Cardiovascular Flashcards
Virchow’s Triad
3 categories likely to contribute to thrombosis
- Stasis of bloodflow
- Endothelial injury
- Hypercoagulability
Arteriolosclerosis (affects what? assoc. w/ what?)
Affects arterioles
Associated w/ hypertension & diabetes
Monckeberg’s arteriosclerosis
Medial calcific sclerosis - calcifications in the muscular wall (tunica media) of arteries
Hyaline arteriosclerosis
Thickening of arteries via deposition of hyaline
Associated w/ hypertension & diabetes
Hyperplastic arteriosclerosis
Narrowing of the lumen of arteries (thickened BM & mm)
Associated w/ malignant hypertension
Atherosclerosis
Affects larger arteries
Formation of intimal lesions (atheromas)
Death rate of atherosclerosis & common cause of the death
50% death rate
25% due to MI
Risk factors to arteriosclerosis
Male 40-60 y.o. Genetics Hypercholesterolemia Diabetes (2x risk) Hypertension Smoking Inflammation (CRP levels) Hyperhomocysteinemia Lipoprotein (a) levels
Hyperhomocysteinemia
High homocysteine levels due to deficiencies of vitamin B6, folic acid (vitamin B9), and vitamin B12
Steps in arterial plaque formation
- Accumulation of excess lipoproteins (LDL+Chol.) in subendothelial vessel wall
- Monocyte adhesion occurs at site of accumulation and the monocytes ingest lipid to become foam cells
- FGF and PDGF secreted by the endothelium and other cytokines released by foam cells recruit s.m. cell proliferation
- Plaque is fully developed w/ collagen cap & lipid core
Fatty streaks
Non-pathological
Appear in children
May progress to atheromas
Reversible
Common place to detect atheromas
Bifurcation of carotid a.
Are atheromas reversible?
No
Normal BP
<140/90
Mild Hypertension BP
<159/104
Moderate/Severe Hypertension BP
> 160/106
Hypertension affects what % of the US population?
20-30%
Concentric L ventricle hypertrophy
Compensated (normal cardiac output)
Outside dimensions are the same (hypertrophy on inside)
L ventricle hypertrophy with ventricular dilation
Decompensated
Dec. contractility, dilation, CHF
Complications of hypertension
Concentric LVH LVH & ventricular dilation Retinal injury Nephrosclerosis Dissecting hematoma of aorta
Malignant hypertension BP
> 200/140
Malignant hypertension complications
Cerebral edema/hemorrhage/encephalopathy
Papilledema
Renal failure
Malignant hypertension prognosis
5 year life expectancy
CHF compensatory mechanisms
Activating neurohumoral systems (release NE)
Frank-Starling Mechanism
Myocardial hypertrophy
Frank-Starling mechanism
Inc. end-diastolic filling volume to contract more forcefully
Which side of the heart is more likely to fail?
Left
Causes of L side heart failure
IHD Hypertension Myocarditis Cardiomyopathy Valvular disease
Causes of R side heart failure
L side heart failure
Pulmonary hypertension
Septal defects w/ L-R shunts
Valvular disease
Symptoms of L side heart failure
Dyspnea
Chronic cough
Orthopnea
Cerebral hypoxia
Symptoms of R side heart failure
Congestion of liver & spleen (nutmeg liver)
Edema (pitting) of subcutaneous tissues
Cerebral hypoxia
How common is CHD?
6-8 : 1,000
Causes of CHD
Environmental factors
Chromosomal abnormalities