95
insulin resistance increases risk of which cardiomyopathies?
dilated
| hypertrophic
96
dilated cardiomyopathy
congestive cardiomyopathy
| rounder than it should be
97
hypertrophic cardiomyopathy
when heart muscle gets thicker and it doesn't allow the chambers to fill up
hypertension is the leading cause
98
restrictive cardiomyopathy
deposition of material in myocardium
| it has normal dimensions but doesn't move as it should.
99
systolic heart failure
inability of the heart to generate adequate cardiac output to perfuse tissues
the heart is just not able to generate enough force and its not able to it blood around the body
100
diastolic heart failure
pulmonary congestion
101
what is the cause of pulmonary congestion due to diastolic heart failure?
LV stiffening
102
why does diastolic heart failure cause pulmonary congestion?
is the left side isn't working well, it's having a hard time getting blood out so its having a hard time getting blood in from the lungs which then causes the lungs to get congested.
103
right heart failure
harder time getting blood to the lungs
| causes by hypoxic pulmonary disease
104
what can result from an increase in left ventricular filling pressure that is reflected back into the pulmonary circulation
right heart failure
105
high output failure
inability of the heart to supply the body with blood borne nutrients despite adequate blood volume and normal or elevated myocardial contractiloty
106
valvular stenosis
narrowing of valves
107
what are types of valvular stenosis?
aortic stenosis
| mitral stenosis
108
valvular regurgitation
leakage of valves
109
what are types of valvular reguritation?
aortic regurgitation
| mitral regurgitation
110
mitral valve prolapse syndrome
when the valve is ballooning up into the atrium
111
aortic valve stenosis
stiffening and narrowing of the aortic valve
blood has difficulty exiting the heart
prolonged ejection sound
112
what are clinical manifestations of aortic valve stenosis?
crescendo-decrescendo systolic hear sound during systole
decrease in stroke volume
increased LV pressure (not getting all the blood out)
decreased systolic BP
decreased HR
hypertrophy of left ventricle resulting in ischemia, left heart failure
113
what does aortic valve stenosis cause a decrease HR?
the heart is trying to maintain function so it will reduce heart rate to not get too full
114
aortic regurgitation
failure of the aortic valve to properly close
| blood leaks back into the ventricle after ventricular contraction
115
what are clinical manifestations of aortic regurgitation?
diastolic murmur (blowing sound) of high pitch over the left ventricle
dysrhythmia
hypertrophy of left ventricle
left heart failure
doppler echocardigram reveals blood flow back through aortic valve
116
mitral stenosis
narrowing or stiffening of the mitral valve
has a hard time opening
blood flow into the ventricle during diastole
117
what are clinical manifestations of mitral stenosis?
```
subtle crescendo diastolic murmur (rumbling)
decreased blood flow from left atrium to left ventricle
increased left atrial pressure
hypertrophy and dilation of left atrium
atrial dysrhythmias
increases pulmonary blood pressure
pulmonary edema
right heart failure
```
118
mitral regurgitation
failure of the mitral valve (left AV valve) to properly close
blood passing into atrium from ventricle during contraction
119
what are clinical manifestations of mitral regurgitation?
```
systolic murmur
dilated hypertrophied left ventricle
dilated left atrium
left heart failure
pulmonary hypertension and edema
right heart failure
doppler cardiography reveals blood flow back through mitral valve
```
120
Which side of the heart is dominant in utero?
the right ride because they don't need their lungs since mom is providing all the oxygen
121
what are the changes in dynamic that take place with a baby's first breath?
decreased pulmonary pressure and increased systemic vascular resistance
122
which structures go away with the baby's first breath?
ductus arteriosus
| foramen ovale
123
what are some prenatal, environmental, and genetic risk factors for infant congenital heart defects?
```
maternal rubella
insulin-dependent diabetes
alcoholism
hypercalcemia
come prescription drugs
chromosome aberrations
```
124
what are some complications that may occur with congestive heart failure?
congestive heart failure
| hypoxemia (which leads to cyanosis)
125
Patent ductus arteriosus
increases pulmonary blood flow
failure of the ductus arteriosus to close
blood moves from the aorta to the PA
blood that just got to the heart from the lungs is going back into the lungs.
126
atrial septal defect
increases pulmonary blood flow
abnormal communication between the atria
there is a communications between the atris so blood will leak from the left side to the right side and will then go back to the lungs where it had just come from.
127
ventricular septal defect
increases pulmonary blood flow
abnormal communication between the ventricles
most common type of congenital heart defect
less consequences the closer the defect is to the apex
128
atrioventricular canal defect
increases pulmonary heart flow results from nonfusion of the endocardinal cushions
the atrium and the ventricles are connected
129
tetralogy of fallot
```
decreases pulmonary blood flow
a mix of four syndromes:
ventricular septal defect
overriding aorta (aorta literally moved to left)
pulmonary valve stenosis
right ventricle hypertrophy
sending less blood to the lungs and increasing the amount of unoxygenated blood to the body
hypoxia
```
130
tricuspid atresia
imperforate tricuspid valve (lack of communication between the right atrium and left ventricle
131
coaractation of the aorta
narrowing of the lumen of the aorta that impedes blood flow
| obstructive defect
132
hypoplastic left heart syndrome
obstructive defect
abnormal development of the left sided cardiac structures
requires a patent ductus arteriosis or a septal defect to move blood into systemic circulation
