Cardiovascular System Flashcards
Tetralogy of fallout
Congenital heart disease.
Most common cyanotic congenital heart defect is 50-70%.
Cause unclear.
Associated chromosome 22 deletion.
4 heart abnormalities:
- Stenosis of the right ventricular outflow tract
- Right ventricular hypertrophy (boot-shaped heart on x-ray)
- Ventricular septal defect (shunting of blood between the ventricles going from the right ventricle to the left ventricle and then through the aorta)
dextroposed aorta overriding pulmonic stenosis, RV hypertrophy
Babies:
Cyanosis
Clubbing in fingers and toes
Feeding difficulty
Failure to gain weight
What are the phases of the heart?
Atrial Systole
Ventricular Systole
Atrial and Ventricular Diastole
LUB-DUB
Atrioventricular valves closing
Mitral valve and tricuspid valve
Semilunar valves closing
Bacterial endocarditis
Streptococcus gallolyticus Staph aureus Heart valve dysfunction in 85% of patients. This may lead to congestive heart failure in 30-40% of patients Symptoms: - chest pain when you breath - fatigue - fever - chills - night sweats - fast heart rate - SOB
Rheumatic heart disease
secondary myocarditis
children following group A hemolytic strep infection
autoimmune, Aschoff bodies, endocarditis esp left valves
mitral stenosis, migratory polyarthritis
Mitral valve prolapse
Most common valve disease
Valve leaflets prolapse into atria during systole.
Calcific aortic stenosis
Aortic semilunar valve becomes calcified creating decreased aortic flow and increased left ventricular pressure
Most commonly due to calcification of a congenital bicuspid (instead of tricuspid) aortic valve
Ischemic heart disease
Reduced coronary flow due to atherosclerotic narrowing of coronary vessels and or thrombosis
Also maybe due to coronary artery spasm
Cause: angina pectoris, sudden cardiac death
COmplications: LCHF, arrhythmias, MI
Infectious Myocarditis
Inflammation of the muscle of the heart
Myo = muscle
cardiac = heart
itis = inflammation
Can lead to heart failure as the contractility of the heart decreases due to inflammation
Viral infections:
- due to coxsackie B is the main cause of myocarditis
- due to trypanosomacruzi - chagas disease
- trichinella - roundworm that moves from intestines to parts of the body. It causes myocarditis
- Lyme disease
Non-infectious myocarditis
SLE (lupus) Polymyositis Drug associated giant-cell Symptoms: - chest pain depending on the position - Arrythimias - Fatigue - Fever - SOB In severe cases, heart failure can occur
What is the main cause of B1 deficiency?
Alcoholism
Just know
The internal carotid arteries do not “feed” any tissue until they get to the brain
The external carotid feds the face
Organs that get direct branching from the aorta
Lungs through the bronchioarteries
Adrenals from the super renal arteries
Gonads from the gonadal arteries
Just know
Most abdominal drainage of venous blood is going to go through the liver (portal vein) with the exception of gonadal veins and the renal veins.
Thromboangitis Obliterans/Buerger’s disease
thrombo = clot -angitis = inflammation of arteries obliterans = blockage Men > women Heavy smokers Inflammation of arteries of extremities. Gangrene = death of tissue due to lack of blood supply. Nodular phlebitis Instep claudication
Claudication
Claudication is a pain in the legs or arms that comes on with walking or using the arms.
Gangrene
Gangrene is a serious condition where a loss of blood supply causes body tissue to die. It can affect any part of the body but typically starts in the toes, feet, fingers, and hands.
Nodular phlebitis
Serious complication.
It is an inflammatory condition.
There is always a clot or thrombus in the superficial vein.
6-40% will have a DVT
Up to 1/3 will have a pulmonary embolism (clot on the lungs) as the emboli might travel to the lungs.
Nearly always occurs in the legs.
Painful, tender, movement makes it worse, there is usually a lump.
Usually occurs in the great saphenous vein.
Diagnosed with ultrasound.
Raynauds Phenomenon
Vasoconstriction of arteries near the skin.
Color changes in fingers and toes
Sometimes affects nose, ears, and lips
Numbness, tingling, pain
The fingers turn white then blue then red due to cold weather.
Reynaud’s disease
primary Raynaud phenomenon Affects fingers and toes symmetrically Severity stays constant Arteries remain undamaged Common triggers: Stress, cold temperatures, nicotine, caffeine, medications that affect the sympathetic nervous system
Reynaud’s syndrome
secondary Raynaud phenomenon
Affects fingers and toes asymmetrically
Hypothalamus
Body’s thermostat
Aneurysms
Abnormal bulge in vessel due to weakening of the walls of blood vessels.
Usually affects arteries instead of veins due to higher pressure.
1.5x bigger than usual
Usually occur in the area of the aorta (abdominal 60% and thoracic 40%) where BP is higher.
Secondary to atherosclerosis, vasculitis, smoking, congenital.
Lower back pain
Men > women
>60
Marfan syndrome
A congenital disease that affects connective tissue
Symptoms:
- Back pain
- Blurred vision
- Bulging or sunken chest
- Fatigue, scoliosis small pupils, stretch marks
Aortic dissection
Lumen of aorta dissects due to pressure and loss of patency.
It creates a false lumen
Takes on a double-barrel shape
Part of the tunica intima is torn.
Causes:
- Hypertension, increase in volume.
Secondary to Marfan’s syndrome, Ehlers-Danlos syndrome, aneurysm
Emergency - can lead to hypotension
Arteriosclerosis
thickening and loss of elasticity
Arterio = artery
Sclerosis = hardening
Irritants (chemicals) or high BP causes damage to endothelial cells.
Certain proteins come inside and deposit themselves inside the tunica media.
Monocytes follow them and eat them but they die from too much eating.
They release cytokines bringing other cells in which in turn will also die and stay deposited in there…
Atherosclerosis
Formation of an atheromatous plaque
… this causes a lesion called fatty streak which is thrombogenic.
Platelets release platelet-derived growth factors encouraging smooth muscle growth.
Arteriolosclerosis
hardening of arterioles
olo = arterioles
Vasculitides
a group of disorders that cause vasculitis, which is inflammation in the walls of the blood vessels.
Since blood vessels pass through organs - vasculitis damages those organs and mimics a variety of diseases.
There are usually systemic symptoms like fever, fatigue, joint pain, and weight loss; as well as organ-specific symptoms that may literally involve any organ.
Erythrocyte sedimentation rate (ESR or sed rate)
a test that indirectly measures the degree of inflammation present in the body. The test actually measures the rate of fall (sedimentation) of erythrocytes (red blood cells) in a sample of blood that has been placed into a tall, thin, vertical tube.
Giant cell arteritis - most common vasculitis in individuals over the age of 50
Polyarteritis nodosa
individuals with hepatitis B/C. Multi-system disease Can occur anywhere in the body. in the skin, it can cause livedo reticularis and palpable purpura. Numbness, pain, burning, muscle weakness
Giant cell arteritis
or
Temporal Arteritis
inflammatory artery disease
Vessel giant cell inflammation of blood vessels going to the temporal artery (portion of external carotid artery).
50% of patients have vision loss
Thrombus vs emboli
Thrombus - Any coagulum inside the vessel. Clotted blood
Emboli - Anything in the blood that shouldn’t be there
Kaposi’s sarcoma
caused by Human Herpesvirus 8 Mostly seen in patients with HIV. 1 of 7 oncoviruses Risk factors: - Immunocompromised - Organ transplant - Immunosuppressive meds
Latent phase vs lytic phase
In the latent stage of the virus life cycle, a limited number of viral gene products are expressed. In contrast, a large number of proteins are expressed during lytic cycle replication.
Hemangioma
Capillary and cavernous types
Capillary type is benign.
Cavernous type is typically found on the skin of the head and neck, and are larger/ If associated with Lindau von Hipple disease = large hemangiomas of brain/eye and internal organs.
Where does the largest decrease in pressure occur?
Across the arterioles, because they are the site of highest resistance.
Hypertension
BP over 140/90 in anyone over 18 years of age.
120/80-139/89 considered pre-hypertension.
Most are asymptomatic
Need three readings to diagnose
Divided into essential and secondary
Essential hypertention
95% of cases
Mainly lifestyle causes
Leads to increased stroke and CHF, renal fibrosis, and coronary artery disease.
Secondary hypertension
5% of the cases
Secondary to renal/adrenal/thyroid/toxemia/aortic/CNS disease, also cocaine, descongestant, and ETOH abuse/use
