Cardiovascular Pathophysiology

Question 1

What is cardiac failure?

Answer 1

Complex clinical syndrome of signs/symptoms where failure to transport blood out of heart, where blood isn’t delivered to meet metabolic demand

Question 2

What are the 2 broad categories of heart failure

Answer 2

1) Systolic: Ability to pump blood around the body is impaired
2) Diastolic: Heart relaxes and fills abnormally

Question 3

What are the 5 main causes of heart failure?

Answer 3

1) IHD
2) Hypertension
3) Cardiomyopathy
4) Excessive alcohol
5) Obesity

Question 4

What is the PP of heart failure?

Answer 4

Heart fails, compensatory mechanisms attempt to maintain CO. As HF progresses, mechanisms are exhausted and become pathophysiological

Question 5

What are the 5 compensatory mechanisms in HF?

Answer 5

1) Sympathetic system
2) RAAS
3) Natriuretic peptides
4) Ventricular dilation
5) Ventricular hypertrophy

Question 6

How does the sympathetic system compensate in heart failure and what is a disadvantage of it?

Answer 6

Improves ventricular function by ^ HR and contractility so CO is maintained
- DA: Arteriolar constriction which increases afterload and myocardial work

Question 7

How can foetal developmental problems lead to heart failure?

Answer 7

1) Misplaced structures

2) Arrest of progression

Question 8

How does reperfusion cause tissue damage?

Answer 8

Injury to tissue due to haemorrhage and oxygen to injury site from free radicals

Question 9

Define pericarditis

Answer 9

Delayed pericarditic inflammatory reaction following infection

Question 10

Outline what an aneurysm is

Answer 10

Dilation of myocyte wall leading to fibrosis and myocyte atrophy –> Blood stasis and thrombosis –> Embolism

Question 11

What is cardiomyopathy and the 3 main types?

Answer 11

Disease of myocardium with contractile dysfunction

1) Hypertrophic (HCM)
2) Dilated (DCM)
3) Arrhythmogenic right/left ventricular (ARVC/ALVC)

Question 12

What is the PP of each type of cardiomyopathy?

Answer 12

1) HCM: Diastole affected, with unable to relax from thickening of ventricular walls
2) DCM: Ventricular dilation and dysfunction –> Poor contractility
3) ARVC/ALVC: Desmosomes attach cells via IF, mutation causes myocytes to be pulled apart and ventricles replaced by fatty fibrous tissue (Gap junctions also affected)

Question 13

What is restrictive cardiomyopathy?

Answer 13

Poor dilation of heart restricting diastole

Caused by amyloidosis

Question 14

What is the commonest cardiac tumour?

Answer 14

Myxoma –> Valve obstruction, embolism and disarrythmia

Question 15

What is vasculitis?

Answer 15

Immune system vessel inflammation -> Deposition of Immune cells so attack vessels compromising immunity

Question 16

What is giant cell arteritis?

Answer 16

Common type of vasculitis: Localised, chronic and granulomatous inflammation of temporal arteries

Question 17

What are the signs of giant cell arteritis?

Answer 17

1) Thickened/Palpable blood vessels
2) Evidence of granulomatous inflammation
(Can cause blindness)