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Pathophysiology > Cardiovascular Heart > Flashcards

Cardiovascular Heart Flashcards

1
Q

what are the 4 major coronary arteries

A
  • right coronary artery
  • left main coronary
  • left anterior descending
  • left circumflex artery
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2
Q

what 2 arteries are considered the “widow makers”

A
  • left main coronary
  • left anterior descending
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3
Q

formula for cardiac output

A

HR x SV = CO

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4
Q

what is normal stroke volume

A

60-100ml / beat

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5
Q

what is normal heart rate

A

70

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6
Q

what is normal Cardiac output

A

4.2-7 L

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7
Q

ejection fraction

A

amount of blood pumped out of the ventricle divided by the total amount of blood in the ventricle

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8
Q

what is normal ejection fraction

A

62%

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9
Q

frank starling law

A

the stroke volume out ot the left ventricle will increase as the left ventricular volume increases due to the myocyte stretch causing a more forceful contraction

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10
Q

heart failure effect on frank starling law

A
  • decreases contractibility
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11
Q

excersize effect on frank starling law

A
  • increases contractibility
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12
Q

preload

A

stretching of the cardiac muscle at end diastole right before contration

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13
Q

decrease in preload effect on cardiac output

A

decreases cardiac output

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14
Q

afterload

A

the pressure that the heat must work against to eject blood during systole (ventricular contraction)

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15
Q

high afterload effect on CO

A

decreases CO

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16
Q

change in the S-T segment indicates

A

damage to the heart

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17
Q

ST segment depression indivates

A

ischemia
- cells are low on oxygen

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18
Q

ST segemnt elevation indicates

A

infraction
- calls are without oxygen (within 20 mins there will be irreversible damage)

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19
Q

Coronary artery disease modifiable risk factors

A
  • dyslipidemia
  • hypertension
  • cigarette smoking
  • diabetes melitus
  • obestiry
  • sedentary lifestyle
  • atherogenic diet
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20
Q

coronary artery disease non-modifiable risk factors

A
  • age
  • gender
  • family history
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21
Q

myocardial Ischemia causes

A
  • stable angina
  • prinzmetal angina
  • silent ischemia
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22
Q

stable angina

A
  • chronic coronary obstruction
  • gradual narrowing
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23
Q

Prinzmental angina

A
  • caused by spasm
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24
Q

Slient ischmia

A
  • can be caused from mental stress (induced ischemia)
    -can be asymptomatic (1/3)
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25
Q

stable angina is activated by

A

physical exertion or stress

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26
Q

stable angina symptoms

A

substernal chest discomfort
- sensation of heaviness or pressure
- may radiate to neck, lower jaw, left arm and shoulder
Pallor, diaphoresis, dyspnea

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27
Q

stable angina symptoms in women

A

atypical chest pain

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28
Q

most women with stable angina do not have CAD they have

A

microvascular angina
- vasoconstriction of small coronary arteries

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29
Q

stable angina risk factors

A
  • uncontrolled diabetes , dyslipidemia, diabetes
  • hypertension
  • increased LDL; decreased HDL
  • sedentry lifestyle
  • high BMI
  • genetics
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30
Q

prinzmental angina is also called

A

variant angina

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31
Q

prinzmetal angina

A
  • unstable, unpredictable, can occur at rest
  • vasospasm of coronary artieries with or without atherosclerosis
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32
Q

prinzmental angina occurs

A
  • often at rest
  • at night between midnight and 6am
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33
Q

prinzmetal agnia results from

A
  • decreased vagal activity (facilitates adaptive responses)
  • hyperactivity of the SNS
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34
Q

prinzmetal angina causes

A
  • cocaine use in younger populations
  • other blood vessel issue
  • migraines
  • raynaulds disease
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35
Q

prinzmetal angina is usually a _______ condition

A

benign

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36
Q

prinzmetal angina can cause

A

dysthrythmias

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37
Q

Silent ischemia symptoms

A
  • fatigue, dyspnea, feelings of unease
  • asymptomatic
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38
Q

stable angina causes

A
  • diabetes mellitus
  • surgical denervation during CABG
  • cardiac transplant
  • Previous MI (local nerve injury)
  • mental stress
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39
Q

How to evaluate silent ischemia

A

transient ST segment changes

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40
Q

People who experience chest pain related to angina and MI often beleive that the pain is

A

Indigestion

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41
Q

how to rule out if chest pain is indigestion

A

take ant-acid to rules out

42
Q

signs and symptoms of angina and MI in men

A

typical symptoms
- sensation of haviness or pressure, may radiate to neck, lower jaw, left arm and shoulder

43
Q

signs and symptoms of angina and MI in women

A

atypical symptoms
- palpations, anxiety, and fatigue, right side chest pain

44
Q

what is the leading cause of death amongst Canadian women

A

Heart disease and stoke

45
Q

Acute coronary syndrome process

A
  1. stable angina
  2. unstable angina
  3. NSTEMI
  4. STEMI
46
Q

nSTEMI

A
  • damage is limited to the myocardium directly below the edocardium
  • ST wave depression and T wave inversion
47
Q

nSTEMI manifestations on ECG

A
  • ST wave depression and T wave inversion
48
Q

STEMI

A
  • damage extends from the edocardium to the epicardium
  • serious risk for complications
49
Q

STEMI manifestations on ECG

A
  • presents with ST elevation
50
Q

how long can cardiac cells withstand ischemic conditions before hypoxic injury occurs

A

20 mins

51
Q

Mi involves the left ventricle

A

-pulmonary venous congestion

52
Q

MI invloves the right ventricle

A
  • increase in system venous pressure
53
Q

myocardial infraction diagnosis

A

history exam, ECG results and increased troponin levels

54
Q

when should troponin levels be drawn after an MI

A
  • immediately
  • 6, 12, 24 hours after initial event (can be delayed)
55
Q

valve disfunction

A

stenosis or regurgitation of all your heart valves

56
Q

stenosis

A
  • valve doesnt open fully so it is hard to get blood past
57
Q

regurgitation

A
  • valve doesnt close properly so blood will leak back into the chamber it has just left
58
Q

what is the most common disorder of the heart valves

A

aortic stenosis

59
Q

aortic stenosis

A
  • most common disorder of the heart valves
  • valve between left ventricle and aorta
60
Q

mitral stenosis

A
  • valve between left atria and left ventricle
61
Q

mitral stenosis is most common in

A

rheumatic heart disease

62
Q

aortic or mitral regurgitation

A
  • inability of aortic valve to close properly or prolapse of mitral valve
63
Q

aortic or mitral regiritation is a result fo

A

chronic hypertension, rheumatic heart disease, bacterial endocarditis

64
Q

heart failure

A

unable to generate an adequate cardiac output

65
Q

heart failure causes

A

dysfunction of the left ventricle

66
Q

right side heart failure is related to

A

pulmonary disease
- pleural effusion, pneumothorax putting pressure on the heart

67
Q

heart failure risk factors

A

ischemic heart disease and hypertension
- age, obesity, diabetes, renal failure, valvular heart disease, cardiomyopathies, myocarditis, congenital heart disease, excessive alcohol disease

68
Q

left sided heart failure signs and symptoms

A

restlessness, confusion, orthopnea, tachycardia, exertional dyspnea, fatigue, cyanosis, pulmonary congestion (cough, crackles, wheezes, blood-tinged sputum, tachypnea), elevated pulmonary capillary wedge pressure, pulmonary nocturnal dyspnea

69
Q

left sided heart failure is

A

decreased ejection fraction

70
Q

ejection fraction <40%

A

inability for the heart to perfuse tissues

71
Q

when can contractibility be decreased

A

in MI, myocarditis, cardimyopathies

72
Q

right sided heart failure can be caused by

A
  • pulmonary hypertension
  • left ventricular failure
73
Q

right sided heart failure

A

inability to pump blood effectively to the lungs; back up of fluid in the vena cava

74
Q

right sided heart failure signs and symptoms

A
  • fatigue
  • increased peripheral venous pressure
  • ascites
  • enlarged liver and spleen
  • distended jugular veins
  • anorexia and complaints of GI distress
  • weight gain
  • dependent edema
75
Q

cor pulmonale

A
  • enlargement, dilation hypertrophy or failure of the right ventricle
76
Q

right sided heart failure occurs without ventricular failure in

A

COPD, cystic fibrosis, ARDS

77
Q

what is hypovolemic shock

A

insufficient intravascular fluid volume

78
Q

what is cardiogenic shock

A
  • heart failure
79
Q

what is neurogenic shock

A
  • neural alteration of vascular smooth muscle tone
80
Q

what is anaphylactic shock

A

immunological process

81
Q

what is septic shock

A

result of infection

82
Q

what are the 3 types of shock

A
  • hypovolemic
  • cardiogenic
  • distributive (neurogenic, septic, anaphylactic)
83
Q

shock general symptoms

A

feeling unwell, weak, dizziness, confused, thirty, hypotension, decrease in respiratory rate (acidosis), cellular edema, cell death

84
Q

hypovolemic shock results from

A
  • loss of whole blood (hemorrhage)
  • loss of plasma (burns)
  • loss of interstitial fluid (diarrhea, diuresis, diabetes mellitus, diabetes insipidus, emesis)
85
Q

hypovolemic shock effect

A

heart rate increases, sats decrease, cardiac output decreases

86
Q

hypovolemic shock manifestation

A

high SVR, poor skin turgor, PALE, COOL, CLAMMY SKIN, thirst, oliguria, low preload, rapid heart rate, thread pulse, mental status deterioration

87
Q

cardiogenic shock is most often caused by

A

myocardial infraction

88
Q

cardiogenic shock effect

A

heart rate increases, SATs decrease, cardiac output decreases, weak pulse, decreased blood pressure

89
Q

cardiogenic shock is caused by

A

myocardial infraction, congenital heart anomalies, cardiomyopathy, myocarditis, arrhythmias, drug toxicity

90
Q

cardiogenic shock manifestations

A

dyspnea, tachypnea, venous and pulmonary edema, dusky skin color, hypotension, oliguria (scant urine) and ileus (lack of movement in bowel)

91
Q

neurogenic shock effect

A

cardiac output decreases, heart rate decreases, SATs decrease

92
Q

neurogenic shock can be caused by

A
  • trauma to the spinal cord
  • interruption of oxygen to the medulla
  • depressive medication, anesthetic agents, severe emotional stress, pain anf other causes
93
Q

relative hypovolemia

A

inadequate distribution of blood volume between the central and peripheral compartments

94
Q

neurogenic shock

A
  • widespread vasodilation
  • overstimulation of parasympathic
  • understimulation of sympathetic
  • loss of vascular tone = relative hypovolemia
    -blood volume is the same - systemic vascular resistance decreases
95
Q

anaphylactic shock

A
  • widespread hypersensitivity
  • exposure to antigen
  • immune and inflammatory response
  • sudden onset
96
Q

anaphylactic shock effect

A

CO decreases, HR increases, SATs decrease

97
Q

anaphylactic shock symptoms

A

anxiety, dizziness, difficulty breathing, stridor, wheezing pruritus with hives, swollen lips and tongue, abdominal cramping

98
Q

septic shock effect

A

CO normal, heart rate increases SATS increases

99
Q

septic shock risk factors

A

genetics, chronic diseases, immune deficiency state, timeliness of intervention

100
Q

septic shock symptoms

A

tachycardia, tempurature instability, renal dysfunction, clotting abnormalities, decreased mental status

101
Q

septic shock process

A

infection –> bacteremia –> systemic inflammatory response syndrome –> sepsis –> severe sepsis –> septic shock –> MODS

Pathophysiology (22 decks)

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