Chapter-18 Cardiovascular Flashcards
Blockage of right coronary artery is more likely to cause
Arrhythmias
Right coronary artery supplies blood to the
SA and AV nodes
Left coronary supplies
Left ventricle
A blockage of left coronary may impair
Pumping capability and cause congestive heart failure
The four types of coronary heart disease are
Arteriosclerosis
Atherosclerosis
Angina pectoris
Myocardial infarction
Arteriosclerosis is a general term for
All types of degenerative arterial changes
Changes usually occur where
In small arteries and arterioles
What happens to the arteries and arterioles in arteriosclerosis
Elasticity is lost, walls become thick and hard, lumen narrows, and it becomes occluded
Insufficient O2 ensues during arteriosclerosis and leads to
Ischemia, necrosis in the brain, kidneys, heart and other tissues
Atherosclerosis is different from arteriosclerosis in that
Atheromas or plaques are formed
The plaques consist of
Lipids
Cells
Fibrin
Cell debris
Atherosclerosis forms where
Primarily in large arteries
LDL is
Bad cholesterol
LDL transports liver from
The liver to the cells
LDL binds to
Receptors on cell membranes and enters cell
HDL is
Good cholesterol
HDL transports cholesterol
Away from cells to liver where it is catabolized and excreted
The major factor in a thermos formation is
LDL bad cholesterol
Non-modifiable risk factors of atherosclerosis (3)
Age (after 40)
Gender (men, women after menopause)
Genetic
Modifiable risk factors for atherosclerosis
Obesity Smoking Sedentary lifestyle Hypertension Diabetes Oral contraceptive with smoking
Why is smoking a risk factor for atherosclerosis
It promotes platelets to adhere, clot formation, and vasoconstriction
Angina pectoris is
Chest pain
Angina pectoris occurs due to
Lack of oxygen in heart muscle, usually when demand is sudden
Chest pain can be due to
Impairment, exertion, or a combination
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
