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
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
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)
4
Q
Define hypertension
A
- 140/90 defined by WHO with no other CVD risk factors, otherwise 130/90 with CVD risk factors
5
Q
Relationship between blood pressure and risk of CVD
A
- as BP increases your risk for CVD increases
6
Q
Normal BP
A
- < 120/80
7
Q
Describe primary hypertension
A
- essential hypertension
- idiopathic
- 90% of all hypertension cases
8
Q
Define idiopathic
A
- disease or condition arising spontaneously or cause is unknown
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
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
11
Q
Symptoms of hypertension
A
- usually asymptomatic
- headache
- vertigo
- flushing
- blurred vision
- spontaneous epistaxis (nosebleed)
- nocturnal urinary frequency
- sleep disordered breathing
12
Q
Complications of hypertension
A
- aneurysms
- congestive heart failure
- renal insufficiency
- hypertensive encephalopathy
- hypertensive retinopathy
13
Q
What is the most common aneurysm
A
- abdominal aortic aneurysm
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
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
16
Q
Define foam cells
A
- white blood cell covered in LDL cholesterol
17
Q
Complications of atherosclerosis
A
- thrombus formation
- aneurysm
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
19
Q
Symptoms of acute coronary syndrome
A
- levine sign (clenched fist over sternum
- ischemia -> angina -> infarction
- EKG changes & blood tests
20
Q
Describe STEMI
A
- ST elevation MI
- complete occlusion
21
Q
Describe NSTEMI
A
- Non-ST elevation MI
- incomplete occlusion
22
Q
Describe ischemia
A
- reduced blood flow
- need 70% occlusion to get symptoms
- temporary decreased contractility & increased stiffness
23
Q
Causes of myocardial ischemia
A
- atherosclerotic narrowing
- spasm
- coronary arthritis
- hypertension
- hyperthyroidism
- artery-venous fistula
- exercise
- emotions
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
Describe stable angina
- occurs during activity or on exertion, temporary pain, terminate activity, monitor, nitro may be effective
26
Describe unstable angina
- periinfarction, occurs at rest without cause or exertion, needs immediate action to reduce risk
27
Describe variant angina
- result of vasospasm of coronary artery in absence of occlusive disease, nitro & calcium channel blockers will help
28
Describe zone of infarction
- complete derivation of oxygen with cell death
29
Describe zone of hypoxic injury
- decreased damage, may recover if blood flow returns
30
Describe zone of ischemia
- reversible zone, injured myocardial tissue produces characteristic EKG changes
31
Clinical manifestations of an MI
- crushing chest pain
- radiating pain
- pallor
- shortness of breath
- perspiration
- diaphoresis
32
Complications of MI
- arrhythmias
- congestive heart failure
- cariogenic shock
- pericarditis
- rupture of heart
- thromboembolism
- recurrent infarction
- sudden death
33
Describe heart failure
- the heart is unable to pump sufficient blood to supply your body's need
34
Clinical manifestations of congestive heart failure
- 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
Describe left sided heart failure
- failure of left ventricle
- results in pulmonary edema or disturbance in respiratory control mechanisms
- symptoms include: dyspnea, fatigue & weakness, & renal changes
36
Describe right sided heart failure
- 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
Symptoms/concerns for congestive heart failure
- 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
Describe Cor Pumonale
- 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
Treatment for congestive heart failure
- 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
Define endocarditis
- smooth membrane that lines the inside chambers and forms the valves of the heart
41
Define myocarditis
- muscular tissue of the heart
42
Define pericarditis
- smooth membrane surrounding the outside of the heart
- outer fibrous layer & an inner double layer of serous membrane
43
Describe bacterial endocarditis
- inflammation by of cardiac endothelium, destroying connective tissue by bacterial lytic enzymes
- fibrin & platelets arrive to protect & form vegetations
44
Symptoms of endocarditis
- arthralgia, arthritis, low back pain, myalgia
- fever, chills, sweats, weight loss, cough
- chest pain, CHF, cold/painful extremities, clubbing
- confusion, cerebrates, meningitis, stroke
45
Complications of endocarditis
- CHF
- arterial, systemic, or pulmonary embolism
- gangrene, renal insufficiency, & osteomyelitis
- valve replacement may be necessary
46
Describe myocarditis
- 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
Causes of pericarditis
- causes include: idiopathic, infection, myocardial injury, metabolic disorders, anemia, neoplasm, aortic dissection
48
Clinical manifestations of pericarditis
- pleuritic chest pain: worse upon lying dow
- fever, joint pain, dyspnea, & difficulty swallowing
- pericardial rub: high pitched scratchy sound on expiration
49
Describe chronic rheumatic endocarditis
- 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
Describe peripheral vascular disease
- 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
Describe immunological condition
- inflammation & damage to large or small vessels often resulting in end-stage organ disease
52
Describe arterial occlusive disorders
- common cause of disability
- result of atherosclerosis or renal arteries, intestinal arteries, & of extremities
53
Describe dry gangrene
- dry, dark, cold, mummified
- one or more arteries become obstructed
- tissue slowly dies
- does not become infected
54
Describe gangrene
- "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
Symptoms of an arterial thrombosis & embolism
- pain, numbness, coldness, changes in sensation, & skin
56
Describe varicose veins
- abnormal dilation of vein
- tortuosity of the vessel
- incompetence of valves
- result of high venous pressure
57
Describe chronic venous insufficiency
- inadequate venous return
- leg trauma, varicose veins, obstruction
- bidirectional blood flow = high pressure
- superficial veins & capillaries dilate = pooling of fluid
58
Describe deep vein thrombosis (DVT)
- partial or complete obstruction of vein by thrombus
- result of clotting cascade
- thrombophlebitis - inflammatory process of clot formation
