Chapter-18 Cardiovascular Flashcards by Jennifer Smith

Blockage of right coronary artery is more likely to cause

Arrhythmias

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Right coronary artery supplies blood to the

SA and AV nodes

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Left coronary supplies

Left ventricle

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A blockage of left coronary may impair

Pumping capability and cause congestive heart failure

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The four types of coronary heart disease are

Arteriosclerosis
Atherosclerosis
Angina pectoris
Myocardial infarction

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Arteriosclerosis is a general term for

All types of degenerative arterial changes

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Changes usually occur where

In small arteries and arterioles

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What happens to the arteries and arterioles in arteriosclerosis

Elasticity is lost, walls become thick and hard, lumen narrows, and it becomes occluded

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Insufficient O2 ensues during arteriosclerosis and leads to

Ischemia, necrosis in the brain, kidneys, heart and other tissues

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Atherosclerosis is different from arteriosclerosis in that

Atheromas or plaques are formed

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The plaques consist of

Lipids
Cells
Fibrin
Cell debris

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Atherosclerosis forms where

Primarily in large arteries

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LDL is

Bad cholesterol

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LDL transports liver from

The liver to the cells

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LDL binds to

Receptors on cell membranes and enters cell

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HDL is

Good cholesterol

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HDL transports cholesterol

Away from cells to liver where it is catabolized and excreted

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The major factor in a thermos formation is

LDL bad cholesterol

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Non-modifiable risk factors of atherosclerosis (3)

Age (after 40)
Gender (men, women after menopause)
Genetic

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Modifiable risk factors for atherosclerosis

Obesity
Smoking
Sedentary lifestyle 
Hypertension
Diabetes
Oral contraceptive with smoking

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Why is smoking a risk factor for atherosclerosis

It promotes platelets to adhere, clot formation, and vasoconstriction

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Angina pectoris is

Chest pain

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Angina pectoris occurs due to

Lack of oxygen in heart muscle, usually when demand is sudden

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Chest pain can be due to

Impairment, exertion, or a combination

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During angina heart usually adapts to oxygen need by

Vasodilation of coronary arteries | autoregulation

If there is arterial damage causing angina then

Blood supply is decreased

Three patterns of angina are

Classic Variant Unstable

Classic angina occurs

Upon exertion

Variant angina occurs

At rest due to vasospasms

Unstable angina occurs

With prolonged pain at rest, more serious.

Causes of angina pectoris are

Atherosclerosis, arteriosclerosis, and vasospasms.

Angina pectoris pain is described as

Tightness or pressure which may radiate to neck and left arm

What is the primary cause of death in American men and women

Myocardial infractions

After first MI there is greater risk for

A second MI, CHF or stroke

MI occurs when

There is prolonged ischemia to heart muscle which leads to cell death or infarction

Most common cause of MI is

Atherosclerosis, usually with thrombus

Three ways infarction develops

Thrombus Vasospasm Embolism

Most infractions are

Transmural and occur in left ventricle

Warning signs of MI

Pressure, shortness of breath, sweating, fatigue, nausea, indigestion, anxiety, fear

Signature sign of MI isolated

Sudden substernal pain radiating to left arm and neck that is severe, steady and crushing with no relief upon rest or vasodilators

MI sign in women is

Milder more like indigestion, or silent

Other MI sign/symptoms are

``` Pallor Sweating Nausea Dizziness Dyspnea Anxiety Fear Hypotension Weak/rapid pulse Low grade fever ```

How to diagnosis MI

High level of C-reactive protein in blood will mark an inflammatory response Blood gas and blood pressure

Congestive heart failure occurs when

The heart is unable to pump blood in sufficient quantities to meet metabolic needs

Congestive heart failure usually occurs as a complication secondary to

Another condition such as infarction, valve defect, hypertension or lung disease

infarction in left ventricle or hypertension CHF effects

Left ventricle first

Pulmonary valve stenosis or pulmonary disease, CHF effects

Right ventricle first

Backup effect of CHF is

Congestion which develops behind the affected ventricle due to output being less than inflow of blood.

Left-sided CHF back-up effect is

Pulmonary congestion (edema)

Right-sided CHF backup effect is

Congestion in systemic circulation

The leading cause of CHF is

Coronary artery disease

Right-sided CHF due to pulmonary disease is called

Cor pulmonale

Signs/symptoms of forward effects of CHF

``` General hypoxia Fatigue,weakness Dizziness, dyspnea Shortness of breath Intolerance to cold and exercise ```

Compensatory mechanisms of CHF

Tachycardia Pallor Oliguria

Left-sided backup effects are related to

Pulmonary congestion

Signs/symptoms of pulmonary congestion

``` Dyspnea Orthoptera Cough Edema Hemoptysis Rapid,weak pulse Cool,moist skin ```

Left-sided backup effects are related to

Systemic edema

Signs and symptoms of systemic edema are

``` Hepatomegaly Splenomegaly Ascites Flushed face Distended veins Headaches Visual disturbances ```

Hypertension is

High blood pressure a silent killer

Three types of hypertension

Primary Secondary Malignant

Primary hypertension is

Essential with unknown cause

Secondary hypertension is

From renal or endocrine disease

Malignant hypertension

Severe and progresses rapidly

Prehypertension exists when

Blood pressure is elevated

What are the two classifications of hypertension

Systolic or diastolic

Essential hypertension develops when

Pressure is consistently above 140/90

Peripheral vascular disease is

Abnormality in the arteries or veins outside the heart and is the most common sites of atheromas.

Signs/symptoms of peripheral vascular disease are

Increased fatigue and weakness in legs due to blood flow decreasing. Intermittent claudication

Intermittent claudication is

Leg pain associated with exercise due to muscle ischemia

Raynaud's syndrome is common in

Young women and considered idiopathic

With raynaud's syndrome vasoconstriction occurs in

The arterioles and small arteries in the superficial tissues of the fingers and toes

Episodes of raynaud's syndrome are triggered by

Exposure to cold, stress or smoking

Thrombophlebitis is development of

A thrombus in a vein

Is inflammation present with thrombophlebitis

Yes

How does thrombophlebitis develop

Platelets adhere to inflamed site and a thrombus develops

Phlebothrombosis is where

Thrombus forms spontaneously in vein without prior inflammation.

Is inflammation present with phlebothrombosis

No but it may develop secondarily in response to thrombosis

Hypovolemic shock is

Loss of blood plasma

Carcinogenic shock is

Decreased pumping capability

Vasogenic shock is

Vasodilation due to loss of sympathetic and vasomotor tone

Anaphylactic shock is

Systemic vasodilation and increased permeability due to severe allergic reaction

Septic shock

Vasodilation due to severe infection, often with gram-negative bacteria