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Pathophysiology > Chapter - 24 Alterations Of Cardiovascular Function > Flashcards

Chapter - 24 Alterations Of Cardiovascular Function Flashcards

1
Q

Thrombus

A

A blood clot that remains attached to a vessel wall.
•Arterial thrombi - ischemia
•Venous thrombi - edema
•Thrombophlebitis - inflammation with a clot in a vein
•Thromboembolus - an embolus that originated as a thrombus

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2
Q

Embolism

A

Is the obstruction of a vessel, typically by a clot of blood or an air bubble

  • a bolus of matter circulating in the blood stream.
  • causes ischemia or infraction of tissue distal to obstruction
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3
Q

Raynaud phenomenon

A

Is characterized by attacks of vasospasm in the small arteries and arterioles of the fingers and, less commonly, the toes.

Triggers:

  • Recurrent vasospasm
  • involving small arteries/arterioles of hand and feet
  • Women > Men
  • Triggered by cold and emotional distress
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4
Q

Varicose vein

A

Is a vein in which blood has pooled, producing distended, tortuous, and palpable vessels.

•caused by trauma or gradual venous distention

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5
Q

Chronic venous insufficiency (CVI)

A

Is inadequate venous return over a long period.
•increases inflammation d/t hypoxia
•Venous stasis ulcers

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6
Q

Deep Venous Thrombosis (DVT)

A
  • Obstruction of venous flow leading to increased venous pressure
  • occurs primarily in the lower extremity.
  • Three factors (triad of Virchow)
    • Venous stasis (immobility, age, congestive heart failure)
    • Venous endothelial damage (trauma, intravenous medication)
    • Hyper-coagulable states (inherited disorders, malignancy, pregnancy, use of oral contraceptives or hormone replacement therapy).
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7
Q

Aneurysm

A

Local dilation or out pouching of a vessel wall or cardiac chamber
•caused by weakening of the arterial wall
•vulnerable to high pressure
•True aneurysm involve all three layers of the arterial wall. Most are fusiform and circumferential , whereas saccular aneurysms are basically spherical in shape.
•False aneurysm involves a break in the vessel wall
•Berry aneurysm are most common in the cerebral circulation (circle of Willis)

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8
Q

Aortic Aneurysm

A

Often are asymptomatic (producing or showing no symptoms) until they rupture, and then cause severe pain and hypotension.
•Causes: atherosclerosis eroding vessel wall, Hypertension, collagen vascular disease, infection of vessel wall
•Sx: dysphasia (difficulty swallowing), dyspnea (Shortness of breath), ischemic (restricted blood supply)

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9
Q

Hypertension (HTN)

A

Is a consistent elevation of systemic arterial blood pressure
•Most common complication of HTN are target organ diseases occurring in the:
1. Heart (Cardiac remodeling- hypertrophy)
2. Brain (Cerebrovascular disease)
3. Vasculature (Peripheral Vascular disease)
4. Kidneys (nephrosclerosis)
5. Eyes (retinopathies)
“END Organ Damage”
HTN is often a asymptomatic until damage to tissue/organs produce sx

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10
Q

Primary Hypertension

A

Is a result of an extremely complicated interaction of genetics and environment

• we do not know what leads to HTN (idiopathic)

BP >140/90 mm ahh

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11
Q

Secondary Hypertension

A

Is caused by an underlying disorder
•Most common - Renal disease
•Parenchyma or renal vascular system
• As renal disease progresses the ability to excrete Na+ decreases, leaving more Na+ in the blood leading to inappropriate RAAS and SNS activation
•Endocrine
•primary hyperaldosteronism
•Adrenocortical adenoma (benign tumor) bilateral adrenal hyperplasia
•Cushing syndrome, pheochromocytoma, hyperthyroidism
• DM (diabetes mellitus)
•Aortic malformation (congenital)

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12
Q

Orthostatic (postural) Hypotension (OH)

A

Refers to a decrease in both systolic and diastolic blood pressure within minutes of moving to a standing position.

  • Lack of normal blood pressure compensation in response to gravitational change on the circulation
  • idiopathic
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13
Q

Arteriosclerosis

A

Is a condition characterized by abnormal thickening an hardening of the vessel walls.

  • Loss of elasticity
  • Smooth muscle cells and collagen fibers migrate to the tunica intimate
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14
Q

Atherosclerosis

A

Is a form of arteriosclerosis that is caused by the accumulation of lipid-laden macrophages within the arterial wall, which leads to the formation of lesion called a plaque.

•Leading cause of (CAD) Coronary Artery Disease and (MI) Myocardial Infarction (heart attack)

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15
Q

Peripheral artery disease (PAD)

A

Refers to Arteriosclerosis (main)/atherosclerotic disease of arteries that perfuse the limbs, especially the lower extremities

  • prevalent in elderly individuals with diabetes and has a very strong link with smoking
  • Exclusive of coronary, aortic, and of the brain
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16
Q

Thromboangiitis Obliterans (Buerger Disease)

A
  • Is an inflammatory disease of the peripheral arteries resulting in the formation of nonatherosclerotic lesions
    • Digital, tibial, planter, ulnar, and palmer arteries (hands and feet)
  • Strongly associated with smoking
  • Mostly in young men
17
Q

Myocardial ischemia

A

Local deprivation of the coronary blood supply

18
Q

Myocardial infarction (MI) - Heart attack

A

Prolonged ischemia causing irreversible damage and cell death

19
Q

Acute coronary syndromes

A
  • Stabile angina - Stable angina is chest pain or discomfort that most often occurs with activity or emotional stress. Angina is due to poor blood flow through the blood vessels in the heart.
  • Unstable angina - Unstable angina is a condition in which your heart doesn’t get enough blood flow and oxygen. It may lead to a heart attack.
  • Prinzmetel angina - (aka Variant) vasospasm even at rest.
20
Q

Acute coronary syndrome

A
  • Silent ischemia and mental stress-induced ischemia - more common in women (there is no pain)
  • Transient ischemia - reversible but impending MI
  • Sustained ischemia - Myocardial infraction
  • Myocardial inflammation and necrosis are seen
21
Q

Acute pericarditis

A

Is acute inflammation of the pericardium. - 80% are viral or idiopathic

22
Q

Constructive pericarditis

A

is long-term (chronic) inflammation of the sac-like covering of the heart (the pericardium) with thickening and scarring.

•develops gradually

23
Q

Tamponade

A

Compression of the heart caused by fluid collecting in the sac surrounding the heart.

24
Q

Pericardial effusion

A

Is the accumulation of fluid in the pericardial cavity and can occur in all forms of pericarditis. 20% are idiopathic but other causes, such as neoplasm and infection, must be considered.

25
Q

Cardiomyopathies

A

A diverse group of disease that primarily affect the myocardium itself.
•Dilated cardiomyopathy- is a disease of the heart muscle, usually starting in your heart’s main pumping chamber (left ventricle). The ventricle stretches and thins (dilates) and can’t pump blood as well as a healthy heart can.
•congestive cardiomyopathy
•Hypertrophic cardiomyopathy- thickening of the myocardium
•Restrictive cardiomyopathy- ventricle cannot relax enough to fill

26
Q

Valvular Dysfunctions

A

Disorders of the endocardium (the innermost lining of the hear)
•Valvular stenosis - failure of the valve to open completely, workload behind valve increases
•Valvular regurgitation - inability of the valve to close, eventually causing heart failure.
•Mitral valve prolapse syndrome (MVPS) - most common valve disorder. Cusps billow upward into left atrium during systole, due to degeneration
•Acute Rheumatic Heart Disease - is a complication of rheumatic fever in which the heart valves are damaged. Rheumatic fever is an inflammatory disease that begins with strep throat. It can affect connective tissue throughout the body, especially in the heart, joints, brain and skin.
•secondary to pharyngeal infection of group A beta-hemolytic streptococcus (strep throat
•Only 3% of those with untreated strep throats will get Rh fever, and 10% of those get Rh disease

27
Q

Dysrhythmias

A
  • Disturbance of the heart rhythm
  • Range from occasional ‘missed ‘ or rapid beats to severe disturbances that affect the pumping ability of the heart
  • Abnormal rate of impulse generation or abnormal impulse conduction
28
Q

Dysrhythmias

A
  • Tachycardia >100
  • Flutter - a tremor-like sensation in the chest.
  • Fibrillation - muscle shaking, no contractions
  • bradycardia <60
  • Premature ventricular contractions (PVCs)
  • Premature atrial contractions (PACs)
  • Asystole - is defined as a cardiac arrest rhythm in which there is no discernible electrical activity on the ECG monitor. Asystole is sometimes referred to as a “flat line.” Confirmation that a “flat line” is truly asystole is an important step in the ACLS protocol.
29
Q

Heart Failure

A
  • General term to describe several types of cardiac dysfunction that result in inadequate perfusion of tissues with blood
  • Can not pump blood forward
30
Q

Left heart failure

A

Commonly called congestive heart failure.
•Systolic heart failure
•Inability to generate adequate cardiac output to perfuse tissues
•reduced contractility leading to low CO
•Ventricular remodeling or loss of myocytes
•Most often from damage or scarring from MI
•Diastolic heart failure
•Pulmonary congestion despite normal stroke volume and cardiac output
•Ventricles can’t fill with blood because they won’t relax or are too thick - ineffective ventricular relaxation
•Blood backs up in pulmonary circulation

31
Q

Right heart failure

A

•Right-sided heart failure means that the right side of the heart is not pumping blood to the lungs as well as normal.

It is also called cor pulmonale or pulmonary heart disease.

  • Most commonly caused by a diffuse hypoxic pulmonary disease
    • COPD
  • Also commonly caused by left ventricle failure
    • can result from an increase in left ventricle filling pressure that is reflected back into the pulmonary circulation

• CAD and MI

32
Q

High-output failure

A

Is a heart condition that occurs when the cardiac output is higher than normal. There is a circulatory overload which may lead to pulmonary edema secondary to an elevated diastolic pressure in the left ventricle.
•Inability of the heart to supply the body with blood-born nutrients, despite adequate blood volume and normal or elevated myocardial contractility

  • Common caused:
    • Severe anemia
    • Hyperthyroidism (exaggerated metabolic demand)
33
Q

Shock

A

•Cardiovascular system fails to perfuse the tissues adequately: tissue/cellular level

 * Impaired oxygen use
 * Impaired glucose use
34
Q

Hypovolemic Shock

A

Is caused by loss of whole blood (hemorrhage), plasma (burns), or interstitial fluid:
•diaphoresis
-sweating, especially to an unusual degree as a symptom of disease or a side effect of a drug
•diabetes mellitus
-a disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood and urine.
•diabetes insipidus
-A disorder of salt and water metabolism marked by intense thirst and heavy urination
•emesis
-the action or process of vomiting
•diarrhea
•diuresis
-increased or excessive production of urine.

•begins to develop when intravascular volume has decreased by about 15-%

•Compensation
•SNS increased HR and vasoconstriction
-leads to more volume loss

35
Q

Neurogenic Shock

A

(Sometimes called vasogenic shock)
Is the result of widespread and massive vasodilation that results from parasympathetic overstimulation and sympathetic under-stimulation.

Causes:
•Head trauma
•Spinal Cord Injury
•Medulla Injury

*Better to be horizontal

36
Q

Anaphylactic Shock

A

Results from a widespread hypersensitivity reaction known as anaphylaxis (A severe, potentially life-threatening allergic reaction)

Causes:
•insect venoms 
•shellfish 
•peanuts 
•latex
•medications such as penicillin
37
Q

Septic Shock

A

A widespread infection causing organ failure and dangerously low blood pressure

•Systemic inflammatory response syndrome (SIRS)

38
Q

Multiple Organ Dysfunction Syndrome (MODS)

A

Is the progressive dysfunction of two or more Organ systems resulting from an uncontrolled inflammatory response to a severe illness or injury.

•Most coming cause of MODS is Septic Shock

Pathophysiology (2 decks)

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