Chapter 11: Cardiovascular Function in Pathological Situations

Question 1

List 4 substances implicated in causing vasodilation and vascular leakage during anaphylaxis.

Answer 1

histamine
prostaglandins
bradykinin
leukotrienes

Question 2

How do endotoxins cause distributive shock?

Answer 2

lipopolysacchardies –> formes inducible nitric oxide synthase in the endothelium, macrophages, and vascular smooth muscles

Question 3

Name 7 compensatory mechanisms taking place in circulatory shock.

Answer 3

• rapid shallow breathing –> increased venous return and CO (respiratory pump)
• sympathetic tone increases and parasympathetic decreases
• RAAS activated
• Vasopressin release
• increaesd epinephrine release by adrenal medulla
• reduced capillary hydrostatic pressure increases reabsorption of fluid
• increased glycogenolysis in the liver –> hyperglycemia –> osmotic pull through capillaries, more volume reabsorption

Question 4

What is Takotsubo cardiomyopathy?

Answer 4

stress-induced transiet weakening of the ventricular myocardium

Question 5

Explain how the cardiac and venous function curves change with heart failure

Answer 5

Question 6

By definition systolic heart failure means the ejection fraction is less than XXXX?

Answer 6

40%

Question 7

Explain how the pressure volume loop changes with systolic heart failure

Answer 7

the end-diastolic volume should be the same, but the end-systolic volume drops –> decreases SV

end-systolic pressure volume relationship (slow) gets flatter

eventually whole loop moves to the right due to volume retention

Question 8

Explain how the pressure volume loop changes with diastolic heart failure

Answer 8

less end-diastolic volume and diastolic slope is steeper (less compliant so more pressure increase for a given volume increase)

Question 9

What is cor pulmonale?

Answer 9

usually caused by pulmonary hypertension - right heart failure