Chapter 26 and 27 Flashcards
What are different types of cardiovascular disease?
•Heart and blood vessel disease
•Heart attack (MI)
•Stroke (CVA)
•Heart failure (R and L)
•Arrhythmia (Dysrhythmia)
•Heart valve disorders
What is the biggest risk factor for cardiovascular diesase?
Hypertension
What is stage 1 hypertension?
Systolic-130-139
Diastolic- 80-89
What is stage 2 hypertension?
Systolic- (140 or higher)
Diastolic- (90 or higher)
What is stage 3 hypertension( CRISIS)?
Systolic( Higher than 180)
Diastolic( Higher than 120)
What is cardiac output?
The amount of blood pumped by heart in a minute
What is peripheral resistance?
The amount of resistance for blood to flow throughout the body
What can lead to hypertension?
Increased cardiac output
-Increased heart rate
-Increased stroke volume
Peripheral resistance
-Increased blood viscosity (Thickness)
-Decreased lumen size of vessels, especially arterioles
What type of risk factor is age and why is it a risk factor for hypertension?
Non-modifiable risk
-Blood pressure can rise as you age which relates to the arterial walls to get stiff. This can affect the systolic preussre
-The ability for kidneys to get rid of sodium, and sodium retention can contribute to hypertension
What type of risk factors of sex and why is it a risk factor for hypertension
Non- modifible risk
-Hypertension is higher in males than females with age
-Occur more in females than males in the black community
What type of risk factor is race/ethnicity and why is it a risk factor
-Non-modifiable risk
More sever for African Americans tend to develop in earlier age than other population
What type of risk factor is family history/genetics and why is it a risk factor for hypertension
Non-modifiable
-Seen most frequently in people with family history of high blood pressure
-Genetic contribution may approach only 50%
What type of risk factor is diet and why is it a risk factor for hypertension?
Modifiable
-Dietary intake of fats and cholesterol can contribute because contribution of dietary fats can lead to dyslipidemia.
-High salt intake, Blood pressure will rise in order to maintain renal salt elimination
What is dyslipidema?
Modifiable
-Increased risk of hypertension
Plaque in arteries increase resistance to blood flow, which will cause blood pressure to increase to increase to overcome the resistance.
What type of risk factor is physical activity and why is it a risk factor of hypertension?
Modifiable
-More exercise and fitness help with lowered blood pressure and are favorable for blood lipid levels
What type of risk factors is tabacco and why is it a risk factor of hypertension
Modifiable
-Been associated with development of hypertension.
But no casual connections have been clearly identifiable
What type of risk factor is metabolic considerations and why is it a risk factor for hypertension?
Modifiable
-Hypertension is one of the components of metabolic syndrome
What type of risk factor is obstructive sleep apnea and why is it a risk factor of hypertension?
Modifiable
-Disrupted sleep interferes with normal “circadian” dipping of blood pressure
What is primary hypertension
Can be genetically or for an unknown reason
What is secondary hypertension
Rise in blood pressure because of another disease/ condition
-Related to clinical condition
illicit drugs: stimulants
Kidney disease
Adrenal disease
Oral contraceptive agents
what is Target organ disease?
Disease in Organs that are highly vascular or dependent on a good amount of blood supply for function are damaged due to hypertension
-Increase perfusion pressure
-Vascular endothelial damage
-Cardiac hypertrophy
-Ischemic heart disease
-Cv accident (stroke0
-End stage renal disease
-Dementia
-Cognitive impairment
-Visual impairment
Increased perfusion pressure can damage target organs
How does increased intravascular pressure contribute?
-Increases intravascular pressure can damage vascular endothelial cells
-Increases the risk for development of atherosclerotic vascular disease which further impairs organ perfusion
What is Orthostatic hypotension
aka postural hypotension
Drop in blood pressure when standing
-Occurs for more than 3 minutes
-Drops 20 mmhg or more
What can cause orthostatic hypotension?
Fluid deficit
Medications
Aging
Defective functions of ANS
Effects of immobility
What is neural mechanisms
Neural mechanisms are automatic body responses
What are different types of neural mechanisms?
Baroreceptors and chemoreceptors
What are Baroreceptors and chemoreceptors do?
-Important for rapid and short term blood pressure regulation
-pressure sensitive receptors in the walls of the blood vessels
What do Barorecptors do?
Monitors how much blood in the vessels and blood pressure inside them
Signals sent to medulla oblongata(brain) or vagus nerve (CNS)
SNS,PNS
What do chemoreceptors do?
Monitor chemicals changes in the blood of 02,C02, and acidosis
What are humoral mechanisms?
Contribute to blood pressure including the renin, angiotensin-aldosterone system, vasopressin and epinephrine
** Blood pressure regulation
What is the process of blood pressure rising
- Renin released
- Angiotensin converted to angiotensin I
- Angiotensin I to angiotensin II
- Vasoconstriction occurs in lungs
- Arteriolar constriction
- Arteriolar constriction in adrenals
- Aldosterone is secreted by glands
- Sodium and water retention
- Increased blood volume
- Peripheral vascular resistance
Dyslipidemia and atherosclerosis are both disease of the arterial system
What are the pathology of this disease?
-Disorders of systemic arterial blood flow
-Vasculitis
-Arterial disease of the extremities
-Arterial aneurysms
Why is Dyslipidemia a problem to the body?
Imbalance of lipids components in the blood.(Triglycerides,phospholipid, cholesterol)
What does triglycerides do for the body?
They are used in energy metabolism
What does phospholipids do for the body?
-Contains phosphate groups which are important structural components of lipoproteins, blood clotting, and cell membranes
What does cholesterol do for the body?
fat wax, helps body make cell membranes, hormones and vitamin d
What happens if there is too much cholesterol in the body?
Cholesterol and other substance may form deposits of plaque that collect on artery walls
What is primary dyslipidemia?
-Could be genetic basis
-Abnormal in lipid and cholesterol levels
-Could be lack of receptors for lipids
What happens during Familian hypercholesterolemia?
LDL receptor is deficient
Most cholesterol is removed through receptor dependent mechanisms, cholesterol levels are increased with this disorder
What is secondary dyslipidemia ?
-Include poor diet(Fat>fiber)
-Obesity (Trig,LDL>HDL
-Metabolic disease
What is the atherosclerosis artery like
Narrowed by plaque
What is Atheroscerosis
Progressive disease, due to the formation of fibrofatty plaques in the intima of large and medium sized vessels
-cause vessels to harden and become narrow
Why are cigarettes a risk factor of atherosclerosis?
Toxins from cigarettes can enter blood stream and damage endothelia tissue.
**Major complications of atherosclerosis
Ischemic heart disease, stroke, and peripheral vascular disease are major complications of atherosclerosis.
What are signs and symptoms?
-Narrowing of the vessel and results of ischemia
-Vessel obstruction due to plaque hemorrhage or rupture
-Thrombosis and formation of emboli
-Aneurysm formation
What are risk factors of atherosclerosis?
-Hypercholesterolemia
-HDL cholesterol <40 mg/dl
-Cigarette smoking
-Hypertension
-Family history of premature CVD in a first-degree relative
-Age ( men older than 45, and women older than 55)
-CRP levels
-Homocysteine levels
***Arterial involvement in atherosclerosis
What will happen in larger vessels ?
Important complications of thrombus formation and weakening of vessel wall
***Arterial involvement in atherosclerosis
What is a concern in medium sized vessels
Ischemia and infraction due to vessel occlusion are more common
***Arterial involvement in atherosclerosis
What are organs involved in this process
Arteries supplying the heart, brain, kidneys, lower extremities, and small intestine are most frequently involved
In hypertension does pressure is blood vessels lead to ?
Cause damage in blood vessel because the increased intra arterial at pressure damages the endothelial
In hypertension what does contraction of blood vessels lead to ?
Angiotensin induces endothelial wall,allowing plasma to leak through inter endothelial spaces
In hypertension, what does deposits of blood vessels lead to?
Plasma that gets a deposited in the vessel walls cause medial necrosis
Describe Coronary artery blood flow
-controlled by Physical, neural, and metabolic factors
-Regulated by myocardial metabolic activity, oxygen demand, and autoregulatory mechanisms
-Heart compressed it’s intramyocardial and subendocardial blood vessels
-ANS can change heart rate, cardiac contractility, and blood pressure
What is ischemia and how does it affect the body?
Ischemia arterial flow reducing to a level that is unable to meet the oxygen amount needed by tissues
Definitely affects the heart tissue
What does impaired blood flow lead to. ?
Coronary artery disease
**Coronary artery disease
What may impaired coronary blood flow cause?
-Angina
-Myocardial infarction or heart attack
-Cardiac arrhythmias
-conduction defects
-heart failures
-sudden death
***Classification of coronary heart disease
What does chronic ischemic heart disease lead to ?
-Chronic stable angina
-Silent myocardal ischemia
-Vareiant or vasopastic angie
***Classification of coronary heart disease
What does acute coronary syndromes lead to?
-Spectrum of ischemic coronary disease
Unstable angina through myocardial infarction
What is Angina and what does it do for the body?
When heart muscle does not receive enough blood oxygen it causes chest pain, tightness
What is fixed angina?
-chest pain that comes and goes
-Fixed coronary obstruction
-Disparity between coronary blood flow and myocardial metabolic demand
-Initial manifestations of ischemic heart disease
What is unstable angina?
-More severe
-Occurs at rest
-Longer durations, more than 20 minutes
What can cause unstable angina?
-Plaque disruption
-Platelet aggregation
-Secondary caridomyopathy
What is cardiomyopathy?
A disease within the heart muscle that makes it difficult for the heart to pump blood throughout the body
How does caridomyopathy affect the body?
- Mechanical or electrical dysfunction of the heart muscle
-Heart muscle becomes enlarged, thick
-Heart doesn’t pump blood to body efficiently - Can lead to valve disorder, arrhythmia, or heart failure
What is the function of the heart valves?
To allow directional flow of blood through the chambers of the heart.
What are the 4 valves of the heart
Tricuspid valve( right side)
Pulmonary valve(right side)
Mitral valve( left side)
Aortic valve( left side)
What can cause disorder in the heart valves?
-Trauma
-ischemic damage
-Degenerative changes
-Inflammation
-Congenital defects(new borns)
**Valvular disruptions
What is stenosis?
-Narrowing of valve opening
-Flaps stiff or thick
-Does not open properly and decreases blood flow
What is Mitral valve disorder?
Problem between left atrium and left ventricle
What is mitral valve stenosis?
Incomplete opening of mitral valve during diastole
-Narrowed opening
-Reduces blood flow
-Thick,stiff valves
What is specifically happening during mitral valve stenosis ?
as Resistance of blood to flow through heart increases, left atrium dilates and left atrial pressure rises.
What is mitral valve prolapse?
Degeneration of mitral valve cause them to become enlarged and floppy
-Valve flaps bulge (prolapse) into upper L atrium during each
heartbeat
BLOOD LEAKS BACKWARDS (regurgitation)
What us Mitral valve reguritation?
-Valves don’t close properly
causing backflow of blood
What happens during aortic valve disorder?
-Valve between left ventricle and aorta narrows and can not fully open
-Blood flow is reduced or blocked from reach the aorta and rest of the body
What is aortic valve stenosis?
Narrow opening, and reduces or blocks blood flow
thick and stiff or fuse
What is aortic valve reguritation?
Valves can not close properly which cause backflow into the left ventricle.
What are potential complications from valve disorders?
-Heart failure
-Stroke
-Blood clots
-Heart rhythm abnormalities
-Death
***Types of cardiomyopathies
What is dilated cardiomyopathy?
-Common cause of heart failure
-Ventricular enlargement, a reduction in ventricular wall thickness
-Impaired systolic function
What is restrictive cardiomyopathies?
Ventricular filling is restricted because rigidity of the ventricle walls
A rare heart muscle disease
What is hypertrophic cardiomyopathy?
Thickening of inter ventricular septum, abnormal diastolic filling, cardiac arrhythmias
Most common cardiopathy
1 in 500 people will get this
What is myocarditis?
Inflammation of the heart muscle and conduction system without evidence of myocardial infraction
what is primary cardiomyopathies?
Heart muscle disease of unknown origin
-Could be genetic, mixed or acquired based on etiology
What is the secondary cardiomyopathies?
-Cardiac abnormality due to another cardiovascular disease
What is Vasculitis
Inflammation of blood vessel wall resulting in vascular injury and necrosis
What is myocardial infarction
Heart attack?
One or more areas of heart muscle don’t get enough oxygen, usually when blood flow to the heart muscle is blocked
What is atherosclerotic occlusive disease? aka Peripheral artery disease
-sudden even that interrupts arterial flow to the affected tissues or organ
-Fatty deposits, like in atherosclerosis
-Narrowed arteries reduced blood flow to arms or legs
What is thromboangitis obliterates
Inflammatory arterial disorder that cause thrombus formation
What is Raynauds disease and phenomenon
Intense vasospasm of arteries and arterioles in the fingers and less often toes
What are the seven P’s of acute arterial embolism?
1.Pistol shot
2.Pallor
3.Polar(cold)
4.Pulselessness
5. Pain
6. Parethesia
7.Paralysis
***Atherosclerotic occlusive disease
What happens in peripheral artery disease?
-Fatty deposits
-Narrowed arteries reducing the blood flow to legs and arms
What are aneurysms ?
Abnormal localized dilation of a blood vessel because of weakness in the vessel wall.
-As size increases the tension in the vessel wall increases and can rupture
What is berry aneurysm ?
Small, spherical dilation of vessel.
What is fusiform and saccular aneurysm?
Found in thoracic and abdominal aorta
-Gradual and progressive enlargement of aorta
What is dissecting aneurysms?
Acute-life threatening condition
- Involves hemorrhage into the vessel wall with longitudinal tearing of vessel wall to form a blood filled channel
What is venous circulation?
One way valve in large veinss
-Limited contractility has skeletal muscle pump
-Thin walled vessel
Disorder of venous circulation
-Clot formation because stagnation of flow and activation of the clotting system
-Varicose veins can form, primary and secondary
What is thrombophlebitis
Inflammatory process
-Blocks one or more veins usually in leg
-Can be caused by thrombophlebitis
-Causes blood clot to form
Vicarious triad associated with venous thrombosis
-Stasis of blood
-Increased blood coagulability
-Vessel wall injury
What are risk factors associated with venous stasis?
-Bed rest
-Immobility
-spinal cord injury
-Acute myocardial infarction
-Congestiive heart failure
-shock
-Venous obstruction
**Venous insufficiency
Deep vein thrombosis
Cause deformity of the valve leaflets
**Venous insufficiency
Valvular incomptence
Loss of unidirectional flow
