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Clinical Medicine I > Common Cardiovascular Pathology > Flashcards

Common Cardiovascular Pathology Flashcards

1
Q

Describe ventricular septal defect

A
  • oxygen rich blood then gets pumped back to the lungs instead of out to the body, causing the heart to work harder & fatigue
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2
Q

Symptoms of an atrial septal defect

A
  • dyspnea especially when exercising
  • fatigue
  • swelling of legs
  • heart palpitations
  • stroke
  • heart murmur
  • blood goes from the left atrium to the right atrium
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3
Q

Describe tetralogy of fallot

A
  • combination heart defects
  • pulmonary stenosis (narrowing of pulmonary artery)
  • ventricular septal defect (large hole)
  • aortic communication with both ventricles
  • ventricular hypertrophy (right)
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4
Q

Define hypertension

A
  • 140/90 defined by WHO with no other CVD risk factors, otherwise 130/90 with CVD risk factors
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5
Q

Relationship between blood pressure and risk of CVD

A
  • as BP increases your risk for CVD increases
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6
Q

Normal BP

A
  • < 120/80
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7
Q

Describe primary hypertension

A
  • essential hypertension
  • idiopathic
  • 90% of all hypertension cases
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8
Q

Define idiopathic

A
  • disease or condition arising spontaneously or cause is unknown
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9
Q

Describe secondary hypertension

A
  • non-essential hypertension
  • diabetes, polycystic kidney disease, Cushing syndrome, thyroid problems, sleep apnea, obesity, & pregnancy
  • identifiable cause
  • 5 to 10% of hypertension cases
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10
Q

Pathogenesis of hypertension

A
  • Blood pressure: blood flow & cardiac output
  • Peripheral vascular resistance: diameter of blood vessels & viscosity of blood, sympathetic nervous system, & renin-angiotensin system
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11
Q

Symptoms of hypertension

A
  • usually asymptomatic
  • headache
  • vertigo
  • flushing
  • blurred vision
  • spontaneous epistaxis (nosebleed)
  • nocturnal urinary frequency
  • sleep disordered breathing
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12
Q

Complications of hypertension

A
  • aneurysms
  • congestive heart failure
  • renal insufficiency
  • hypertensive encephalopathy
  • hypertensive retinopathy
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13
Q

What is the most common aneurysm

A
  • abdominal aortic aneurysm
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14
Q

Describe atherosclerosis

A
  • group of diseases of fatty deposits in arteries
  • thickening & loss of elasticity of the arterial wall due to build up of: lipids, macrophages, T lymphocytes, smooth muscle cells, extracellular matrix, & calcium
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15
Q

Endothelial cell injury leading to atherosclerosis

A

1) arterial wall damage
2) infiltration of macromolecules (may include cholesterol)
3) macrophage & fibroblast aggregation/foam cells
4) platelet aggregation
5) thrombus formation

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16
Q

Define foam cells

A
  • white blood cell covered in LDL cholesterol
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17
Q

Complications of atherosclerosis

A
  • thrombus formation
  • aneurysm
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18
Q

Clinical manifestations of atherosclerosis

A
  • symptoms result from loss of blood supply
  • palpitations
  • dyspnea
  • paroxysmal nocturnal dyspnea
  • cardiac syncope
  • fatigue
  • cough
  • cyanosis
  • claudication
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19
Q

Symptoms of acute coronary syndrome

A
  • levine sign (clenched fist over sternum
  • ischemia -> angina -> infarction
  • EKG changes & blood tests
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20
Q

Describe STEMI

A
  • ST elevation MI
  • complete occlusion
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21
Q

Describe NSTEMI

A
  • Non-ST elevation MI
  • incomplete occlusion
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22
Q

Describe ischemia

A
  • reduced blood flow
  • need 70% occlusion to get symptoms
  • temporary decreased contractility & increased stiffness
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23
Q

Causes of myocardial ischemia

A
  • atherosclerotic narrowing
  • spasm
  • coronary arthritis
  • hypertension
  • hyperthyroidism
  • artery-venous fistula
  • exercise
  • emotions
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24
Q

Describe angina

A
  • chest pain or discomfort
  • imbalance of supply & demand to heart
  • usually secondary to CAD
  • often mistaken for indigestion
  • discomfort in the chest, may radiate into left shoulder & upper extremity
  • any dermatome C3-T4 may be affected
25
Q

Describe stable angina

A
  • occurs during activity or on exertion, temporary pain, terminate activity, monitor, nitro may be effective
26
Q

Describe unstable angina

A
  • periinfarction, occurs at rest without cause or exertion, needs immediate action to reduce risk
27
Q

Describe variant angina

A
  • result of vasospasm of coronary artery in absence of occlusive disease, nitro & calcium channel blockers will help
28
Q

Describe zone of infarction

A
  • complete derivation of oxygen with cell death
29
Q

Describe zone of hypoxic injury

A
  • decreased damage, may recover if blood flow returns
30
Q

Describe zone of ischemia

A
  • reversible zone, injured myocardial tissue produces characteristic EKG changes
31
Q

Clinical manifestations of an MI

A
  • crushing chest pain
  • radiating pain
  • pallor
  • shortness of breath
  • perspiration
  • diaphoresis
32
Q

Complications of MI

A
  • arrhythmias
  • congestive heart failure
  • cariogenic shock
  • pericarditis
  • rupture of heart
  • thromboembolism
  • recurrent infarction
  • sudden death
33
Q

Describe heart failure

A
  • the heart is unable to pump sufficient blood to supply your body’s need
34
Q

Clinical manifestations of congestive heart failure

A
  • ventricular dilation
  • 1st compensatory phase: right ventricle increases blood to the lungs
  • 2nd compensatory phase: sympathetic nervous system increases HR
  • 3rd compensatory phase: activation of renin-angiotension-aldosterone (RAAS)
35
Q

Describe left sided heart failure

A
  • failure of left ventricle
  • results in pulmonary edema or disturbance in respiratory control mechanisms
  • symptoms include: dyspnea, fatigue & weakness, & renal changes
36
Q

Describe right sided heart failure

A
  • failure of right ventricle to pump to the lungs
  • results in peripheral edema & venous congestion of organs
  • symptoms include: depenndent edema, jugular venous distension, sharp RUQ pain, & cyanosis
37
Q

Symptoms/concerns for congestive heart failure

A
  • pre-renal failure due to decreased blood flow to kidney & increased work load
  • increased peripheral & pulmonary edema
  • decreased efficiency musculoskeletal system
  • fatigue
  • fluid/weight gain
  • dyspnea, PND, orthropnea
38
Q

Describe Cor Pumonale

A
  • complication of increased BP in pulmonary arteries
  • causes right ventricle to enlarge & pump less effectively
  • symptoms include: shortness of breath, tiredness, increased HR, & lightheadedness
39
Q

Treatment for congestive heart failure

A
  • medication management: increase pumping action of the heart to decrease workload
  • Digoxin: works to increase contractility
  • Diuretics: reduce preload & thus left ventricle end diastolic V (LVEDV)
  • reduce water & salt retention, dietary changes
40
Q

Define endocarditis

A
  • smooth membrane that lines the inside chambers and forms the valves of the heart
41
Q

Define myocarditis

A
  • muscular tissue of the heart
42
Q

Define pericarditis

A
  • smooth membrane surrounding the outside of the heart
  • outer fibrous layer & an inner double layer of serous membrane
43
Q

Describe bacterial endocarditis

A
  • inflammation by of cardiac endothelium, destroying connective tissue by bacterial lytic enzymes
  • fibrin & platelets arrive to protect & form vegetations
44
Q

Symptoms of endocarditis

A
  • arthralgia, arthritis, low back pain, myalgia
  • fever, chills, sweats, weight loss, cough
  • chest pain, CHF, cold/painful extremities, clubbing
  • confusion, cerebrates, meningitis, stroke
45
Q

Complications of endocarditis

A
  • CHF
  • arterial, systemic, or pulmonary embolism
  • gangrene, renal insufficiency, & osteomyelitis
  • valve replacement may be necessary
46
Q

Describe myocarditis

A
  • decreased ability to pump, rapid, or abnormal heart rhythms
  • symptoms include: chest pain, fluid retention, fatigue, clot formation, heart failure, arrhythmias, & shortness of breath
47
Q

Causes of pericarditis

A
  • causes include: idiopathic, infection, myocardial injury, metabolic disorders, anemia, neoplasm, aortic dissection
48
Q

Clinical manifestations of pericarditis

A
  • pleuritic chest pain: worse upon lying dow
  • fever, joint pain, dyspnea, & difficulty swallowing
  • pericardial rub: high pitched scratchy sound on expiration
49
Q

Describe chronic rheumatic endocarditis

A
  • caused by scarring & deformity of heart valves
  • inflammation of endocardium = swelling of valve leaflets with erosion
  • vegetation clumps - platelets & fibrin deposit on chordae tendinea
  • shortening & adherence over time = decreased valvular elasticity
50
Q

Describe peripheral vascular disease

A
  • commonly diseases of blood vessels to extremities
  • encompasses pathological conditions of blood vessels to major organs
  • a broad group encompassing disorders or arterial & venous vessels
51
Q

Describe immunological condition

A
  • inflammation & damage to large or small vessels often resulting in end-stage organ disease
52
Q

Describe arterial occlusive disorders

A
  • common cause of disability
  • result of atherosclerosis or renal arteries, intestinal arteries, & of extremities
53
Q

Describe dry gangrene

A
  • dry, dark, cold, mummified
  • one or more arteries become obstructed
  • tissue slowly dies
  • does not become infected
54
Q

Describe gangrene

A
  • “wet” if a bacterial infection is present
  • swelling & blistering common
  • trauma to toes, feet, or legs may result
  • severe burn or frostbite when blood flow is impaired
55
Q

Symptoms of an arterial thrombosis & embolism

A
  • pain, numbness, coldness, changes in sensation, & skin
56
Q

Describe varicose veins

A
  • abnormal dilation of vein
  • tortuosity of the vessel
  • incompetence of valves
  • result of high venous pressure
57
Q

Describe chronic venous insufficiency

A
  • inadequate venous return
  • leg trauma, varicose veins, obstruction
  • bidirectional blood flow = high pressure
  • superficial veins & capillaries dilate = pooling of fluid
58
Q

Describe deep vein thrombosis (DVT)

A
  • partial or complete obstruction of vein by thrombus
  • result of clotting cascade
  • thrombophlebitis - inflammatory process of clot formation

Clinical Medicine I (26 decks)

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