cardiovascular adult Flashcards
Acute Coronary Syndrome
• Sudden coronary obstruction because of thrombosis formation over a ruptured atherosclerotic plaque
Atherosclerosis
- Thickening and hardening caused by the accumulation of lipid-laden macrophages in the arterial wall
- Plaque development
• Symptoms and signs are the result of inadequate perfusion of tissues.
Cardiomyopathy
• Any vascular disorder that narrows or occludes the coronary arteries
• Results in an imbalance between coronary supply of blood and myocardial demand for oxygen and nutrients
•
Aortic Stenosis
valve narrows, causing diminished blood flow from the left ventricle into the aorta
Clinical manifestations: angina, syncope, and heart failure
Mitral Stenosis
Impairment of blood flow from the left atrium to the left ventricle
Most common cause: acute rheumatic fever
Clinical manifestation: opening snap
aortic regurgitation
Inability of aortic valve to close properly during diastole
Clinical manifestations: widened pulse pressure as a result of increased stroke volume and diastolic backflow
mitral regurgitation
causes: mitral valve prolapse, rheumatic heart disease, infective endocarditis, MI, connective tissue disease, dilated cardiomyopathy
Permits backflow of blood from the left ventricle into the left atrium
tricuspid regurgitation
Leads to volume overload in the right atrium and ventricle,
increased systemic venous blood pressure, and right heart failure
Mitral valve prolapse syndrome
o Anterior and posterior cusps of the mitral valve billow upward (prolapse) into the atrium during systole
Clinical manifestations: asymptomatic
heart failure
• Is a pathophysiologic condition in which the heart is unable to generate adequate cardiac output, resulting in an inadequate perfusion of tissues or an increased diastolic filling pressure of the left ventricle, or both
Systolic heart failure
• Inability of the heart to generate adequate cardiac output to perfuse tissues
Clinical manifestations
• Dyspnea, orthopnea, cough of frothy sputum
• Fatigue
• Decreased urine output and edema
diastolic heart failure
8• Heart failure with preserved ejection fraction
• Decreased compliance of the left ventricle and abnormal diastolic relaxation (lusitropy)
• Clinical manifestations: dyspnea on exertion and fatigue
cardiac output
depends on the heart rate and stroke volume•
stroke volume
contractility
preload and
afterload
increased Preload
increased when decreased contractility or excess plasma volume is present
increased Afterload
Increased afterload is most commonly from increased peripheral vascular resistance
right heart failure
• Is the inability of the right ventricle to provide adequate blood flow into the pulmonary circulation
Clinical manifestations
• Jugular venous distension, peripheral edema, hepatosplenomegaly
High output failure
• Is the inability of the heart to supply the body with bloodborne nutrients, despite adequate blood volume and normal or elevated myocardial contractility
Common causes
• Anemia, septicemia, hyperthyroidism, and beriberi
Infective Endocarditis
• Inflammation of the endocardium from infectious agents
• Most common: bacteria, especially streptococci, staphylococci, and enterococci
Clinical manifestations
• Fever
• New cardiac murmur
• Petechia
• Osler nodes/ Janeway lesions
Weight loss, back pain, night sweats, heart failure, emboli
Myocardial Infarction
• Prolonged ischemia causes irreversible damage to the heart muscle (myocyte necrosis).
o Subendocardial infarction
o Transmural infarction
clinical manifestations
Sudden severe chest pain ECG changes Troponin I: most specific (CPK-MB), LDH Hyperglycemia
Myocardial Ischemia
• Develops if the supply of coronary blood cannot meet the demand of the myocardium for oxygen and nutrients
stable angina
causes predictable chest pain
prinzmetal angina (varient)
causes unpredictable chest pain
Angina pectoris
causes transient substernal chest discomfort
