CVS

Question 1

Age-related changes to CVS

Answer 1

• decreased myocardium contractility
• more time for diastolic filling and emptying (slower P)
• less responsive to sympathetic NS (fight or flight)
• decline in electrophysiology (pacemaker cells, more fat, collagen, and elastic fibers around SA node)
• diameter of aorta lumen increases to compensate for arterial stiffening
• increase in systolic BP due to vascular resistance
• increase work (thickening) of L ventricle to oxygenate body due to peripheral resistance
• diminished blood flow
• less effective valves to return blood to heart
• less effective baroreceptors that control BP
• in vasculature, changes in tunica intima contribute to atherosclerosis and changes in tunica media contribute to HTN

Question 2

Pathologic RISK factors affecting CV function

Answer 2

• arrhythmias
• HF
• MI
• PVD
• DVT or PE (clot in lungs)
• CVA
• TIA
• Atherosclerosis (plaque, loss of O2)

Question 3

Risk factors for CVS

Answer 3

Physical inactivity (30mins of moderate activity 5Qweek)

Smoking

Dietary habits (such as high fats and sodium intake)

Obesity (BMI 30 or more)

Question 4

Leading cause of death in Canada for almost a century

Answer 4

Heart disease

Question 5

HTN Risk factors

Answer 5

• age
• ethnicity
• hx
• weight
• physical inactivity
• psychosocial stressors
• sleep apnea (breathing starting and stopping)
• low education and socioeconomic factors

Question 6

2 Pathologic CONDITIONS affecting CVS

Answer 6

Orthostatic hypotension
- reduction in systolic BP and diastolic BP of at least 10-20mmHg within 1-3 mins of standing due to blood pooling in legs and the body taking longer to pump it
- risks: parkinsons disease and its medications
- symptoms: fatigue, blurred vision, lightheadedness, syncope

Postprandial hypotension
- reduction in systolic BP of 20mmHg+ within 2 hours of eating
- causes: impaired autonomic function, GI vasoactive peptides, impaired glucose metabolism

Question 7

Guidelines for Assessing for hypotension

Answer 7

Orthostatic hypotension
- maintain the person’s arm in the same position during supine and standing positions while getting initial BP after a person has been sitting/lying for 5 minutes, and second BP reading after standing for 1-3 minutes

Postprandial hypotension
- initial BP before meal and second & third at 15-minute intervals after meal