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Pathology > Cardiovascular System (Exam 2) > Flashcards

Cardiovascular System (Exam 2) Flashcards

1
Q

What are the most common type of birth defect?

A

congenital heart defects (DECREASED CARDIAC OUTPUT)

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2
Q

What are some risk factors for congenital heart defects?

A

heredity
genetic disorders (DOWN SYNDROME)
fetal substance exposure
maternal health status (obesity, diabetes, etc.)

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3
Q

Name 4 manifestations of congenital heart defects (8 total)

A

• HEART FAILURE
• heart murmurs
• dyspnea
• tachypnea
• cyanosis
• fatigue
• chest pain/discomfort
• difficulty gaining weight

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4
Q

What is pericarditis and what are some possible causes?

A

inflammation of the pericardium by viral infection, thoracic trauma, myocardial infarction, TB, malignancy, and autoimmune disorders

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5
Q

What can pericarditis cause?

A

pericardial effusion

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6
Q

What is pericardial effusion?

A

fluid accumulates in space between pericardial sac and heart, where swollen tissue creates friction

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7
Q

What is cardiac tamponade?

A

life-threatening cardiac compression from fluid accumulation (pleural effusion)

COMPLICATION OF PERICARDITIS

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8
Q

Name 4 manifestations of cardiac tamponade

A

• falling arterial pressures
• rising venous pressures
• narrowing pulse pressure
• muffled heart sounds

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9
Q

What is constrictive pericarditis?

A

loss of elasticity from chronic inflammation

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10
Q

Name 4 manifestations of constrictive pericarditis (7 total)

A

• pericardial friction rub (grating sound)
• sharp, sudden and severe chest pain that increases with DEEP RESPIRATIONS and decreases when SITTING UP/LEANING FORWARD
• dyspnea
• tachycardia
• palpitations
• edema
• flulike symptoms

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11
Q

What is infective endocarditis (bacterial endocarditis) and what is it commonly caused by?

A

infection of the endocardium and heart valves

STREPTOCOCCUS AND STAPHYLOCOCCUS

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12
Q

In infective endocarditis, thrombi form that travel (emboli), causing…?

A

microemboli and microhemorhage

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13
Q

Name 4 manifestations of infective endocarditis (7 total)

A

• flulike symptoms
• embolization (blockage of blood flow)
• new onset heart murmur
• petechiae (small brown spots on skin from bleeding)
• splinter hemorrhages under nails
• hematuria (RBCs in urine)
• oslers nodes
• edema

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14
Q

What are some risk factors regarding infective endocarditis?

A

IV drug use
valvular disorder
prosthetic heart valves/implanted devices
rheumatic heart disease
aortic coarctation
congenital heart defect
Marfan syndrome

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15
Q

Name 3 life threatening complications of infective endocarditis

A

MYOCARDIAL INFARCTION
STROKE
PULMONARY EMBOLISM

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16
Q

What is myocarditis?

A

uncommon and poorly understood inflammation of the myocardium by organisms, blood cells, toxins, and immune systems that damage the muscle

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17
Q

Name 4 complications of infective myocarditis

A

HEART FAILURE
CARDIOMYOPATHY
DYSRHYTHMIAS
THROMBUS FORMATION

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18
Q

Name 6 manifestations of infective myocarditis (12 total)

A

• flulike symptoms
• dyspnea
• dysrhythmia
• palpitations
• tachycardia
• heart murmurs
• chest discomfort
• cardiomegaly
• pale and cool extremities
• syncope
• decreased urine output
• joint pain and swelling

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19
Q

What are valvular disorders and what can they lead to?

A

includes stenosis and regurgitation of one or more heart valves

LEADS TO DISRUPTION OF BLOOD FLOW

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20
Q

What is valve stenosis and what does it do?

A

NARROWING; less blood can flow through the valve

DECREASES CARDIAC OUTPUT, INCREASES WORKLOAD, CAUSES HYPERTROPHY

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21
Q

What is atresia?

A

failure to open valve, MAY ACCOMPANY STENOSIS

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22
Q

What is valve regurgitation and what does it do?

A

INSUFFICIENT CLOSURE; bidirectional blood flow

DECREASES CARDIAC OUTPUT, INCREASES WORKLOAD, CAUSES HYPERTROPHY AND DILATION OF VENTRICLES

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23
Q

What are some causes of valvular disorders?

A

congenital defects
infective endocarditis
rheumatic fever
myocardial infarction
cardiomyopathy
heart failure

MANIFESTATIONS MAY VARY BUT REFLECT CHANGED CARDIAC FLOW

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24
Q

What is cardiomyopathy?

A

acquired or inherited conditions that weaken and enlarge myocardium; disease that makes it harder to pump blood

CAN LEAD TO HEART FAILURE

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25
Q

What are the 3 main types of cardiomyopathy?

A

DILATED
HYPERTROPHIC
RESTRICTIVE

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26
Q

What is dilated cardiomyopathy?

A

MOST COMMON; cardiomegaly and ventricular dilation damage myocardium muscle fibers, causing decreased CO and blood stagnation

RISK HIGHER IN BLACK MEN AND OLDER FOLKS

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27
Q

What are some causes of dilated cardiomyopathy?

A

chemotherapy
alcoholism
cocaine abuse
pregnancy
infection
thyrotoxicosis
diabetes mellitus
neuromuscular disease
hypertension
coronary artery disease
medication hypersensitivity

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28
Q

Name 6 manifestations of dilated cardiomyopathy (11 total)

A

• breathing changes and nonproductive cough
• fatigue
• dysrhythmias, cardiac pain
• dizziness, activity intolerance
• abnormal lung sounds
• peripheral edema
• ascites, hepatomegaly
• weak pedal pulse
• cool/pale extremities
• poor capillary refill
• jugular vein distention

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29
Q

What is hypertrophic cardiomyopathy?

A

ventricle wall becomes stiff and unable to relax; MAINLY AFFECTS SYSTOLIC FUNCTION IN MEN AND SEDENTARY PEOPLE

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30
Q

What are some risk factors for hypertrophic cardiomyopathy?

A

hypertension
obstructive valvular disease
thyroid disease
dominant genes

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31
Q

Name 4 manifestations of hypertrophic cardiomyopathy (8 total)

A

• dyspnea/intolerance on exertion
• fatigue
• syncope
• orthopnea
• angina
• dysrhythmias
• left ventricular failure
• myocardial infarction

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32
Q

What is restrictive cardiomyopathy?

A

rigidity of ventricles affects diastolic function with a poor prognosis

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33
Q

What are some causes of restrictive cardiomyopathy?

A

amyloidosis
hemochromatosis
radiation
connective tissue diseases
myocardial infarction
sarcoidosis
cardiac neoplasms

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34
Q

Name 5 manifestations of restrictive cardiomyopathy (9 total)

A

• fatigue
• breathing and lung changes
• angina
• hepatomegaly
• jugular vein distention
• ascites
• murmurs
• peripheral cyanosis
• pallor

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35
Q

Dysrhythmias affect what 2 things?

A

CARDIAC OUTPUT (CO) AND BP

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36
Q

What are some causes of dysrhythmias?

A

acid-base imbalance
hypoxia
congenital heart defects
connective tissue disorders
degeneration of conductive tissue
drug toxicity
electrolyte imbalance
stress
myocardial hypertrophy
ischemia
infarction

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37
Q

What is preload?

A

volume of blood in ventricles at end of diastole

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38
Q

What are some conditions that have higher preload?

A

HYPERVOLEMIA
REGURGITATION OF HEART VALVES
HEART FAILURE

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39
Q

What is afterload?

A

resistance left ventricle must overcome to circulate blood

HIGHER AFTERLOAD=HIGHER CARDIAC WORKLOAD

40
Q

What are some conditions where afterload is higher?

A

HYPERTENSION
VASOCONSTRICTION

41
Q

What is heart failure (congestive heart failure CHF) caused by?

A

inadequate pumping that leads to decreased CO and increased preload/afterload

CONGENITAL DEFECTS
MYOCARDIAL INFARCTION
VALVULAR DISEASE
DYSRHYTHMIAS
THYROID DISEASE

42
Q

What is systolic dysfunction (heart failure)?

A

decreased contractility; ventricles can’t pump hard enough during systole

43
Q

What is diastolic dysfunction (heart failure)?

A

decreased filling; not enough blood fills ventricles during diastole

44
Q

What is mixed dysfunction (heart failure)?

A

decreased contractility and filling (both systolic and diastolic)

45
Q

Describe left sided heart failure

A

CO falls; blood backs up to pulmonary circulation which causes congestion, dyspnea and activity intolerance

46
Q

What are some causes of left sided heart failure?

A

left ventricular infarction
hypertension
aortic or mitral valve stenosis

47
Q

Describe right sided heart failure

A

blood backs up to peripheral circulation, causing edema and weight gain

48
Q

What are some causes of right sided heart failure?

A

pulmonary disease
left sided failure
pulmonic or tricuspid valve stenosis

49
Q

Regarding heart failure, what do the manifestations depend on?

A

type and severity (graded I-IV) but appear as compensatory mechanisms fail

50
Q

What causes aneurysms?

A

caused by weakening of an artery

51
Q

What are some risk factors of aneurysms?

A

congenital defect
atherosclerosis
hypertension
dyslipidemia
diabetes mellitus
tobacco use
age
trauma
infection

52
Q

True aneurysms affect…

A

all 3 vessel layers

53
Q

What is a saccular aneurysm?

A

bulge on the side (asymmetrical)

54
Q

What is a fusiform aneurysm?

A

affects entire circumference (symmetrical)

55
Q

What is a dissecting aneurysm?

A

occurs in inner layers, NOT TRUE ANEURYSM

56
Q

What are some manifestations of aneurysms?

A

DEPEND ON LOCATION/SIZE; PULSATING MASS, PAIN, RESPIRATORY DIFFICULTY AND NEUROLOGIC ISSUES

57
Q

What is dyslipidemia and what are 3 things that classification is based on?

A

high levels of lipids in the blood, which increases risk for chronic disease

CLASSIFIED BASED ON DENSITY, TRIGLYCERIDES (low density), AND PROTEIN (high density)

58
Q

Low density lipoproteins (LDL’s)

A

bad cholesterol

59
Q

High density lipoproteins (HDL’s)

A

good cholesterol; helps remove LDLs from blood

60
Q

Dyslipidemia is ASYMPTOMATIC UNTIL…

A

it causes other diseases and complications

61
Q

What is atherosclerosis?

A

chronic inflammatory disease triggered by vessel wall injury and characterized by thickening lesions calcifying on arterial wall

LEADS TO PLATELET AGGREGATION AND VASOCONSTRICTION

62
Q

What are some complications of atherosclerosis?

A

peripheral vascular disease
coronary artery disease
thrombi
hypertension
stroke

ASYMPTOMATIC UNTIL COMPLICATIONS DEVELOP

63
Q

What is peripheral vascular disease?

A

narrowing of the peripheral vessels
commonly atherosclerosis in arteries

CAN ALSO BE CAUSED BY THROMBUS, INFLAMMATION OR VASOSPASM

64
Q

What is thromboangitis obliterans (buerger disease)?

A

chronic inflammation of the arteries; may lead to thrombosis and eventual occlusion of small arteries in extremities

MOST COMMON IN MALES 20-40 WHO SMOKE

65
Q

What is Raynaud phenomenon?

A

vasospasms of the arteries r/t sympathetic stimulation, associated with autoimmune conditions like lupus

MOST COMMON IN WOMEN 18-30; MAY LEAD TO ISCHEMIA

66
Q

What is coronary artery disease?

A

narrowing or blockage of the arteries supplies the myocardium, occasionally caused by atherosclerosis (or vasospasm, cardiomyopathy, thrombi occlusion)

obstructive, nonobstructive, coronary microvascular

MOST COMMON HEART DISEASE, LEADING CAUSE OF MYOCARDIAL INFARCTION

67
Q

What are some nonmodifiable risk factors for coronary artery disease?

A

MALES OVER 45 AND WOMEN OVER 55; premature menopause

family history (first degree male relatives)

68
Q

What are some modifiable risk factors for coronary artery disease?

A

tobacco use
obesity
physical inactivity
stress
diabetes mellitus
hyperlipidemia
hypertension

69
Q

What is obstructive CAD?

A

plaque accumulates in large arteries causing narrowing and decreased blood supply to myocardium; artery is occluded by more than 50% and blood flow could become completely occluded

70
Q

What is Nonobstructive CAD?

A

large arteries occluded LESS than 50%; caused by damage to lining of coronary arteries that impact the ability to vasodilate in response to increased myocardial O2 demand

71
Q

What is coronary microvascular disease?

A

arteries don’t respond to signals to vasodilate with increased myocardial O2 demands; affects the smallest arteries of the myocardium

72
Q

What are some causes of coronary microvascular disease?

A

molecular changes in small vessels as you age
damage (inflammation, diabetes, hypertension)

73
Q

What is stable angina?

A

chest pain caused by ischemia that is initiated by increased O2 demand and relieved with decreased demand at rest

74
Q

What is unstable angina?

A

chest pain that becomes unpredictable, occurs at rest or increases in frequency and intensity

PREINFARCTION STATE

75
Q

Name 5 manifestations of coronary artery disease (CAD) (9 total)

A

• angina that may radiate to neck, jaw, arm, or back
• indigestion like sensation
• nausea and vomiting
• cold, clammy extremities
• diaphoresis
• dyspnea
• fatigue
• weakness
• sleep disturbances

76
Q

What is a thrombus?

A

blood clot that forms anywhere in the circulatory system

VENOUS THROMBI MORE COMMON DUE TO LOWER PRESSURE AGAINST GRAVITY

77
Q

What are 3 conditions that promote thrombus formation?

A

endothelial injury
sluggish blood flow
hypercoagulability

78
Q

What is an emboli?

A

portion or all of a thrombus breaks loose, travels to circulatory system and embeds in a smaller vessel

can also be air, fat, bacteria, amniotic fluid, tumor cells, foreign substances

79
Q

Right side of the heart origin for emboli

A

venous circulation that travels first to pulmonary circulation, creating pulmonary embolism

80
Q

Left side of the heart origin for emboli

A

arterial circulation and travel to other organs such as brain or heart, causing infarction

81
Q

What is pulmonary embolism?

A

when thrombus originates elsewhere and disrupts blood flow in the pulmonary artery or its branches

82
Q

What are varicose veins?

A

dilated, engorged veins r/t improper venous valve formation caused by increased venous pressure and blood pooling

CAN CAUSE DECREASED CIRCULATION, VENOUS STASIS ULCERS, AND NECROSIS

83
Q

What are risk factors for varicose veins?

A

genetic predisposition
pregnancy
obesity
prolonged sitting or standing
alcohol use and liver disorders (esophageal varices)
constipation (hemorrhoids)

84
Q

Name 6 manifestations of varicose veins

A

• irregular purplish, bulging veins
• pedal edema
• fatigue
• aching in the legs
• shiny, hairless pigmented skin on legs and feet
• skin ulcers

85
Q

What is lymph edema?

A

unusual swelling in extremities r/t lymph obstruction; unilateral or bilateral

STAGING SYSTEM FOR SEVERITY

86
Q

What are some causes for lymph edema?

A

RARE AND CAUSED BY CONGENITAL ABSENCE OR DECREASE IN NUMBER OF LYMPHATICS
surgical removal (mastectomy)
scarring by radiation
occlusion related to tumors
obstruction related to infection
injury/trauma

87
Q

Name 4 manifestations of lymphedema

A

• edema and skin changes
• hyperpigmentation
• ulceration
• “elephant skin”

88
Q

What is a myocardial infarction (acute coronary syndrome)?

A

HEART ATTACK

death of the myocardium from sudden blockage of coronary blood flow, cannot meet body’s O2 demand, cells die leading to necrosis

ineffective tissue perfusion r/t ATHEROSCLEROSIS, THROMBUS, VASOSPASM

89
Q

What are some risk factors for myocardial infarction?

A

dyslipidemia
diabetes mellitus
hypertension
stress
tobacco use

90
Q

Name 6 manifestations of myocardial infarction (12 total)

A

• unstable angina
• fatigue
• nausea and vomiting
• coughing, shortness of breath
• diaphoresis
• indigestion
• elevation in cardiac biomarkers
• dysrhythmias
• anxiety
• syncope
• dizziness
• sleep disturbance

91
Q

Hypertension creates…

A

excessive cardiac workload due to vasoconstriction, INCREASING AFTERLOAD

decreased renal blood flow activates renin-angiotensin-aldosterone system (RAAS)

ONE OF THE MOST PREVALENT CONDITIONS IN THE US

92
Q

What are some risk factors for hypertension?

A

age
ethnicity (AA)
history
weight
inactivity
tobacco use
high sodium diet
low K, Ca, Mg diet
high vitamin D intake
alcohol
stress

93
Q

Primary hypertension

A

MOST COMMON (95% of adult cases), DEVELOPS GRADUALLY OVER TIME WITH NO IDENTIFIABLE CAUSE

94
Q

Secondary hypertension

A

more sudden and severe

caused by: renal disease, diabetes, adrenal gland tumors, certain meds, illicit drug use (cocaine,etc.)

95
Q

Pregnancy-induced hypertension

A

preeclampsia that may lead to eclampsia (seizures)

96
Q

Malignant hypertension (hypertensive crisis)

A

INTENSE AND NONRESPONSIVE TO INTERVENTIONS

BP AT LEAST 180/120 AND SYMPTOMATIC

Pathology (10 decks)

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