Cardiovascular Diseases Flashcards
What are common names for Ischemic heart disease?
Coronary artery disease
Atherosclerotic cardiovascular disease
Coronary heart disease
What is pathophysiology?
physiological process associated with the disease or injury
What is the pathophysiology of ischemic heart disease?
limitation of blood flow to the heart causes ischemia (lack of O2)
Results in cell death (myocardial infarction)
Leads to heart muscle damage and muscle death
Leads to myocardial scarring without regeneration
CAD occurs when inside the coronary artery develop atherosclerosis
What is atherosclerosis?
narrowing of coronary arteries which can lead to ischemia, ventricular arrythmia and ventricular fibrillation and death
Artery linings become hardened and swollen with calcium, fat and inflammatory cells (plaque)
What is plaque?
large formations that protrude into the artery casuing partial obstruction
What are some signs and symptoms of ischemic heart disease?
Angina: a cindtiona marked by severe pain in the chest, which spreads to the shoulders, arms, neck and back caused by inadequate blood supply to the heart.
What is the difference between stable and unstable angina?
Stable is chest pain/discomfort that most often occurs with activity and stress
Unstable is unexpected chest pain and usually occurs while resting
What are risk factors of ischemic heart disease?
Smoking, Family history Hypertension Obseity Diabetes Lack of activity stress, High blood lipids
What are blood fats?
Risk with high blood [triglycerides]
Blood cholesterol is composed of LDL and HDL
What is the difference between LDL and HDL?
LDL is a carrier and results in dropping of cholesterol
HDL picks up the dropping and takes them to the liver
How is ischemic heart diseaese diagnosed?
Medical history and complete physical
ECG demonstrates evidence of coronary artery ischemia
Noninvasive exercise treadmill stress test or pharmacological stress test
Coronary angiogrraphy
-injecting dye and x-ray blood flow
What is cerebrovascular disease?
Encompasses all disorders in which an area of the brain is temporarily or permanently affected by ischemia or bleeding
How do restrictions occur in blood flow to the brain?
Vessel narrowing (stenosis)
Clot formation can be caused by plaque (trombosis)
Blockage due to the breaking of thrombosis (embolism)
Blood vessl rupture (hemorrhange)
Restricted blood flow can result in death
Once cells die they cannot regenerate
What is a stroke?
an abrupt intrerruption of constant blood flow to the brain that causes loss of neurological function
Ischemic stroke is caused by interruption of blood flow (80% of all strokes)
What are the two types of ischemic stroke?
Thrombotic and Embolic
Many times the blockage is not complete with a small trickle of blood completely cut off die in 5 minutes
Cells with reduced blood flow can survive about 3 hours
What is a hemorrhage stroke?
More deadly stroke caused by bleeding in the brain
Hypertension casues a rupture iof an aneurysm
What is an aneurysm?
An excessive localized enlargement of an artery caused by a weakening of the artery wall
What are risk factors of cerebrovascular disease?
High BP Smoking Carotid artery disease Diabetes High blood cholesterol Physical inactivity Obesity
What is peripheral vascular disease?
Circulation disorder that affect blood vessels outside the heart and brain
Supplies the arteries and veins that supplies the arms, legs and organs
What are two locations of PVD?
Peripheral arterial disease -most common form of PVD -12-20% of people over 65 have PAD Deep vein thrombosis -PVD in the deep veins
What are the two types of PVD?
1) Functional PVD
2) Organic PVD
What is functional PVD?
Does not involve physical problem Short term restriction due to -emotional stress -smoking -cold -vibrating machines
What is organic PVD?
Arteriosclerosis is primary cause Affects structure of the blood vessel Causes: -Smoking -High BP -Diabetes -High cholesterol
How is PVD diagnosed?
Measure the pulse in legs and ankles
Wooshing sounds is called a bruit = narrowed vessel
Ankle-brachial index
-BP and ultrasound reading
-BP is taken before and after treadmill walk
Angiography
-Catheter inject dye for x-ray
What is heart failure?
Heart is unable to pump sufficient amounts of blood
Congestive heart failure or chronic heart failure
Congestive is used as one to the common symptoms (swelling/H2O retention)
What are common causes of heart failure?
CAD High BP Atrial fibrillation Valvular heart disease Infection
What is left side failure?
Left ventricle responsible for receiving O2 blood from lungs and pumping it to th rest of the body
Failure of the left causes blood to congest in the lungs
Results in respiratory symptoms as well as general fatigue due to reduced oxygenated blood
What right side failure?
Right ventricle reduced function
Congestion of systemic capillaries and fluid accumulation in the body
What are two areas of swelling in rigth side failure?
Peripheral edema: swelling under the skin usually affecting the foot and ankle in people standing
Sacral edema: swelling in the sacral region in people who are lying. Severe liver congestion may result in jaundice and liver dysfunction
What is biventricular failure?
Failure of both sides of the heart
What is the pathophysiology of heart failure?
Causes: anything that reduces the efficiency of heart muscle (SV)
Myocardial infarction, hypertension
Reduced SV as a result of reduced systole, diastole or both
Increased ESV (after ventricle contracts) caused by reduced contractility
Decreased EDV (before ventricular contraction) due to impaired ventricular filling
What is systolic dysfunction
Decreased ejection fraction less than 45% normal
Results in reduced SV (Q)
What is diastolic dysfunction?
Failure of the ventricle to relax and typically denotes a stiffer ventricular wall
Causes reduced filling of the venticle, decreased SV and therefore decreased Q
Results in cardiac remodelling
What is congenital heart disease?
Disease that occurs at birth Blood vessles near the heart don't develop normally before birth present in 1% of live births Most cases no known causes Different conditions -Obstruction of blood flow -septal defects
What are possible causes?
Viral infections
inherited condition
drug/alcohol abuse
What are types of obstruction of blood flow?
Pulmonary stenosis
Tricuspid atresia
Aortic stenosis
Coarctation of the Aorta
What is pulmonary stenosis?
Pulmonary valve becomes narrowed
Right ventricle must work harder to pump blood to lungs
Increased stress results in enlargement of the rightt ventricle
What is tricuspid atresia?
Tricuspid valve does not properly form
No opening between the two chambers
No blood can flow into lungs
What is aortic stenosis?
Aortic valve becomes narrowed
What is coarctation of the aorta?
The aorta becomes narrowed and restricts O2 flow to the rest of the body
What are septal defects?
There is an opening in the septum separating the right and left sides of teh heart
Results in blood flow between the left and right without going to the lungs
Increased stress causes the heart to enlarge
What are teh two forms of septal defects?
Atrial septal defects
Ventricular septal defects
What is an atrial septal defect?
opening exists between the atria
allows deoxygenated blood to flow to the left stream
severity depends on the size of opening
hole present at birht genreallly closes at 1 year
What is ventricular septal defects?
opening between the ventricles
Oxygenated blood pumped to right ventricle
Severity depends on size of opening
What is rheumatic heart disease?
a group do acute and chronic heart disorders that occur as a result of rheumatic fever
What is rheumatic fever?
Starts as strep throat
Inflammatory disease affects many connective tissues in the body
Occurs in children 5-15
About 6% of people with rheumatic fever develop some degree of heart disease
How does rheumatic fever affect the heart?
Every part may be damaged by subsequent inflammation but also most common are heart valves
What is the role of antibiotics in rheumatic fever?
prevent streptoccal
Any child with presistent sore throat should have a throat culture
