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Human Pathophysiology > Cardiovascular diseases > Flashcards

Cardiovascular diseases Flashcards

1
Q

How do you calculate mean arterial blood pressure?

A

CO* Peripheral resistance

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2
Q

What are 2 causes of increased blood pressure?

A
  • Increased CO (HR X SV)

- Increased peripheral resistance (reduced vessel diameter and increased viscosity)

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3
Q

What is peripheral resistance?

A

Opposition to flow that blood encounters in vessels away from the heart

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4
Q

What are 2 variables that effect resistance?

A
  • Blood viscosity

- Vessel radius (most powerful)

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5
Q

What elevates blood viscosity?

A

-RBC count and albumin concentration

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6
Q

What are the two types of baroreceptors?

A

Arterial (HP) baroreceptors
-located in carotid sinus + aortic arch (fast response)

Low pressure baroreceptors
-walls of major veins + right atrium (slower response)

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7
Q

What do LP baroreceptors do?

A
  • Detect a blood volume decrease
  • Cause afferent signals to be sent to hypothalamus
  • ADH is released (water reabsorbed)
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8
Q

What does the stretching of atrial receptors (volume increase) do?

A

Increases secretion of atrial natriuretic peptide (ANP) which promotes increased water and sodium excretion via urine

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9
Q

What does the bainbridge reflex do?

A

Cause an increase in the heart rate (decreases pressure in S + I venae cavae)

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10
Q

How do the kidneys respond to low pressure baroreceptors

A

-Secreting excess salt and water via urination

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11
Q

What happens if the GFR falls

A
  • Macula relaxes
  • Macula densa stimulates JG cells
  • Blood flow increases
  • Release of renin from juxtaglomerular cells
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12
Q

What happens if the GFR rises

A
  • More NaCl is reabsorbed
  • Reduced paracrine stimulation of JG cells
  • JG contract (reduce GFR)
  • Mesangial cells contract
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13
Q

What happens when the pressure is rising during systole + decreasing during diastole?

A

Frequency of afferent impulses increases

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14
Q

Where is the cardiovascular centre located?

A

In the medulla of the brainstem

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15
Q

What are the 2 components of the cardiovascular centre and what do they do?

A
  • Cardiostimulatory: make the heart beat faster and stronger
  • Cardioinhibitory: slow the heart down
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16
Q

What is the vasomotor center?

A

Cluster of sympathetic neurons in medulla (oversee changes in blood vessel diameter)

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17
Q

What is primary hypertension?

A

95% of all hypertension

-Combined systolic + diastolic

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18
Q

What is secondary hypertension?

A

Usually from kidney disease, adrenocrotical disorders, primary aldosteronism, pheochromocytoma, renal artery stenosis & coarctation of the aorta

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19
Q

What are some risk factors for primary hypertension?

A

-Obesity, genetics, aging, hyperlipidemia, sleep apnoea, smoking, increased blood viscosity

20
Q

What causes secondary hypertension?

A

Systemic disease that raises peripheral resistance

21
Q

What is malignant hypertension?

A

Intense spam of arteries e.g cerebral arteries, retinal vessels (swelling of optic nerve)
-Sudden development of extremely high blood pressure

22
Q

What are modifiable risk factors for hypertension

A
  • Diet
  • Obesity
  • Smoking
  • Oral contraceptives
23
Q

What are some treatments for hypertension?

A

Diuretics, ACE inhibitors, Ca channel blockers, beta blockers

24
Q

What is atherosclerosis?

A

Progressive disease characterised by thickening and hardening of arteries caused by formation of fibrofatty plaques

25
Q

What is the difference between stable and unstable plaques?

A

-Stable do not form clots / emboli + only partially block vessels + have thick fibrous caps (unstable = opposite)

26
Q

What can initially trigger the plaques (6)?

A
  • Hypertension
  • Diabetes
  • Turbulent blood flow
  • Smoking (nicotine)
  • Infection
  • High cholesterol + LDL
27
Q

What is stable angina?

A

Predictable pattern of intermittent angina during exercise/ excitement (relived by rest)

28
Q

What is variant / prinzmetal angina?

A

unpredictable course, frequency + duration of pain at rest

29
Q

What is silent ischemia?

A

No pain w/ ischemic event

-High association with mental stress

30
Q

What is unstable angina?

A

Myocardial ischemia ranging between stable angina to myocardial infarction

31
Q

What are the 5 common diagnostic techniques?

A
  • Electrocardiogram
  • Exercise stress test
  • Coronary angiogram
  • Holter monitor
  • Serum markers
32
Q

What medication can be used to control blood pressure, heart rate, contractility & left ventricular volume (7)?

A
  • Nitrates (vasodilator)
  • Beta blocker (reduce sympathetic tone)
  • Angiotensin converting enzyme inhibitors (ACEI) (prevent formation of angiotensin II)
  • Calcium channel blockers (reduce contractile force of heart)
  • Angiotensin II receptor antagonists (reduce effects of angiotensin II)
  • Statins (lipid lowering agents)
  • Antiplatelet agents (asprin, sulfinpyrazone, dipyridamole)
33
Q

What are two surgical treatments for heart conditions?

A
  • Stent insertion

- By-pass graft

34
Q

What is heart failure?

A

Inability of the heart to pump blood at a sufficient rate to meet the metabolic demands of the body

35
Q

What is the difference between left and right heart failure?

A
  • Left = congestive heart failure (cant pump oxygenated blood into A circulation) e.g. pulmonary edema
  • Right = inability of heart to pump blood through P circulation e.g. systemic oedema
36
Q

What are some events that can weaken the heart (leading to failure?)

A
  • Coronary artery disease
  • Heart attack
  • High blood pressure
  • Infections
  • Heart valve abnormalities
  • Heart muscle diseases
  • Heart inflammation
37
Q

What is the early phase of remodelling characterised by?

A

Thinning and elongation of the fibrous scar within the infarcted zone

38
Q

How does the heart respond to stress

A
  • Concentric hypertrophy (Increased LV wall thickness)
  • Eccentric hypertrophy
  • Efficiency of muscle is reduced leading to reduced cardiac output
39
Q

What does concentric hypertrophy from pressure overload lead to?

A

Wall thickening

40
Q

What does eccentric hypertrophy from volume overload lead to?

A

Chamber enlargement

41
Q

What is right heart failure?

A
  • Result of left heart failure (sometimes in result of lung disease)
  • Damming back of blood occurs leading to accumulation in systemic circulation
  • Peripheral edema
  • Enlarged liver
42
Q

What are causes of left heart failure?

A
  • Myocardial infarction,
  • Cardiomyopathies
  • Valvular defects
43
Q

What are the 4 classes of heart failure?

A
    1. disease but no limitation in activity
      1. disease w/ slight limitations (normal activity = fatigue, dyspnea, palpitations, angina)
      2. disease w/ marked limitations of physical activity
      3. disease w/ inability to carry on physical activity
44
Q

What is atrial fibrillation?

A

Irregular, chaotic beating of the UPPER chambers of the heart

45
Q

Where does the electrical activity start during an atrial flutter?

A

-Large ‘re-entrant’ circuit

46
Q

What are treatments for atrial fibrillation + flutter?

A
  • Medicine to reduce stroke
  • Medicine to control fibrillation
  • Cardioversion (electric)
  • Catheter ablation (uses energy to remove small areas of heart tissue)
  • Pacemaker

Human Pathophysiology (6 decks)

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