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Bioscience 2 > Cardiovascular 2 > Flashcards

Cardiovascular 2 Flashcards

1
Q

Insufficient blood supply to the heart for less than 20 minutes =

A

Angina (chest pain)

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2
Q

Insufficient blood supply to the heart for more than 20 minutes=

A

Myocardial infarction (heart attack)

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3
Q

Infarction is cell death through ………….resulting from prolonged or severe ischaemia

A

Necrosis

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4
Q

Clinically, Angina will be more painful. true or false

A

False.

myocardial infarction will be more painful and is unrelieved by rest

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5
Q

Biochemical markers that will be raised after myocardial infarction include

A

Creatine kinase-MB and cardiac troponin

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6
Q

Modifiable risk factors for ischaemic heart disease include:

A
  • Dyslipidaemia
  • Hypertension
  • Obesity, sedentary lifestyle
  • Diabetes mellitus, insulin resistance
  • Smoking
  • Inflammation
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7
Q

Non-modifiable risk factors for ischaemic heart disease include:

A
  • Increasing age
  • Male gender
  • Female after menopause
  • Family history of heart disease
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8
Q

The lack of blood supply to a tissue is called

A

Ischaemia

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9
Q

Causes of myocardial ischaemia include:

A
  • Insufficient blood supply to myocardium

* Increased myocardial demand for oxygen

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10
Q

Clinical features of myocardial ischaemia include:

A
  • Hypoxia activates nociceptors (pain receptors)
  • Chest pain often radiating to neck, lower jaw, left shoulder, arm
  • increased HR, ECG changes
  • Pallor
  • Diaphoresis (excess sweating)
  • Dyspnoea
  • Anxiety
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11
Q

With myocardial ischaemia, cell changes after several minutes include:

A
  • Insufficient ATP
  • Anaerobic respiration for up to 20 minutes
  • impaired contractility
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12
Q

Name the 3 types of stable angina Pectoris…

A
  1. Stable angina
  2. Prinzmetal (variant)
  3. Silent
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13
Q

Explain angina Pectoris :

A

• pain or discomfort due to myocardial ischaemia
…. Often mistaken for indigestion
… Recurrent, predictable
• cell changes are reversible
… No permanent damage if blood supply restored quickly

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14
Q

Explain stable angina (most common):

A

• usually exertional or stress-related

… Fibrous/hard plaque: narrow coronary arteries can’t dilate during physical activity or stress

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15
Q

Angina Pectoris is relieved by rest and/or glyceryl trinitrotoluene. True or false

A

True
• coronary artery vasodilation
• peripheral coronary vasodilation

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16
Q

Define infarction:

A

Region of necrosis in the tissue

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17
Q

Pathophysiology of unstable angina:

A

• soft plaque:
… Prone to rupture, causing thrombosis and vasoconstriction
• warning that a MI may occur soon

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18
Q

Myocardial infarction…

When myocytes don’t get enough oxygen, they release …

A
  • adrenaline and noradrenaline: vasoconstriction and increased HR
  • angiotensin II: vasoconstriction, coronary artery spasm
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19
Q

MI…

After 20 minutes of hypoxia, there is irreversible injury. True or false

A

True…

Cardiac muscle does not regenerate and there is permanent loss of function in affected region

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20
Q

50% of patients with heart attack have no pain. True or false

A

False: 20% experience no pain

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21
Q

Explain penumbra…

A

Region of vulnerable tissue, surrounding ischaemic region

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22
Q

Damage to the heart is repaired by 8weeks. True or false

A

False

The heart is very weak for 10-14 days and is repaired by 6 weeks

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23
Q

Which of the following cardiac bio markers is the preferred marker
A. LD-1 (lactate dehydrogenase)
B. Cardiac troponin (I or T)
C. CL-MB (creative kinase-MB)

A

They are all cardiac bio markers but the answer is

B. Cardiac troponin…which is raised for 5-14days

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24
Q

MI…

Non-STEMI involves full thickness of the ventricle wall. True or false

A

False
Non-stemi involves only inner part of the ventricle wall (subendocardial)
…Stemi involves full thickness (trans mural)

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25
Q

MI …

On an ECG, STEMI shows as ST segment _______whereas Non-STEMI shows as ST segment ________

A

Elevation

Depression

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26
Q

Explain angiogram

A

Viewing of arteries without treatment

…via the insertion of a catheter

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27
Q

Explain angioplasty

A

Insertion of a catheter with balloon into artery…inflation of balloon to displace blockage…usually deployment of a stent to maintain vessel diameter

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28
Q

Risk factors for hypertension include:

A
  • family history
  • smoking
  • obesity
  • alcohol
  • makes
  • females post-menopause
  • high intake of Na
  • low intake of K
  • chronic inflammation
  • hyperglycaemia
29
Q

Explain hypertension

A

Blood pressure consistently greater than 140/90 due to • increased peripheral resistance (vasoconstriction) and • increased cardiac output (increased blood volume)

30
Q

Evaluation for hypertension includes:

A
  • repeatedly elevated blood pressure
  • blood tests…electrolytes, LDL & HDL
  • urinalysis … Blood and protein
  • ECG
31
Q

Lifestyle modifications for hypertension include:

A
  • exercise
  • diet
  • weight loss
  • decreased smoking, alcohol
32
Q

Medication management for hypertension includes:

A
  • diuretics
  • ACE inhibitors
  • angiotensin II blockers
  • a & b blockers
33
Q

Left ventricular hypertrophy, heart failure, aneurysm and retinal haemorrhage are clinical manifestations of…

A

Hypertension

34
Q

Localised abnormal dilation of a blood vessel is called an a______ and is caused by __________…

A

Aneurysm

Cause by arthrosclerosis or congenital weakness of the tunica media

35
Q

Aneurysm risk factors include:

A
  • atherosclerosis
  • hypertension
  • smoking
36
Q

What are the treatments for aneurysm …

A

For slow growing: reduce blood pressure

For rapidly dilating: surgery

37
Q

Arthrosclerotic aneurysm usually occurs in the a_______ a______.

A

Abdominal aorta

38
Q

Berry aneurysm is a congenital defect and occurs in the c____ __ w____

A

Circle of Willis

39
Q

inability of heart to pump sufficient blood to meet oxygen needs of the tissues is known as…

A

Heart failure

40
Q

Backward effects of left heart failure include:

A

Pulmonary oedema, cough, dyspnoea, fatigue and limited exercise tolerance

41
Q

Forward effects of left heart failure include:

A 
• Activation of RAAS
...Retention of salt and water 
...increased blood pressure
 ...increases preload and afterload
 ...peripheral oedema
42
Q

Backward effects of right heart failure include:

A
  • Increased jugular venous pressure (JVP)
  • development of peripheral oedema in legs and ankles
  • enlargement of the liver (hepatomegaly) and spleen (splenomegaly)
  • abdominal oedema, pulmonary oedema
43
Q

Forward effects of right heart failure include:

A

Reduced output to Pulmonary circulation

44
Q

The overall rates of rheumatic heart disease in Australia are low. true or false

A

True but there are high rates in the aboriginal population

45
Q

Rheumatic heart disease clinical manifestations include:

A 
Fever 
tachycardia 
abdominal pain 
nausea 
vomiting
46
Q

Heart failure management includes…lose weight, limit sodium intake, limit fluid intake and restrict alcohol consumption. True or false

A

True

47
Q

Pathophysiology of rheumatic heart disease includes:

A
  • Inflammation of the heart tissue
  • damage to heart valves
  • left heart failure
48
Q

Treatment of rheumatic heart disease includes:

A
  • Antibiotics: penicillin
  • anticoagulation
  • valve surgery
49
Q

List the two types of heart valve disease

A
  • Stenosis (narrowing)

* regurgitation (insufficiency)

50
Q

Valve stenosis is obstruction of an open valve and causes include:

A

Atherosclerosis, hypertension,

calcification

51
Q

Valve regurgitation is incomplete closure of valve, leading to back flow of blood and causes include:

A

Congenital abnormalities,

Rheumatic heart disease

52
Q

Treatment of heart valve disease includes:

A
  • Surgery to repair the valve

* valve replacement

53
Q

Explain bradycardia

A

Bradycardia is a slow heart rate below 60 bpm

54
Q

Explain tachycardia

A

Tachycardia is a fast heart rate above 100 bpm

Look up Jess in the dictionary 😉

55
Q

Sinus rhythm is…

A

Normal regular rhythm of the heart

56
Q

Sinus arrhythmia is:

A

Normal fluctuations in heart rate with the respiratory cycle

57
Q

Arrhythmias can be due to:

A

•Abnormal impulse generation
•abnormal impulse conduction
and can result in cardiac arrest

58
Q

In cardiac arrest death may be prevented by:

A
  • CPR

* Defibrillation (particularly if the cause is an arrhythmia)

59
Q

Congenital heart defects are the most common type of heart disease in children and includes:

A 
Abnormal openings (shunts) between atria and ventricles...example, ventricular septal defect or failure of foramen ovale to close
• it allows mixing of pulmonary and systemic blood
60
Q

Circulation changes at birth include:

A
  • Closing of foramen ovale
  • Closing of ductus arteriosus and ductus venosus
  • Closing of umbilical arteries and umbilical vein
61
Q

Depending on the severity of the arrhythmia, slight bradycardia or tachycardia may correct itself… True or false

A

True…if the underlying cause is addressed

62
Q

Cardiac arrest, commonly arises from…

A
  • MI

* also arrhythmia

63
Q

Third degree heart block is not serious…true or false

A

False

Third degree heart block is life threatening. There is no conduction through the AV node

64
Q

Explain heart block

A
  • abnormal impulse conduction

* Delay or total inability of conduction to reach the atrioventricular node

65
Q

First degree heart block is life-threatening…true or false

A

False
First degree is not serious.
Every SA signal reaches the AV node but is delayed

66
Q

Abnormal impulse generation: atrial flutter …contracts _____ but very ______.

A

Regularly

rapidly

67
Q

Abnormal impulse generation: ventricular fibrillation….contracts in an ________manner

A

Uncoordinated

ventricular fibrillation is life-threatening

68
Q

In valve replacement, what is the difference between mechanical valves and donor tissue valve replacement

A

•Mechanical valves last a lifetime but require treatment with warfarin •donor tissue valve replacement may not last as long but warfarin is not necessary

Bioscience 2 (9 decks)

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