Effects of systemic Disease on the CV System Flashcards
what are the 2 main pathogenic types of diabetes?
1- autoimmune
2- insulin resistance
what is type 1 diabetes?
destruction of beta cells in pancreas by an immune process
what is type 2 diabetes?
loss of insulin function associated with insulin resistance can lead to peripheral tissue problems
islets of langerhans deposition of amyloid material
what are the effects of Diabetes on the kidney?
areas of matrix where there is poor perfusion and these leak = microvascular disease
small vessel disease- damaged leaky kidney vessels in time failure due to reduced circulation
how is diabetes related to cardiovascular disease and how does this effect the CV system?
Cv disease affected by diabetes in terms of atherosclerosis and small vessel damage
glycation- non enzymatic addition of glucose to protein basement membrane of small vessel altering permeability leading to protein trapping altering its electrical charge
how do endocrine disorders lead to hypertension?
retention of sterone or aldosterone hence retaining sodium and therefore water leading to increased blood volume and increased blood pressure
what are the effects of hypertension on the CV system? how would the patient be likely to present?
-LV hypertrophy due to increased workload of the heart
present with: retinopathy, headaches, renal failure, cardiac symptoms
what is familial hyperlipidaemia? what causes it?
increased risk of atherosclerosis, have fibrosis because of cholesterol crystals
causes: genetic, high HDL or LDL cholesterol
how does familial hyperlipidaemia lead to CV problems?
can lead toatherosclerosis increasing resistance=hypertension
can get MI or ischaemia
describe the features of COPD
abnormally large holes in lung
capillary circulation necessary for gas exchange holes increase surface area less area for oxygenation of blood
emphysema can additionally affect
what is emphysema?
enlargement of airspaces by destruction
destroy alveolar walls you have no capillary circulation hence you have no gas exchange leading to symptoms of breathlessness
how does COPD affect the CV system?
still got to get CO from the right side of heart to get to left side of heart
holes= less channels to push blood through leading to increased resistance
increased pressure of blood needed to be pumped by R side = pulmonary hypertension
how does pulmonary hypertension affect the heart?
right ventricular hypertrophy
effects on heart as a result of COPD leading to pulmonary hypertension?
increased workload because increased muscle therefore requires more oxygenation
back pressure in R side is not used to it so harder for blood to drain= congestive cardiac failure leading to accumulation of blood in the body
what is the effect of congestive cardiac failure?
blood accumulates in the body
harder for blood to drain from veins
accumulation of fluid=oedema
what is amyloidosis?
disease accumulation of amyloid, amyloid binds to iodine to give a blue colour
what is amyloid?
protein with a specifically organised structure which allows iodine to bind this structure is a beta pleated sheet
what are the 2 types of amyloid?
amyloid light chain AL
amyloid associated protein
describe the features of AL
produced by plasma cells
associated with underlying problems with plasma cells= malignancy
cancerous plasma cell= myeloma
describe the features of amyloid associated protein
produced by the liver as part of an acute response
abnormal inflammatory or acute phase response such as sepsis, TB, rheumatoid arthritis RA, osteomyelitis
where may amyloid tissue be deposited? what can this lead to?
- damaged microvasculature amyloid may be deposited in vessels and intersitium leading to problems getting O2 and nutrients
- give ischaemia, if in heart may leading inefficient pumping leading to heart failure and ischaemia, localised in brain = alzeihmers or Creutzfeld Jakubs, or in pancreas type 2
how would patients present with amyloid deposition?
renal failure
diarrhoea
how can RA affect the heart?
associated with direct pathology of the heart
the valves and pericardium of heart can be a target
excess cardiovascular death
how can vasculitis effect the CV system?
autoimmune type pneumonia where blood vessels are the target
takyasus target coronary arteries and patients present with acute coronary symptoms
how can thyroid dysfunction affect the CV system?
increase cardiovascular mortality with patients with hypothyroidism
patients are treated with thyroxin which speeds up heart and puts extra stress on CV system
how does sarcoidosis affect the CV system?
T cell mediated response, type 4
granulomas formed if formed in heart it can lead to problems with the conduction system because you are altering the conduction pathway
leads to: arrhythmias, bradycardia
how does nutrition lead to problems with the CV system?
due to famine
lack of energy balance and the proper foundations being laid down
how do drugs lead to problems with the CV system? which drugs?
cancer drugs can knacker the CV system
serious damage to heart or ill patients if they already have a damaged myocardium
