Cardiovascular Flashcards
From the innermost to the outermost, what are the layers of the heart?
endocardium
myocardium
pericardium
fibrous pericardium
What is the pericardium consisted of?
visceral, pericardial cavity, and parietal
preload vs afterload
pre: is the amount of blood that enters heart prior to contraction while
after: is the pressure that is generated to push the blood from the ventricles into the aortas
___ inhibitors will decrease preload and angiotensin II
ACE
Inotropic drugs will influence the force of ____ ____
cardiac contraction
Chronotropic drugs affect ___ control
HR
what is the normal level for cardiac output?
3.5-8 liters/min
Atheroscleorsis
there’s buildup of plaque in the arteries which can cause ischemia, angina, and claudication
LDL vs HDL
low density lipoprotein is bad cholesterol that contains less percentage of protein compared to high density lipoprotein which is good cholesterol with a high concentration of protein
What are the layers of an artery wall? innermost to outermost
tunica intimate: has contact with blood
tunica media: layer of smooth muscle & elastic tissue
tunica externa (adventitia): layer of connective tissue
What are the steps to acquire atherosclerosis?
- the tunica intima will have rips/holes
- LDL will go into the hole, activating the immune response
- a fibroblasts will from a fibrous cap around the wound
next step happens if theres a fissure/opening in the cap - platelets and fibrin will start to accumulate, making a thrombus
How does LDL activate the immune response in atherosclerosis?
Since LDL moved into the rip, it will attract monocytes which turn into macrophages. these will start to eat the LDL and then die becoming foam cells.
T or F
When a thrombus is present, it’s considered a stable plaque.
FALSE
a thrombus is present in unstable plaque
T or F
An embolism can be made from __,__,___.
blood, air, fat
Normal BP?
Elevated BP?
Stage 1 HTN?
Stage 2 HTN?
<120/<80
120-129/<80
130-139/80-90
>140/>90
___ Na levels
___ Ca, Mg, and K level cause HTN
high
low
What are possible complications of HTN medications?
cerebral vascular accident, proteinuria, blindness, MI
What is secondary HTN and what are examples?
its HTN that happens because of another disease
examples are
-renal vascular disease: high RAAS, decreases renal flow
-renal parenchyma: damaged tubules, high RAAS
-adrenocortical and adrenomedullary tumors
What are first line drug medications that are prescribed for HTN?
-thiazide type diuretics
-calcium channel blockers CCB
-ACE inhibitors
-Angiotensin II receptor blockers ARBs
What are last line drug medications for HTN?
beta blockers
alpha blockers
loop diuretics
aldosterone antagonists
T or F
Thiazide and CCB are prescribed to african americans?
true
T or F
Thiazide, ACEI’s and ARBs are prescribed to people with CKD?
False
only ACEI’s and ARBs
If theres more than a ___ drop in systole and ___ drop in diastole, its considered to be orthostatic hypotension?
20, 10
Right vs Left sided Heart Failure
Right sided HF is when the heart can’t pump enough blood to the respiratory system so it will back up into the circulatory system through the superior/inferior vena cava and its caused by LHF
Left sided HF happens when ventricle cant produce stroke volume which leads low CO, and blood in the lungs
What normally causes LHF?
hypertension
Cardiomyopathies, CAD, and valvular disorders are primary disorders that cause ___?
HF
Sign/Symptoms of
LHF vs RHF
LHF: causes shortness of breath, coughing, pink frothy sputum, paroxysmal nocturnal dyspnea and decreased urine output
RHF: causes peripheral edema, swollen neck veins, nocturne, rapid weight gain
What is it called when theres an accumulation of fluid in abdomen?
ascites
How do you diagnose and treat HF?
diagnose:EKG, ECHO (EF), blood work ( electrolytes, and B natriuretic peptides
treatment: diuretics (decreases preload), vasodilators (decrease after load)
Peripheral Vascular disease
-disease of veins which cause poor circulation to legs (claudication)
-can cause artherosclerosis, raynaud phenomenon, thromboangiitis
This is an inflammatory disease of the peripheral ARt.It’s seen in young men who smoke and causes thick malformed nails, pain, and/or gangrene.
Thromboangiitis obliternas or Buerger disease
Raynaud phenomenon
This consists of vasospasm attacks in small arterioles in fingers
this can cause numbness, rubor, brittle skin
Varicose veins
valves in veins are damaged, so blood starts to pool, causing distention
seen in people who stand a lot, clots or trauma to veins
- can cause cell death/necrosis, or ulcers
Deep vein thrombosis
blood clot in vein which causes pain, edema and warmth
TR: heparin, enoxaparin
T or F
Heparin does NOT dissolve thrombosis
true
What are the risk factors of DVT?
-circulatory stasis
- atrial fibrillation, varicose veins,
-vascular wall injury
- atherosclerosis
-hypercoagulable state
-pregnancy
Can platelets aggregate in a plaque if theres no fissure?
NO, there needs to be an opening to allow them in
Coronary Artery Disease
stable vs unstable?
risks?
TR?
-Unstable plaque will cause pain even at rest
-risks: dyslipidemia, HTN, DM, Obesity
-TR:cath lab ( insert ballon to open artery),CA bypass, or anti platelet drugs
CAD
Transmural injury vs subendocardial injury
Transmural is when the whole wall is blocked while sub is only a part of it is blocked
This type of pain comes from vasospasm and has no relation to artherosclerosis
prinzmetal angina
Stable angina
symptoms subdue @ rest
medications consist of nitroglycerin which dilate CA’s
Myocardial Infarction (MI)
- this is cell death in the heart which leads to ischemia
-two types are Non-STEMI & STEMI
NON: is when the ST segment is the same as the O line while STEMI is when the segment is elevated
What will an MI look like on a EKG?
ischemia: inverted T waves, ST depression
injury MI: ST elevation
Indication of past MI: Q waves
___,___,___ are biomarkers for an MI
CKMB, troponin I and troponin T
How do you treat an MI?
Nitrates to dilate CA’s
ASA: anticoagulant
thrombolytic : remove thrombosis
Acute pericarditis
inflamed pericardial due to viruses
causing chest in pain, worsens when moving
signs: pulse paradoxus (pulse stops when inhaling), friction rub, HTN
Accumulation of fluid in pericardial cavity
pericardial effusion
Cardiac tamponade
theres accumulation of fluid which compresses heart, affecting its beating
happens cause of MI
signs/symptoms: muffled heart sounds, Hypotension, distended neck veins
What is becks triad?
muffled heart sounds, Hypotension, distended neck veins seen in cardiac tamponade
Cardiomyopathy types
-dilated ?
-restrictive?
-hypertrophy?
Dilated is when the heart is big and floppy, and it can’t pump
restrictive is when the heart is rigid, Diastolic increases
Stenosis vs regurgitation in valvular defects
in stenosis, the valve doesn’t open COMPLETELY while regurgitation it doesnt properly close meaning blood moves back
This is when the valves open up instead of down, seen in women and is a congenital HD.
sign/symp: new heart murmur
TR: antibiotics (ABX)
mitral valve prolapse
Rheumatic HD
caused from infection of group A streptococci throat infection causing a fever and needs to be treated with ABX
