Cardiovascular 2/3 Flashcards
What is hypertension?
Hypertension, also known as essential (idiopathic) hypertension, is a sustained elevation in resting blood pressure (systolic ≥ 140 and diastolic ≥ 90).
How does blood pressure affect mortality?
With each increase in blood pressure, the risk of mortality goes up. Both high diastolic and systolic have the same effect on mortality/disease.
How does exercise affect blood pressure in a person with hypertension?
Before exercise, resting blood pressure is higher with hypertension. During exercise, the blood pressure is the same whether the person has hypertension or not. After exercise, blood pressure is higher with hypertension.
What factors control blood pressure?
Blood pressure is controlled by the kidney (renin-angiotensin system), diet (amount of salt and water), autonomic nervous system, heart/brain/adrenal/lung (hormones), and arteries (structural changes).
What are the risk factors for hypertension?
The risk factors for hypertension are high salt intake, obesity, low physical activity, smoking, high alcohol consumption, stress, and rarely due to family history (genetic factor).
What are the complications of hypertension?
Complications of hypertension include cardiac hypertrophy, structural changes in arteries, atherosclerosis in eye, kidney, adrenal, risk for stroke and Alzheimer’s, and can lead to a variety of things: stroke, heart failure, sexual dysfunction, vision loss, heart attack, kidney failure.
What is the treatment for hypertension?
Treatment for hypertension includes non-pharmacological control such as decreasing alcohol, eating healthy, decreasing weight, increasing physical activity, stopping smoking, and pharmacological control with drugs affecting heart, brain, kidney, autonomic nervous system, and blood vessels.
How does salt intake affect the incidence of hypertension?
The more salt people eat, the higher the incidence of hypertension.
How does salt pathogenesis occur in hypertension?
Salt pathogenesis is complex. It alters the microbiome, triggering inflammation. Dendritic cells respond, T cells are activated causing inflammation, and high salt in CSF affects the peripheral nervous system, causing peripheral vasoconstriction.
What is the effect of hypertension on the heart?
Hypertension can cause cardiac hypertrophy as the heart has to work harder to go against the high blood pressure.
What are the structural changes in arteries due to hypertension?
Hypertension can cause remodelling of the arterial wall, stiffening of the arterial media (middle layer) and adventitia (outer layer), hypertrophy and hyperplasia of the smooth muscle cells in the wall, and formation of myofibroblasts
What is the effect of hypertension on the brain?
Hypertension can increase the risk for stroke and Alzheimer’s. It can damage the blood-brain barrier, so more things can go in and out. It can also lead to aneurysms and possible occlusion.
What is the viscous cycle in hypertension?
Atherosclerosis makes hypertension worse and the hypertension makes atherosclerosis worse.
What is the prevention for hypertension?
Prevention for hypertension includes good lifestyle choices and monitoring blood pressure.
: What is ischemic heart disease?
Ischemic heart disease is a condition where there is not enough blood in the heart, which usually involves the coronary arteries: Left anterior descending CA, Left circumflex CA, and Right CA.
What is coronary heart disease?
Coronary heart disease is an impairment in one or more of the major coronary arteries, usually due to atherosclerotic plaque in proximal regions. With time, stenosis occurs, and a thrombus can form, leading to sudden death.
What is angina pectoris?
Angina pectoris is chest pain due to an imbalance between the supply and demand of blood in the heart. The supply comes in through the coronary arteries, and the demand increases with exercise, hypertension, and adrenaline.
What are the symptoms of angina pectoris?
Symptoms of angina pectoris include radiating pain that can be in the neck, jaw, upper abdomen, shoulders, and arms. Symptoms may be felt during exercise since O2 demand increases significantly. The severity is related to the extent of stenosis.
What is the treatment for angina pectoris?
Treatment for angina pectoris can include nitroglycerin, coronary artery bypass, balloon angioplasty, and stents.
What is a myocardial infarct?
A myocardial infarct is the death of cardiac muscle on different regions of the heart, depending on which vessel is occluded. If the blood supply is restored fast enough, the damage can be minimized.
What are the symptoms of a myocardial infarct?
Symptoms of a myocardial infarct include intense pain, trouble breathing, feeling of passing out, usually in the left chest, arm, shoulder, and/or face.
What is the impact of collateral circulation on the consequences of ischemic heart disease?
If there is minimal stenosis, a complete occlusion is usually accompanied by myocardial infarction since there will be little anastomoses. When there is a gradual stenosis, anastomosis open up, meaning that complete occlusion may be accompanied by only minor damage.
What is variant angina?
Variant angina is a type of angina that is due to coronary artery spasm.
How is angina pectoris detected?
Angina pectoris is detected by performing an ECG (electrocardiogram).
What are the causes of a myocardial infarct?
A myocardial infarct can be caused by a thrombus that forms on the spot, an embolus that was transported, hemorrhage at the site, or spasms.
What is the short-term strategy for treating angina?
The short-term strategy for treating angina is nitroglycerin, which eases the pain by relaxing the veins, and therefore decreases the workload on the heart.
What are the surgical treatments for angina?
Surgical treatments for angina include coronary artery bypass, where an artery (or vein, which will eventually change its properties to become more like an artery) is added to bypass the obstructed area, and balloon angioplasty, where a catheter is inserted in the vessel and a balloon is blown up to open up the occluded region. And, the addition of a stent, which is a permanent “balloon-like” cage that ideally keeps the vessel open (can do this in the periphery too).
What is mechanical failure in the context of ischemic heart disease diagnosis?
Mechanical failure refers to the condition where part of the heart can no longer contract. The severity is related to the extent and location of the failure.
What is electrical failure in the context of ischemic heart disease diagnosis?
Electrical failure refers to the condition where the pacemaker activity of the heart may be abnormal, which may lead to arrhythmias. This can be detected by looking at an ECG.
What happens in the blood after a myocardial infarction?
After a myocardial infarction, there will be leucocytosis (up to 1 week) where neutrophils mobilize by chemotaxis of necrotic muscle, and enzymes are released from necrotic muscle which can indicate the extent of injury.
What is the aim of immediate and long-term therapy for ischemic heart disease?
The aim of immediate and long-term therapy is to prevent death, minimize areas of necrosis that is going to occur, and maximize the chance of survival to allow the heart to heal.
What are the complications of ischemic heart disease?
The complications of ischemic heart disease include risk of rupture as the dead cells are reabsorbed and the wall thins (cardiac dilatation), risk of embolus, cardiac rupture, papillary muscle rupture (which impairs the ability to contract), ventricular aneurysm (which increases the risk of thrombus and decreases cardiac efficacy), damage to ventricular septal which has to be repaired surgically, and heart failure.
What are the risk factors for ischemic heart disease?
The risk factors for ischemic heart disease include metabolic syndrome, obesity, fatty liver, hypertension, smoking, diet, etc. These risks are additive, but they are modifiable.
What is the role of the coronary care unit in the treatment of ischemic heart disease?
In the coronary care unit, various treatments can be used such as electroshock, antiarrhythmic drugs, and many other drugs as appropriate to maximize the chance of survival and allow the heart to heal.
